Induction vs. fetal monitoring

[shirleycat1]

I'm only 40 + 3 so hopefully things will get moving before I ned to really think too seriously about this, but I am getting the fear about it already and I think it would be good to educate myself now with some evidence based literature so I can make an informed and unhysterical decision.

My gut feeling would be to go for monitoring. I want a home birth and natural labour as I had with my first. But I've not really researched it and I was just wondering if anyone else had and could point me in the direction of some research.

Thanks in advance...

Interesting question. I'm no help: 20+1 with first but I'll be reading this thread with interest.

Good luck with everything!

I'm 40+2 so another one who's no help at all but who has more than a passing interest! My gut instinct says go for induction but I can't articulate why which is not the best way to make a decision...

Have you read the NICE guidelines? www.nice.org.uk/guidance/CG70

It assesses the evidence base.

Btw, I refused induction before 42w and had a couple of foetal well being tests before my waters broke.

Nice one, thanks Issy - I'll check out the NICE stuff. Just had a stretch and sweep so fingers crossed that gets stuff moving. Really would rather not have an induction.

Good luck to you pottering and mary...

Hi Shirleycat1, no need to worry just yet as induction questions don't tend to arise until 41 wks, and you may go into labour an day. You fears and anxieties will delay yr labour though (the natural biochem response) so try and relax (practice yr deep breathing and relaxation exercises BTW did you have any antenatal brush up?), but at the same time be proactive. Eat loads of tropical fruits, spicy foods, yr already drinking yr raspberry leaf tea right? research clary sage/lavender oils for the bath and massage HTH

I'm off for some reflexology tomorrow. Worst case scenario I've spend £26 for a long relaxing foot massage!

I would go for monitoring. This is what I did when I got to 40+10. They will take anything unusual seriously and recommend induction if that is the case. This is what happened to me so I never got further than 40+10 as a scan and fetal monitoring indicated baby wasn't too happy (she is a happy toddler now!).

I have absolutely no experience in this area (am only 21wks) but it came up in conversation recently at an active birth class. But thought I'd share some views that were raised, for other MNs to comment.

No hard facts and I'm not saying any of it is right or wrong...

• If labour isn't progressing, there's generally a reason why (baby not ready, not in position, mother is anxious etc) and induction won't necessarily fix the problem
• Induction tends to only work if you're getting close to labour
• Acupuncture can be effective alternative in getting things moving, as is exercise/gravity (lots of walking, hip swivels, ball bouncing) - but again, only if labour isn't far away
• Induction (especially multiple inductions) can cause the baby distress and raise it's heart rate, which in turn can result in a cascade of intervention
• You have to hang around the hospital for hours waiting for something to happen (don't know if other hospitals let you go home) - not very relaxing and depending on the timing, you may lose a nights sleep in the run up to labour, just when you need as much energy as you can muster.
• Different drugs are used for inductions in different hospitals - some are better/have different side effects than others
• This one is definitely fact: one of the local hospitals has recently changed it's policy on induction - it now limits induction to 1 attempt (because, I believe, of the risk of distress to the baby, but it could be cost cutting, who knows!) whereas the other local hospital still offers up to 3 induction attempts.

This sounds like an induction-bashing - it's not meant to be. Just 1 side of the argument I guess.

My consultant wants to induce me on due date regardless of whether or not the baby/placenta is healthy, simply because that's what he likes to do for all women in their 40s. Not a convincing enough argument for me I'm afraid; I'll be opting for monitoring initially.

Im 43 and 36 weeks. My consultant won't let me go past my due date as i'm an older mum and have had a cot death and several losses. I was induced with my other 2 children and it hurt like hell. However, looking at it from a medical point of view i can see he is right and it's the safest route for me to take. I would love to go in to labour naturally this time but i am petrified of something going wrong or having a stillbirth.

I was induced at 42 weeks exactly with both of mine.

Went along with the first without question.

Second time, went into hospital but asked to see consultant and asked to be monitored instead - she said, quite bluntly - we can monitor you every day, no problem - but everything could be fine in the morning and your baby could be dead by the afternoon - we cannot guarantee anything, especially not past 42 weeks, where the risk of stillbirth increases quite dramatically I think. i.e. whatever the scan would show, wouldn't really mean very much.

Was obviously a no-brainer for me - I wanted to give birth to a live baby so said induce me now!

Sorry to be blunt, as she was, but those were the words of a top consultant, and I think it's only fair to pass them on to you.

they were happy to wait until 42 weeks both times though - and that was two different hospitals