40 + 10 and refused induction - given quite a hard time

[Elderberries]

Hello - I just wonder if anybody could tell me if I am being very foolish as the doctor today made me feel very bad for wanting to hold out till 40 + 14 to see if I could have a natural start to child birth.

I'm 37 and have a high BMI and I had borderline pre-eclampsia in my last pregnancy which was induced at 40 + 7.

This pregnancy I've had no problems.

The doctor said that the risks of still birth go up exponentially around 42 weeks and that I was risking still birth by not having the induction. I complained that I thought she was using over the top scare tactics because my reading of the stats was that risk of still birth was about 2-3 in 30,000 at 41 weeks and 6 or 7 in 30,000 at 42 weeks so it was a small risk that went up a bit. I also said that I only wanted to delay to + 14 days which was my understanding of the outside limit of a normal pregnancy and I was prepared to come in for daily monitoring (which is what they asked me to do). Anyway after making me feel awful about the whole thing she has booked me in for induction at + 13.

I am a bit unhappy by the treatment I got but I wonder if other people think I am being overly risky?

Gwendolinemary - I'm not policing the thread, I'm giving my opinion which is that being passive and accepting what the doctors say simply because they're doctors is not the way to proceed. There are two schools of opinion on this thread and the school who feel she has made the wrong decision seem totally in love with insulting her intelligence and compromising her right to decide what happens to her body. I'm not enthusiastic about that stance.

So let her speak for herself. That's twice you've tried to get people who have the opposite opinion to stop it. It's not your debate, give your opinion and let others give theirs, that's all. I'm not looking for a fight, I'm just uncomfortable with someone else trying to dictate the way the discussion goes. It's for her to do that.

In my case, looking back, I wouldn't have waited. I did the 40+14, and I was completely exhausted at the end. I couldn't sleep, my BP went right up. I had an induced very long labour, and couldn't push the baby out as I was so completely exhausted and ended up with em c sec. DS was fine but it took me such a long time to recover. Looking back, I would have been induced earlier but only for the reasons I say here.

I see Gwendoline - so everybody may give their opinions, insulting the Op's intelligence, implying she does not have the best interests of her child at heart and declaring that doctors know best and I may not repeatedly challenge those views? Your definition of discussion is much narrower than mine!

Hi
I am also the same age as you and also have a hi bmi. I have had 4 children one went to 13 days over due and had no problems. Personaly as long as there is no protein in the urine and your bp is ok all of which could be monitored by the gp rushing things isn't always expedient. I am sorry for those people who had problems but there are also problems associated with induction ( using sytocin) as it can often lead to more intervention and c section if the woman's body isn't ready. Induction isn't always a panacia for every one especially if the woman's body isn't ready. Induction brings labour on incredibly quickly and strongly often leading to the woman needing an epidural and then becoming immobile. My 3rd child came 13 days late but her labour started naturally so I coped well. You can ask for monitoring I will do this to avoid the medicalised birth that frightens me and intend for a home birth where I will be more relaxed and if I need to I will go to hospital which is 10 mins away from my home.

Take time to make your own mind up.

I did some reading about this when making the same decision in January. As I remember it, studies that have controlled for other risk factors (IU growth restriction, foetal problems) have not found an elevated risk of stillbirth for women who go to 42 weeks. Sorry, but the best info I found wasn't freely available so I'm linking to the abstract only www.ncbi.nlm.nih.gov/pubmed/20156009

I had a non-stress test at 42+10 and requested a sweep. Walked home from hospital and went into labour.

Regardless of your decision I would not be impressed with the doctor.

should have said - didn't specifically look up about high BMI or PE as not relevant to me

Thank you to all that have posted. I really appreciate it. Sorry I've not responded but I was down at the hospital having another tracing done. All fine with the tests.

I'll take a look at everything that people have linked to this afternoon.

I also have a pineapple to eat and some clary sage oil to anoint myself with! I'm a sceptic about these things but at this point what the hell.

I was hoping that the midwives would give me another sweep but apparently in this area you are only offered one before induction. Sigh.

Lovely sunny afternoon though. Will post a bit later.

hi elderberries, i have been in your situation three times now, the first 2 i thankfully went into spontaneous labour but the last ended up with induction. induction DOES carry risks, my child is thankfully with us but had a long stay in special care. be certain of your decision.

HI - I haven't got any helpful comments or opinions but I did want to say that I think this is a very interesting thread. I read the OP and immediately thought "but of course she should let them induce her" (my son was induced at 37 weeks due to my ill health, and it was fine, really - we were both alive and well, which was all I cared about) - but reading the replies, I do feel I've learned something.

Thanks OP for being so calm and thoughtful in your replies, and I hope all goes well for you.

I'm back after a bath and a relax and a read of the things that have been linked to and also some other papers/abstracts that we have found ourselves. My conclusions run something like this.

There is a higher risk of stillbirth with expectant management over induction after 41 weeks or so but it is extremely small. There is a higher risk of problems associated with meconium going into the lungs of the baby of later term women. There is also a higher risk of having a cesarian section (because of large baby's and problems cropping up that need to be dealt with promptly).

Having said all that the risks of any of that happening is still very small and most women who do expectant management will be fine - and some studies have found no difference in risk.

There are risks with induction too but they don't tend to lead to many still births because you get wheeled off to theatre pretty fast when things go bad. But, and this is a big but, the vast majority of women induced would have gone on to have fairly normal births I think. And also the experience of induction is unpleasant for a fair few women.

So what have I decided. Well honestly I think I am entirely comfortable to hold out till Friday (day 13) with expectant management and would have been happy to go to day 14 but I will gracefully and with good will have an induction at that point.

Having said that I think women who do have longer pregnancies are not mad or stupid to do so. With expectant management the risks are small and most women will have a good outcome. Some women just gestate for longer and if they want to wait I respect that. Since NICE respects that too I think Doctors should be more supportive of women who want to take this route.

As an aside I was born in a mud hut on top of a mountain with no medical input at all. Women don't necessarily need hospitals for birth - sometimes they do.

I'll keep you updated with how it all goes. Nothing happening yet!

Thank you to those that posted - all of you. I'm grateful for the links to the information and also the page about 10 month mummas - wow!

Good luck Elderberries - not long now til you meet your bubs . It's good to hear you sounding relaxed (daytime bath - one of the nicest things to do when you're heavily pregnant!).

And I'll keep my fingers crossed that you go into labour naturally before Friday (still plenty of time for that!).

Hopefully something will kick off shortly

This isn't an easy situation because obviously the odds are so high. I think that very often the decisions we make can be intrepreted as 'selfish' because they are decisions that we make for ourselves and not things that are imposed by others 'in the best interests of the baby'.
The temptation is to apply a sliding scale and of course an intervention laden induction is better than a baby who has died. But none of this can be reliably predicted and so we all just do the best we can with the information at hand. Some will choose one thing, others another. Unfortunately having a baby is never a risk free enterprise. Nothing can remove the risk of an IUD. The two babies I know lost in pregnancy were lost in unpredictable and unavoidable circumstances. If I knew of a cast iron 100% way to avoid the pain my friends have suffered I would be the first one shouting for it. But it doesn't exist.

Where I live it's super strict (latin america) and I was only allowed to go to 40 plus 10 for my DS2 as had section with DS1. No induction or catheter allowed either. I was gutted as wanted nat birth and had section. When he was delivered there was meconium in the bag and like DS1 the cord was round his neck.

You can ask for fetal monitoring, they can check what grade the placenta is in the scan and if there is adequate amniotic fluid. Also, has your belly dropped? Are you having contractions, any plug lost? Drink raspberry leaf tea if you can...try the hypnobabies "baby come out" CD. good luck, I hope your baby comes soon!

Thanks for a very informative and enlightening thread, Elderberries. I hope all goes well for you and that it's the kind of birth you're hoping for! Hope you're not waiting too long.

Selma Blair went 18 days overdue with her baby...

FFS NL, stop making this about you. Jeez. You're the one insulting her intelligence by implying that she isn't capable of weeding out what she considers to be unnecessary information. Most posters can do that without your help.

Elderberries, glad you've reached a decision that you're comfortable with. Good luck :)

Thanks for well wishes guys. I've not gone into labour yet so looks like induction tomorrow. It's all OK though. I am very glad that I posted this question here because all the feedback and comments have really helped me come to terms with the situation.

Mentally I am now feeling peaceful and positive. There is a little bit of me that feels regret that I will never know what natural childbirth is like (not going to have more children) but I will deal with it.

Now the only questions I have are about whether to take an epidural if I end up on the drip.

Good luck with the induction. Hopefully the pessaries will do the trick but if you do need the drip I think the consensus is take the drugs!

Gwendoline - I really don't know what to say to you. I cannot imagine why you need to post so unpleasantly to me.

Good luck I had an
induction with ds1 and personally would recommend an epidural if you have a drip. Hope everything goes really well with your delivery

Good luck I had an epidural. Which was quite nice as it meant it didn't hurt at all...

oh damn! wanted to do my first flowers. Here you are

from me too - good luck tomorrow. You sound like you're in a good frame of mind

Good luck Elderberries.

Best of luck, Elderberries. I've got a foreign keyboard and can't find the damn square brackets to send you anything!! Was going to offer a virtual glass of wine....