Refusing induction - Crazy?

[madcatsazz]

Has anybody else refused induction? I'm 41 weeks today and assuming checks and monitoring show baby is healthy, I am planning to refuse induction. I have appt with obstetrician on thursday and I wondering what points he's going to throw at me. I know there is an 'increased risk' but I have read the stats and they are still seriously low and know that scans and heartrate checks should show any signs of distress in the baby. I also know there's an increased risk of meconium in the waters - does anybody know of further research on this? Any advice or opinions welcome (go easy on me though, I'm a heavily pregnant hormanal woman!)

Hi,

I was 42 weeks when they finally induced me. I think you should go for it. Since then i have spoken to several specialist and with a 1st baby they really should not let you wait more that 41 weeks max.

It really was ok, it took 2 tablets to get me started. In the end i had to have an emergency C section as she was in wrong position and cord around her neck.

Good luck xx

My DCs are teens now and in those days pregnancies were routinely allowed to continue to 42 weeks. One friend refused induction and went to 43 weeks with no ill effects.

My ds1 was a few days early and looked fine whereas dc2 was born at 40+6 and came out covered in vernix which is usually an indication of premature birth So babies must need different 'cooking times'!

Heed your obstetrician's advice - I'm sure he won't be trying to 'force' you into induction if you don't want it - he'll just be thinking that you'll be desperate to get the baby out!

Good luck

I think I would not want to be induced either.
I read a study that suggested that for certain groups (e.g. white, northern European women) the average date for spontaneous labour to start is 8 days overdue. So why should your body be forced into labour because it takes a couple of days longer than average?

To me it seems madness that, if the baby, you and placenta are coping fine, they might go for induction. A large number of my friends (75%, I reckon) who have been induced with their first ended up with emcs. I am sure induction is a useful tool where indicated, but if it were me I would probably want there to be a reason specific to me for using it.

You never know - your consultant might be sympathetic. When I went for a VBAC my consultant did not even want to discuss booking me in for a section until I went past 42 weeks, which really took the pressure off. Yours might be just as helpful!

ask a lot of questions about whether induction is being recommended for protocol or reasons which pertain to you individually. and how close they think you might be to going into labour natrually.

i had an induction because my waters broke and didn't follow the timescales = ecs. vnewmummy what a pita you had to have the induction first.

my mum lied about her dates to avoid induction with no3

i have gone overdue with all four of mine, currently preg again and if i go overdue, or rather WHEN i go overdue i will ask for expectant management, ie i will go into hospital for monitering and extra scans if necessary but i will try and hold out as long as possible.

with ds3 i got to 3wks overdue! and he was absolutely fine, infact all my boys who have all been at LEAST two weeks overdue were all born fine, with vernix and the midwifes who delivered them checked the placentas and said that htye looked fine, i am just obviously meant to be preg for longer!

my mum went almost a month overdue with me!

i tried accupuncture with my third baby and i am sure it helped, i could really feel it working and had loads of contractions etc.

with ALL of mine ihave ended up going in and getting induced by ARM as i am allergic to the prostin that they use. however ARM (artificial rupture of membranes) is all ihave needed, and thne i have laboured easily, on each occasion i was already in the latent phase of labour, having irregular contractions and was 3cm or so dilated, it seems i just need that kick start to go into labour properly.

i do think that if you end up being induced the longer you wait the better and more chances it will work easily as your body is more likely to be ready to go into labour

good luck there are a few other threads on this, one called expectant management i think, do a thread search and i am sure you will find loads more, plus there is a thread for overdue mummies! xxx

thanks all - this is actually my second pg but with first I went into labour via SROM AT 39+5 so this is alien territory to me. I obviously don't want to put the baby at risk but as some of you said, I don't want to be induced 'because it's the policy to do so'. Having said that, I am feeling pretty fed up today so maybe by 42 weeks I'll want the baby out anyway! I think you're all right though, the longer I leave it, the better chance I will respond to low level intervention (ie. ARM or prostin). It just seems so barbaric on some level that we force the issue with a crochet hook or chemicals. I know it's not that bad really. I am concentrating on happy thoughts and 'relaxing' although as you all know, relaxing at this stage is a myth! I guess I'll know more when I talk to the obstetrician. I was also hoping for a waterbirth - at least to labour in it if not to deliver - but induction or not my chances are slim past 42 weeks anyway. I have 7 days until I'm officially 'high risk' though so here's hoping!

I think I am right in saying that if you have already had a vaginal delivery your chances of doing so again even if induced are good.
Anecdotally, friends who have been induced with their second have all been fine as their bodies know what to do. It's the first timers who have had the torrid time of it.

Can fully understand you not wanting unnecessary intervention, though.

Have you tried evening primrose oil? You can take it orally and (ahem) put it on your cervix. It's full of prostoglandins and I am sure it helped get things going for me with DD2. Babies in my family are almost always 41+ weeks and she came at 40+2!

Just wanted to add this. My first baby was born at 41 weeks and one day, according to scan dates. However, according to my dates he was only one day overdue. I didn't have my own dates with no2 and no3 and they were born 12 and 10 days over the scan dates. Whatever they may tell you, scan dating at 12 weeks is not necessarily more accurate than your own dates, and if the baby shows absolutely no sign of distress or risk of such, I think it is irresponsible for a doctor to make the decision that you are "overdue" and need to be induced. Dates can be wildly off due to varying ovulation cycles and it is really un-natural, in my opinion, to force a baby out before it is ready. I am aware that it is normal practice for women to have a sweep, and even be induced when they go so much as one day overdue, but I can't understand why. You've waited this long, a few more days can't hurt. In this situation, I would be happy for daily monitoring, and hope that things happen by themselves before too long. There are other problems with induction of course, such as increased risk of further intervention because with childbirth usually one intervention leads to another. I have heard of babies being induced at full term, and are born underweight and clearly not as far along as was thought. You must do what feels right to you in the situation, but don't be frightened to say you want to wait, it is totally your right.

Oh and one other interesting thing. The scan at 12 weeks dates the baby according the length from head to rump, and my babies came in order of how long they were. My first and shortest was 8 days over scan dates (49cm), my third baby was 10 days over (55cm) and my second and longest baby was 12 days overdue and 57cm! So they may date by length, but I don't the length of the pregnancies were different, just the length of my babies! =)

the current guideline is not to induce until 42 weeks - the average gestation is 41 weeks as someone has already said.

inductions increase the pain burden on the mother...

tweak nipples to induce! it works and is much more pleasant..

so no, you aren't crazy. it seems crazy to me that some practices are keen to induce for dates only when dating is only accurate +- ten days. Unless, that is, there are other pressing reasons in your case they believe it is better to induce.

A friend of mine just made it to 43 weeks before being induced. No idea how her dates compared to their dates and obviously she was fairly closely monitored in the last week or so.

I'm hoping as my calculation is 5 days ahead of their due date, that I can side step the need for induction. But who knows.

Have a look at the homebirth site's overdue section. Ignore the specific homebirth bits, but there's loads of info about going overdue in there, there's bits about meconium, induction, natural induction methods, links to research, birth stories from people who went overdue etc...

hello, i too am overdue, 40+2 with dc3 and desperately want a home water birth. the midwife told me their policy is induction at 41+5, and i am very reluctant to agree to this. i had ds1 at 41+5, the policy then was i think induction at 42 weeks.

my dates are not very certain, they refused to date me by scan and said the dating software only worked if i told them a LMP. as i was/am still breastfeeding i didn't have an accurate one, so they guessed and then my EDD is calculated from that guess! the scan dating says 6 days later so i am going to argue that. but even so, i don't see why the baby has to pop out by a certain date, the increased risk don't seem that much greater to me...

i have looked at the NICE guidelines which say

"Women with uncomplicated pregnancies should usually be offered induction of labour between
41+0 and 42+0 weeks to avoid the risks of prolonged pregnancy. The exact timing should take into
account the woman?s preferences and local circumstances.

"If a woman chooses not to have induction of labour, her decision should be respected. Healthcare
professionals should discuss the woman?s care with her from then on."

good luck, i hope the appointment on thursday goes well (or better still, that you have baby before then!)

I wish I had refused induction.

thanks Weasle - I hope appt goes well on thursday too. I think at this stage I'll agree to sweep on monday which is when I'm at 42weeks so we can at least see state of cervix although my midwife already told me that second pgs usually mean the cervix is ripe anyway so not sure what that will tell us. I will try the nipple stimulation I think but part of me keeps thinking if I am so opposed to forcing the baby to come before she's ready, why would I try a 'natural induction' instead?! Nipples preferable to chemicals though (although nipples are extremely sensitive currently!)

Anyway, thanks to everyone's answers, it's nice to see I'm not totally crazy to be objecting. To be fair - I haven't encountered any pressure from medical staff yet - I'm just trying to prepare for obstetrician. Hopefully, they'll be happy to wait until 42 before they start applying the pressure.

I went to 43+3 with my DC1. I was under huge pressure to be induced, but politely declined! Ended up having a fantastic planned homebirth. My DD was 7lb 11oz, and covered in vernix.

Kooky, did you ever start to doubt yourself?

I had the support of some brilliant Independent Midwives who had were just amazing - even coming with me to the hospital to fend off the consultants! I didn't doubt that I was doing the right thing for my baby and for me - was desperate not to give birth in hospital, but it was a very tough few weeks physically and mentally. Absolutely though, it was the right thing for me. I did quite a lot of reading around and decided it was an educated risk that I was taking.

(BTW, two years later my DS was then born on his due date, which took me by surprise!)

Appointment with consultant today and he was....really reasonable!! I explained I didn't want to be induced for the sake of policy and his words were..."if that's what you want, I'm happy with that" He went on to say his job was to make sure I was informed of the risks and to support me in my choice. Booked me in for monitoring next week and was fine. We talked through my concerns about baby's position and as far as he could, he put my mind at ease. He did say he was a consultant up north for many years and found the north south divide to be interesting - ie. Northern ladies seem far more inclined to get on and birth whilst he's encountering a lot more "just give me another c-section" attitudes down here which I find fascinating. He's been tasked with reducing CS and increasing VBACs so I couldn't have asked for a better suited consultant really. He also said, assuming I eventually go into spontaneous labour that there's no reason to treat me as 'high risk' and that I shouldn't need CFM unless there's another reason to do so. And if CFM is not necessary then likewise he could think of no reason I couldn't labour in water!!!! If only he was on the delivery suite when the time comes hey? I doubt everyone will be so maverick in attitudes. Anyway, one barrier out of the way. My one complaint is that he performs sweeps like you would imagine a typical man to do. Official and painful!

sounds like a good app, did he write in your notes about no cfm and being able to use the birth pool if all goes well? if its there in black and white on your notes then it should be agreed to when you go in to the labour ward etc. they cant make you do anything you dont want to anyway!

hope the sweep helps move things along and you go into labour asap xxx

thanks for replying 4mad, I am still slightly in shock it went so well and was eager to share on here as most people in RL are struggling to see why I'm making such a fuss anyway (not that they're saying as much but what they don't say speaks volumes!)

The sweep was hideous and I would never recommend them and tbh, probably won't be having anymore. The reflexology session I went for afterwards was far more pleasant

Now I intend to sit back, relax, and wait.

i have had sweeps and some have been horrid, others have been fine, it really depends on who is doing it, and how ripe or not your cervix is.

reflexology is meant to be very good at inducing labour and i had accupuncture with ds3 and i am sure it helped!

i will be in the same position as you in 6mths time, i am sure baby no 5 will be late as all my others were!

good luck and i have my fingers crossed for you xxx

Do you know when you actually conceived? i.e. at what point in your cycle you actually ovulated - Adjusting for that may help you assess the situation more accurately.

sadly I don't Dilys - it was a bit of a surprise (although not totally as I was definitely there for the conception )

4mad, I'm sure you're right about the sweeps - I'm feeling somewhat 'violated' this evening though. All achey and sore though sadly no signs of good ol' fashioned contractions. I'm sure by monday it won't have seemed so bad and I'll go for another one with the midwife!

I refused to countenance induction until term + 14 days. I went into spontaneous labour (which lasted 6 hours with first baby) at term + 11. Our NHS policy is to induce at 10 days.

It is widely accepted that a full term human pregnancy is 37 - 42 weeks so I cannot understand this mania for inducing before 42 weeks unless medically indicated. Apparently only 3% of pregnancies go over 42 weeks.