Not sure if I should have an induction... any advice?

[KittyChat]

I'm 40+4 but it feels like my body is just not ready to give birth. Have had a very straightforward pregnancy and the baby just doesn't feel 'ready'. Still very high up and not engaged or effaced at all.

I am provisionally booked in for an induction on Monday. I do realise anything could happen between now and then, but does anyone have any advice on going on past their induction date? I know the risks with the placenta, but I am monitoring closely and baby is moving about as per normal. Will of course discuss this with my midwife later in the week but I know she will advise induction and I'm curious to see what others have experienced.

Looking forward to reading the replies on this as my doctor wants to induce me at week 40. From what I have read to date a sweep can help labour start if your body is ready to give birth. Having the drip does mean birth will be much more medicated with higher chance of intervention. I was very anti induction until I was told about risks of stillbirth. Although I realty want natural labour have to balance this against risks to baby. Good luck with whatever you decide.

I was booked in for an induction when I was 10 days over my due date. MW tried to do a sweep but my cervix was too high and not remotely ready.
My waters broke naturally the day before my induction was due but I didn't go into labour and was induced. It did turn out to be quite a medical delivery, as no show from baby after 48 hours of waters breaking and had a cs and epidural, but it was fine, baby came out fit and well.
My understanding is that the conditions in the uterus start to deteriorate after a certain point which is less good for the baby, but I'm sure there will be people on here who have positive stories of leaving it later.

cookie - yes I'm with you with the weighing up the risks. I just have a strong feeling my baby isn't ready yet! Though I will happily submit myself to any monitoring to check and am not about to discount any expert advice obviously.

Beamur - my cervix is the same! Glad your baby came out ok - of course that's the most important thing.

Interesting article here from the Guardian about how the notion of being 'overdue' is out of date. Not sure I'd want to wait until 43 weeks, mind!

www.guardian.co.uk/lifeandstyle/2010/oct/01/pregnant-for-10-months

Personally I wouldn't. I was induced at 14 days over due and it was terrible! I ended up having an emergency c section. There is absolubtly no way I would ever agree to one again. I'd have a c section first.

Oh and it still took until I was 16 days over for them to finally get him out

I was induced at 16 days overdue with DD1. I had three lots of prostin pessaries over two days. These gave me very bad cramping pains (like the worst period pain ever). The prostins did not cause labour to start, and did not make my cervix dilate to any significant degree. On the third day, my waters were broken (no waters actually came out) and I spent approx 9am-9pm on a syntocinon drip. I got to 2-3cm dilated by the end of that time. Before going on the drip, I had an epidural, because I couldn't stand the pain of the cramps any more after 2 days (TENS and paracetamol didn't help). After only getting to 2-3cm, I had an emergency cs, and DD1 was born half an hour shy of 19 days overdue. I was absolutely exhausted, having had no sleep during the 3 days I was being induced, and having been in pain for much of that time.

With DD2, I had 6 membrane sweeps between 37 weeks and the birth 15 days overdue. I did go into labour naturally, but again after 3 days of early labour, and again having my waters broken, only got to 2-3 cm. I again had an emergency cs, in preference to going on the drip, as it hadn't worked with DD1.

I was told when I was having DD2, by one of the midwives, that 5% of women do not respond to induction - I think I was in that 5%, and obviously 95% of women do respond, so the odds are in your favour!

I also firmly believe that there is some issue with my cervix. I had a mc a couple of weeks ago, and again got into trouble because my cervix did not open, and had to have an ERPC. Again, I would imagine most women are blessed with cervixes that actually open when they are meant to... If I ever have another child, I will opt for cs, despite really wanting to experience a natural birth.

To balance this, one of my friends was induced, and had a completely different experience. She did say that she "took off like a rocket", which meant it was harder to cope with the pain, because there was no slow build up of contractions for her. Other than that, she was fine and it worked for her, although it was definitely more difficult and painful than her non-induced second birth.

I agree that you have to weigh up the risks to the baby. Round here, the medical professionals seem happy enough for you to go 14 days over, before they get a bit antsy, so long as you are keeping track of movements. Both my DDs were fine :)

I hope I haven't scared you (its hard to balance making it a horror story with justifying my view of it IYSWIM) - remember my friend was OK with induction, and the odds are stacked in your favour for it to work!

Good luck whatever you decide x

I think at this stage you have to take each day as it comes - at 40+4 I was definitely nervous about the idea of induction, did not want it, was investigating all sorts of ways to avoid it etc etc. At 40+12 I couldn't get in there quick enough and would have pretty much let the doctors do anything they wanted to get that baby out!

However my son - even at 40+12 did not look like an overdue baby - he was big (nearly 10 lbs) but he was still covered in vernix and not that different in appearance to my dd who was 40-2.

if you are only 40+4 then inducing on monday just for being overdue seems quite early, will that put u at only 7 days over?? if your blood pressure and everything is okay, and they are inducing purely for being overdue, then personally i would not be too happy with a date of only 7 days overdue, as it does not give you much chance to go into labour by yourself? i would rather talk to them about making it somewhere between 10-14 days over at the earliest, as that is more the normal thing i thought? don't normally hear of hosps inducing at only 7 days over, if there are no other reasons..
however if there are other reasons then i suppose that is different.
i had one induction for my 1st, at i think 9 days over? but due to high blood pressure and pre eclamsia symptoms they didnt want to leave it longer. i dont think he was ready to come out either, and was not that easy of a birth but it worked out okay in the end.

my mum was induced with me, it wasn't much fun. with her two subsequent pgs she waited till went into labour and it was fine - 43 weeks for the third. i was induced for waters broken but it didnt work (and i got no epidural when on drip) and ecs. ds arrived on due date. He never engaged either.

I had an induction with DS which was absolutely fine (just to balance out the 'bad' induction) stories and I'd be happy to be induced again.
However, I agree with Firawla that only 7 days over seems too soon for an induction which is purely for being overdue, particularly if this is your first baby. I was 12 days over and totally ready, virtually started contracting as soon as the pessary touched my cervix. I had had a sweep at 7 days overdue which obviously didn't work so I hadn't been ready then. I would be asking the midwife if I could have a sweep on Monday and the induction date put to the end of next week.
Good luck anyway :) I am very that you are so close, I am 36 weeks and these last weeks are relentless!

I was 11 days over with dd and went naturally, i was convinced that i would be the same with ds so i begged them not to induce me on the 11th day they booked me in for 13 days over, I had 3-4 sweeps but nothing worked my cervix was still high and hard so i had this microchip thing put in instead of the gel pessery as it can stay in for 24 hours so they thought it was going to take ages but within an hour i was having contractions, it went in at 11am i begged to be examined at 7 pm and i was 3cm they took the chip thing out and my labour carried on naturally i didnt have to have any drip or my waters broken, i had ds at 3am just with gas and air he was 10lb3
Im 35 weeks with my 3rd and im expecting to go over again but im not as scared about induction this time, i would like it to be natural but they are not all really long painful and end in cs. Good luck x

I was induced at 38+5 due to complications. I did find it uncomfortable and ultimately had an epidural and forceps... I don't view it as a negative experience at all, I needed my baby out and that was how they chose to do it. It did take a long time but I think most 1st labours can... I am due dc3 in 12 weeks and need to have a c section and am far more upset about that.
But like someone said at 40+4 youse feel v differently to how you'll feel in a week or so!

Generally women are advised that after 14 days the placenta does not work as effectively and the risk of still birth is increased. Therefore induction prior to that date is advised. Induction can take 2 or more days so Term + 10 or 12 seems to be the most preferred date. However, this is not the only option. You may find this article interesting. midwifethinking.com/2010/09/16/induction-of-labour-balancing-risks/

I think all you can do is what feels right for you - at some point continuing the pregnancy will no longer feel like the "right" thing to do.

One question that might be interesting is to ask for expectant monitoring from Monday rather than an induction. In theory, if they're concerned enough about your baby's health to offer induction then they should be more than happy to monitor every couple of days if you decline the induction. That's the theory... but many women seem to find that having had induction pushed hard they won't be offered any form of monitoring if they decline, or they agree and then something crops up at the hospital so their induction is delayed. It does make me question what the real motivation for the induction is...

If it were me and I had no other risk factors then I would be reluctant to be induced at 41+0 - but its a very personal decision and there isn't a universal right answer.

Fingers crossed for a nice gentle and effective labour for you that starts spontaneously (and soon!) :)

Hello, thank you for all your stories (both good and bad - need to be realistic here) and your wishes, it's really appreciated.

I've just been to see the MW who gave me a sweep (it felt brutal and I am still bleeding a bit). My cervix is in a very good position apparently, and when I dialate it should happen quickly. But it's still very 'long' and she agreed the baby doesn't feel ready.

However - she has booked me in for an induction on Sunday (41+2) because otherwise they can't fit me in until the following Friday (42+0). I am really of two minds now, will do everything I can to get this baby out by Sunday and then reassess.

Have definitely taken on board what a few of you have said (eg Boosaphena and LifeofKate about not feeling ready at 40+4 but then a week later feeling completely ready! I am 40+6 today and really not comfortable with the idea. Will wait until Sunday.

Thank you thank you again, reading your replies has helped clarify my thoughts. x

i had my son in jan so my induction is still very fresh in my mind. i was 41+12 when i was induced. i had 2 sweeps 1 at 40+1 and other at 41+1. the 1st seemed to work,felt very heavy drag in my pelvis but the following morning it had gone. so off to hospital we went to be induced. i had 2 prostins then a 3rd before i finally went into labour but they had to brake my waters. all in all my active labour took 17 hours but 40 hours in total. baby was back to back so the had to internally move him it was horrendous, i had gas and air 1st then an epidural as i was so tired. i had a blockage with the epidural so all my contraction pain went straight into my left bikini line were the blockage was mw was rubbish and left me in agony until shift change when other mw wanted to no why i was in so much pain if i had epidural she sorted it out by turning me onto my side and giving me a top up the pain just disappeared. which was a good job because i was ready to push. 2 hours of pushing and finally the docs said enough i had to have a vontous assisted delivery but warned that if they couldnt get him out with 3 pulls i was going to have a c section. bearing in mind i knew they had to cut me so i pushed for dear life. 2 pushes and pulls and he was finally out. he was absolutely fine. unfortunately for me i was that great they had cut me from front to back i also tore and it look over an hour to stitch me. they in had to catheterise me to stitch me because it was so close to my urethra. i got infection straight away had to have penicillin for 2 weeks and my stitches burst open.
still after all that i would do it again and i would have another induction. after all ever pregnancy and birth are different.
wishing u all the best

My induction was ok. I was back to back but didn't need ventouse or forceps. I was happy with it.

Do you have a long cycle? I thought this might be why I went 10 days over.

Just read your post and haven't had a chance to read all the responses, so sorry if someone has already said any of this. I was induced at 40 weeks, they didn't want me to go overdue, so different to you in that respect. I will spare you the details, but it was four days of on/off labour, my body did nothing at all on its own, all chemical induced and at the end of the four days I had got to 4cm, they did an emergency c-section. I was exhausted, dh was exhausted - most importantly, baby was fine, but it was no start to parenthood.

What I would say is - I tend towards the feeling that we have to listen to the medics as, on the whole, they know more than us. But, you could consider talking to them about a time limit - so, if the induction hasn't worked after so many hours / pessaries / time on the drip for example, that they talk you through all your options and you can make an informed decision. That's the biggest thing I'm taking from my experience into the next one (when/if!) - to ask, ask, ask, and force them to communicate with us. Get them to explain where you are on the Bishop Score too, not just your dilation, there's so much more to it than that and noone told us until much later when we went for debrief.

Also, it tends to be that once the process has started, you don't leave hospital until it's concluded - one way or another. Your nhs may do it differently, but might be worth checking.

Ok - I have two stories for you.

1. my friend went in for induction at 40+12, she has 5 lots of induction (differing methods) and she had no contractions. Ended up with a ELCS at 40+17. She said it was more frustrating than anything else.

2. my mum was induced with me on my due date (she had a DVT) (bear in mind this was 34 years ago) 2 hours and 27 minutes ater they started drip I was born (MWs were amazed) but - they now say that heparin (for he DVT) can sped up labour (not sure they knew that then). Having said that my mum's other two labours were 4 hours and just under 6 hours so she doesn't exactly take her time :)

I went into labour spontaniously 3 days before my induction was planned for with DD - so you never know what may happen before your induction date.

have read all the posts

Had 3 children and one late miscarraige (hate calling it that but that is understood term)

Induced late miscarriage and hurt like hell but effectively full labour with no pain relief
1st baby was premature and normal delivery, had drip at one point but no memory of extreme agony, did have pethidine

baby 2 induced at 40 plus 10. Sweep ineffective. had pessary and delivered within 4 hours. No drip, no time for epidural
baby 3 (just 8 days ago!) induced at 39 weeks at my request. 6 hours after pessary, went into labour. baby arrived within 1 hour of feeling pain.

for both inductions never got past gas and air
think no big deal about induction, I was ready mentally and wanted to go with it and was good for me