If I Ask For An Induction, Am I Likely To Get One?

[midori1999]

I will be 32 weeks tomorrow. I have a consultant appointment next week at 33+1, I have been seeing them fornightly and will then see them weekly, and want to discuss the plan/options for birth.

I have a blood clotting disorder (APS) so am on clexane and asprin and I also have GD which has had to be insulin controlled as there was zero chance with diet. I say 'controlled' and they are happy with my levels, but they are rarely what they should be as I struggle to increase my insulin quickly enough to keep them under proper control. I am having to increase in every 2-3 days at the moment.

At my last scan baby's growth seemed to have dropped off a bit, from 75th centile to 50th, so depending on growth at my next appointment, or from now to the birth, things might change anyway.

Anyway, things so far have been left pretty open ended re: the birth, but I was thinking of asking for an induction at around 38 weeks. One of the reasons being that I know the risk goes up after 38 weeks if you have GD. Another is that a planned delivery will mean I can come off the heparin and will therefore make the birth slightly less risky and also mean I can have an epidural if I do end up needing a c-section for any reason. On top of that, my DH is in another country at the moment, as is my Mum, who is planned to come and take care of my DC when I go into hospital. So, a planned delivery would mean my would definitely get back in time for the birth and my Mum could be here. I've had quick labours with my other DC, so it's likely my DH wouldn't get back in time if I went into spontaneous labour.

Lastly, I lost my twins last year after they were born very prematurely, which has made this pregnancy all the more difficult and I feel for emotional support I need my DH there at the birth and that for emotional reasons he also needs to be there.

I feel all my reasons are good ones, but a part of me still feels it's insane to ask to be induced due to the possibility it could lead to a c-section.

Am I mad? Are they likely to agree to my request? Has anyone had a requested induction agreed to?

Midori I need my dh there and I've not been through what you've been through, nor do I have your medical conditions. Of course you need him there!

FWIW, I was induced at 38wks due to SPD. There is nothing life threatening in that - I was simply fed up with being in such pain. Also, it gave me a chance to plan coming off the strong meds I was on to ensure there was no crossover to baby which could affect him at birth (and made sure my consultant was at the hospital whilst I was labouring in case of any difficulties)

It didn't lead to a section. DS was back to back, but maybe that would have happened anyway?

DS was my third so getting it going was not difficult at all and I think I'm right in saying that statistically it's first timers who generally have the higher c-section risk. If you've had trouble free deliveries before then there's no reason to assume this one will be different.

Go and ask. If they refue, get them to give you clear reasons why they won't do it. Good luck!

i think given your gd and the conditions with clotting that they will WANT to bring you in and induce you so they can do it during the day when staffing levels are good and not risk you coming in as an emergeancy at thenight/wkend tbh!

you have numerous legitimate reasons for induction and i can not imagine them saying no to you at all.

if it helps i have been induced with all 5 of mine and never had a c section.

with my 5th i got induced earlier than with the others (tho still overdue) but because i had been ill and was exhausted and i was concerned about babies movements, they were more than happy to induce me.

there is plenty you can do to try and help get your body ready for labour as well, ie sitting on birth ball, trying to get baby in a good postion, you can also put evening primrose oil on your cervix (get dissolvable capsules) stick them in as far up as you can and they lay down with your pelvis/bum tilted on a pillow. sex, obviously if you feel like it. nipple stimulation. all of these can help soften the cervix/release the right hormones so you are more likely to go into labour easily when they induce you.

seriously you are 'high risk' and i think they will most certainly induce you xxx good luck xxxx

I have been a midwife for a few years now at a few different hospitals and I would be surprised if they were not strongly advising an induction at 38 weeks. Your clotting disorder is an indication for IOL at 38/40, as is your GD, as is your previous history! I think it is they who will be pressing for an induction, and if you have already had vaginal deliveries you are very unlikely to end up with a CS.

Good luck x

Phew. It's always nice to hear a professional say the same as the tripe joe public opinion I spout!

Sounds like you might not even have to ask then!

I have clotting issues too and an induction seemed to be a bit of a 'given'. It had to be balanced against my age (risk of placental deterioration and danger of going too far over due date) and the need to avoid a CS due to clotting risks. The advice was to try an induction and vaginal birth earlier rather than later as that would be the least risky. This was all explained to me at my 34 wk check so I'm sure your case would be fairly clear cut

Thanks for the replies.

So far my hospital have been non committal about what will happen at the birth is terms of natural/induction. They do know I want to avoid a section if I can.

I was originally in a joint obstetric/haematology , so saw a haematologist and an ob who specialised in pregnancies involving blood disorders/clotting problems. The haematologist sorted out a birth plan for me eons ago (she's super efficient) saying that spontaneous labour was preferable, but induction could be considered from 39 weeks in order to plan me coming off the clexane. That was prior to my GD diagnosis, but still stands from her point of view.

When I was diagnosed with GD and then became insulin controlled, I changed to a joint obstetric/diabetes clinic, so the ob specialises in pregnancies involving diabetes and similar issues. They have said I won't be allowed to go past term, but delivery could be any time after 36 weeks, depending on circumstances and assuming nothing drastic happened before then which warranted delivery. I got the impression though that they would be more than happy for me to get to term, assuming all was otherwise OK.

I think I will push for some answers at my next appointment and ask about the induction. It makes sense to me for all the reasons I have given and I think it would also save me a lot of worry.

Thanks again, it's nice to know people (including a midwife) think induction is warranted in the circumstances and that I am not just being precious.

not being precious AT ALL!!

i am sorry for you previous loss, this pregnancy must be hard both physically (from the sound of it) and also emotionally. there is no wonder you want to get this all sorted out, so you can make plans and then focus on getting through the next few weeks until you get to hold your precious little one.

xxxx

I have been induced twice at 37 weeks due to a (different) medical problem. My experience of health professionals is that they do not want complicated pregnancies to go too far - I had mine at different hospitals and both were more than happy to induce at 37 weeks. As your body has laboured before (I presume you have not had a previous CS?) then your chances with the induction should be good.