So upset - week 41 and all of a sudden I am told I am "high risk"

[ladyfoucault]

Sorry, this is a long story ... I am now week 41 and so far I was told I had a low risk pregnancy. In week 38, I made the mistake to ring one of the community midwives (my own midwife was away) to say that I had been very thirsty. That midwife told me to get a blood glucose test done at the hospital which I did. The second score (after the fasting) was slightly raised so I was seen by the diabetes team afterwards. I had another blood glucose test plus did home testing plus had a growth scan which showed the baby was a normal size, possibly on the small side. The diabetes consultant said to me he was confident that I did not have gestational diabetes, he said at that stage they would not usually carry out the blood glucose test (I forgot the reason unfortunately) plus the other tests and the scan were reassuring. So far, so good, I was pleased with this of course and took it that I was therefore still low risk.
Now being past the 40 weeks I was on edge this week. A few days ago, after a night of no sleep and following a quite unsettling telephone conversation with my parents who live far away I was particularly anxious and because I couldn't remember whether I had felt the baby move I rang the hospital. They told me to come in where I got a CTG done. It was fine. The midwife who saw me there showed my notes to the consultant who said they would like me to come in for an induction the next day. I had been to the hospital twice before, earlier in my pregnancy, because I couldn't remember whether I had felt the baby move (I guess I am of a nervous disposition) - it was always fine - but this was cited as a reason. I said I didn't want an induction but would see my midwife the next day and discuss what to do. The consultant and the midwife at the hospital were fine with this (I didn't see the consultant but the midwife spoke to him). They booked me in for another CTG at the weekend.
On Friday, I saw my midwife who supported me when I said I didn't want to have an induction. She said as long as I felt the baby move well this was okay. The plan was for me to monitor the baby and to think about having a sweep at the beginning of next week.
Yesterday, when I had the CTG the consultant said that due to a history of lack of fetal movements and a raised blood glucose level I was high risk, and being overdue I should have an induction and the plan I had made with my community midwife was putting my baby at risk. I had an argument with him when I said that I was told by the diabetes consultant that I did not have gestational diabetes, and that me having come to hospital three times was possibly more to do with my anxiety than a proper lack of fetal movements.
This consultant, who most of the time did not even address me or look at me but conversed with my partner instead, said I should come into hospital for daily monitoring if I don't have an induction, so I am now booked in again today for a CTG. I can feel all the work I have done of weeks of hypnotherapy being ruined, I am starting to associate hospital with stress and fear and I wonder what to do. I don't know why this consultant yesterday reacted so strongly, and I feel this is not evidence based. Ideally, I would like to monitor the baby at home (baby is moving about wildly as I write this) and stay away from the hospital as long as possible as it does nothing for my peace of mind. I know I could do this but this consultant has scared me so much. What do I do?

The trouble with the Internet is the facts presented are no substitute for a face to face conversation with your health professionals. It's the same as googling symptoms of an illness. We freak ourselves out.

OP, I really think you need to speak to your MV when you have your sweep and ask for the test and a second opinion. But most importantly, you need to relax so this baby can come of its own accord.

Each birth affects any subsequent ones, and I believe how you are feeling emotionally and mentally are key. If you can keep and open mind, accept intervention may be necessary, and put your mind to rest, you will be in a better place.

Lots of deep breaths, long, warm baths and chamomile tea along the way

I have got to agree with mariefrmstmortiz your a higher risk of m/c aftet 40 weeks also it is a doctor (trained in medical profession and deals with this every day) feels this would be best for your baby. Maybe they have a point. I can see you are a worrier but when you dont feel the baby move and to go to the hospital for it says it was a little more than worry maybe some fact to it. I have got to say if it was me I would put my own feelings aside at the end of the day a healthy baby is what every one wants and to risk this for a week is daft. At 42 week you will have to be induced anyway. To go further than this adds loads more complications than youve already got also you midwife will then agree with the hospital.

Thank you all for your messages. This is really appreciated but I am afraid I am even more scared now and there appear to be two camps, one is the clinical evidence based one and the other side is the go with the flow one. The problem as I see it is that here in the UK all the antenatal care is done through midwives and NCT classes (which I thought was lovely) and I seem to have formed my view through this type of care. I got the idea with the hypnobirthing from a midwife. The few times I met a doctor I was told everything was fine (even by the diabetes consultant). On the other hand, it appears women need to be aware of things that are often in conflict to what they are told by midwives, and they need to be experts themselves. To make an informed decision when the advice and information that is given is so conflicting is not easy. I don't even know if I would call it an informed decision any more. There is no joint-up advice, consultants themselves have different views.
I am so scared of induction because I read so many things about it - stressful for the baby, increased risk of interventions including c-section, but I am so tired and frustrated now and of course I don't want to put the baby at risk. I can't cope with this any longer I think will ask to be booked in for induction. The people I know who had inductions at our local hospital have not been positive about it. As I said in an earlier thread before where I worried about induction, the staffing at our local hospital is shocking, the midwives are lovely but they are not allowed to make decisions; the patient has to wait for hours to see a doctor and this just doesn't fill me with confidence that it will be okay.
The plan is for me to go in again today to have a sweep and maybe I can speak to a consultant who will take me more seriously and look at me, not my partner, when speaking to me (no, I wasn't hostile, I was only anxious), and hopefully then I am more satisfied and make a decision about induction.

there is always the option of ELCS. Its an alternative to induction and you will be of course get great care throughout it.
I was in the go with the flow camp - had my first at home (planned) and it went great but I am now much older and having read several heartbreaking stories of babies who suddenly died full term I personally wouldn't risk going overdue. Neither would i allow them to induce me. Sorry not very helpful but its good you're not so hung up on hypnobirthing now and are considering other options.

If you feel you aren't being adequately informed or respected by the doctor, call them on it. Right there and then. I know it's hard when you are tired and worried. You never know, you may already be underway when you go in today, my mother was when she went in to be induced with her first baby.

I think you are doing the right thing by speaking to the MW and consultant again.

For me, I didn't want intervention but that was about hospital protocol. When the doctors came in after pushing for two hours the next step was intervention. Baby was fine, I was fine there really was no need. Likewise for my last baby, as long as we were ok it was unnecessary in my opinion, even after 40+ weeks.

But with the confusion over the diabetes the best way forward is to talk more and accept it MAY be necessary.

I really do wish you the best of luck. Keep us updated won't you?

Have you discussed your position with your DH - your fears, concerns etc.so that you have a united view of how you want to proceed?

If you feel that the doctor is not taking you seriously you need to ask to speak to a second doctor and also your DH needs to be able to advocate your (united position) on your behalf if you are not able.

It sounds like you are in a difficult position, and I sympathise.

I can only give my opinion, based on how I was treated. I had gest diabetes. I had no symptoms, I wouldn't have had the faintest idea that I had it, and yet I had it badly, I had to have insulin twice daily, and my baby was born with v low blood sugar despite incredibly close monitoring, and being induced on my due date. This is pretty standard in Australia, and my consultant told me that because of this, they have incredibly low stillbirth rates as a result of placental deterioration due to the diabetes.

I was induced, and yes, my DS did go into distress and I ended up with a EMCS. But it was all carefully managed and neither of us were in any danger, and now that he is 19 months old, I very rarely think of his birth, apart from to think "I am very lucky to have a healthy child".

If I were in your position now, I would demand a test for diabetes. If you have it, you've probably had it for a few weeks, and this is the danger for placental deterioration. If you have it, I personally would recommend an induction.

If you get tested and you're all clear, then I would recommend the CTG testing and very careful at home self monitoring of the kicks, as you're probably at no more risk of the deterioration than any other pregnancy.

It's going overdue and having the diabetes which is the issue for concern, not just the going overdue.

Hope that is some help - good luck!

Getting yourself stressed over it will do you no good hun, so the best thing I can recommend is getting a second opinion when you next go in and see someone, hopefully you with then get all the facts. Explain what your concerns are and hopefully they will put your mind at rest.
Not all inductions are bad. I had to be induced early with both of my children, and I had great labours. Yes I'd have loved to go into labour naturally, but it wasn't an option for me to wait for it to happen.
Relax, get your information and make the choice that will be best for you, and best for baby. Good luck xx

NICE guidelines are due date + 10 days over, so I guess you're pretty much at that now.

You do also need another diabetes check, and hopefully they'll get into that today.

Thanks, ladies, for your advice and kind words. I just want to make clear, I had the blood glucose test twice, once earlier in pregnancy and it was negative, and then the second one, which was in week 38. This one had a slightly raised level after the two-hour fast. The subsequent test that was carried out by the diabetes team afterwards was again negative, so was my home testing which I did for a week. None of the urine tests, neither at the midwife nor at the hospital, showed any evidence of diabetes. In my notes, the diabetes consultant wrote two weeks ago that he didn't believe I had gestational diabetes and therefore was not at a higher risk, based on evidence. I was therefore quite happy to go along with the local hospital policy to wait until full term plus 12 with induction, and I did say so to all professionals. However yesterday this consultant said the raised level put me at a higher risk which completely threw me. I don't think he read what the diabetes consultant had written.
I will go in later as I am booked in, and try and speak to another consultant, and then make a decision. My partner is of the same view as I am. Just one question, people write I should have another diabetes test - what would that entail, how would that test look like? Another blood test?
I am so downtrodden now, and faced with having to go in every day for monitoring (which will show only a small window of movements anyway) when the journey takes me 45 minutes one way, I might just go with the induction asap to get it over with.

You are probably in shock too - suddenly the rug has been pulled from under you.

OP - this is a very upsetting situation and I'm sorry that this thread hasn't helped you in the way you maybe hoped. There is a LOT of information oit there and a lot of pressure on the pregnant woman to do 'what's best for the baby' which is usually equated with 'do as the doctor tells you'

Your situation is that a diabetic consultant has told you he is not concerned about your blood sugar, you know the baby is measuring a normal size and responding well on monitoring. That seems a pretty good position to me - one if which you have choices about what happens next. If you are ready to deliver then book the induction and likely it will go very well. If you want to hang on a bit then keep doing what you're doing and monitor baby's movements. No birth choice is risk free so there's no right or wrong answer here.

As a point of information for everyone on the thread - there is no point at which you have to be induced. Induction will be offered and can be declined, just like any other procedure. Placenta function doesn't turn in to a pumpkin at midnight on 41 + 5 whatever. It's impossible to predict what will happen and of course the temptation is to err on what seems like the side of caution but induction is not complication/risk free. I think it's important to be clear about that because so often induction is not presented as a choice but as an instruction.

OP, I completely understand why you don't want an induction. It sounds like you very likely don't have GD. You're having monitoring to ensure your baby is happy while you wait to go into labour. Inductions carry their own risks too.

If you feel that waiting with expectant monitoring is the best thing for you and your baby then that's what you should do.

I meant a simple poas test for blood sugar, which they'll do today.

Sometimes when you're heading towards the trust's particular date for induction (in your case dd +12), consultants/registers sort of assume that you will want to be induced and think they're doing you a favour by booking you in.

As pp say, you don't have to be induced and can have expectant monitoring, though that can be pretty anxiety inducing too.

Hope that you feel better after your apt this pm and that you birth goes well.

Thank you, ladies. I have been to hospital now and have had a long conversation with the consultant. He read through my notes and confirmed that I don't have diabetes. However, he said that he would recommend induction due to me having come in three times with reduced fetal movements. I basically shot myself in the foot by coming into hospital when I was anxious. Somehow I have now agreed to come in for induction in a couple of days, and because of me having come in three times with reduced fetal movement I will not be able to go home with a pessary but have to stay in hospital. This is the hardest thing for me, hanging around in hospital waiting, where I can't relax (it is a horrible hospital, and I have had such a bad experience in there - not in the maternity ward though). I can foresee that I will need interventions purely because I am so stressed. I probably won't be able to sleep and will be so tense. And I will be so upset when my partner goes home at night.
I agreed to a sweep but they couldn't even do it. So I guess spontaneous labour in the next couple of days is unlikely...
I guess on the day I am booked in for induction I can still change my mind if the baby has been moving well, and ask for another sweep on Tuesday, and then have an induction on Thursday. Not that they will like that.

It doesn't matter what they like, they see hundreds of patients in various states of anxiety and are quite used to it. What sort of ward is it? Do they have a birthing centre?

The consultant is erring on the side of caution. I don't see why they can't continue to monitor until 42 at least. Still, you have 4 days and there is every chance that your baby will come of its own accord by then. By this time next week you could well be sat with your baby in your arms and this will all seem like a distant memory.

If you are using hypnobirthing can you contact your instructor and ask them to do a fear release session for you so you can put aside your worries about induction. It is perfectly possible to have a good induction experience, but if you are this worried and stressed now about it then that will really really not help.

Of course, all this may be academic, as you may well be in labour tomorrow . Cervixes can change rapidly and without warning, from shut and miles aways from birthing, to ready to go ASAP.

Good luck, and do let us know how you get on .

Also, remember you can change your mind at any stage should you wish to, either to request a c-section, or decline anything offered.

you didn't shoot yourself in the foot. you were looking after your baby. The possibility of being induced was always there- you may not have been worried about fetal movements but got to 42 weeks and were advised baby should come out. This has nothing to do with your actions. The doctors have to be cautious and you don't have to agree to anything you don't want to.
Sounds like you were planning on a hospital birth anyway so try to stop worrying about the induction and focus on all hypnobirthing techniques you have learnt. That's what they are there to help you deal with the fear and trust in your body. We can never guarantee the birth we want.
You do have other options, you can say no to induction and wait it out , you can say no to induction but yes to an ELCS. Its your decision.
Hopefully you will go into labour within next 2 days. I'd try to get some rest and brush up those things you've learnt.

Lady, its tough when things don't go the way we expect or hope for them to. I really hope that you and your baby have as straightforward a birth as possible for you both to be safe and happy.

In your last post, you used the phrase 'I will feel...[negative emotion]' a lot. It sounds like you are feeling scared and panicky because the situation has departed from what you hoped for and planned. I'm not a hypnobirthing expert (halfway through reading a book and pregnant with my first) but I get the impression that your hypnobirthing techniques are meant to be able to help you with births that aren't straight forward too.

Try to reframe what has just happened positively, and replace the 'I will feel [negative]' statements with positive ones about how you have made the best decisions you could make with the available information. Then find some positive ones that will help you manage your emotions whilst in hospital, during labour, during birth, and during any further divergence from your plans (such as a c-section).

You have given your baby and your body another few days to try and give birth without assistance. But sensibly, you have made arrangements for that assistance to be given if it is needed.

Find ways to deal with the hospital stay. This may involve taking reading material, or a personal music player to listen to music/audio book/hypnobirthing on. It could involve deciding that you will make use of the time your partner is seperated from you to sleep and relax so that you are well rested for labour. Maybe you'll decide to remain as active as possible during labour. You will remain calm by doing whatever relaxing techniques work for you. If your baby requires extra assistance, you will not blame yourself for that, some babies need extra help and it is not your fault and accepting that help could be just what your little one needs.

Relaxation techniques and hypnobirthing, aren't just about having the 'perfect' birth (if such a thing exists). It's about accepting what needs to happen for YOUR baby to get into this world and have your mind and body working together with your baby (and with medical assistance if it is requred) to help your baby be born healthily and happily. If your baby needs to be induced, if your body needs pain relief, if your baby needs to come out by CS - none of these things will mean that you have failed at birth, or womanhood or as a mother. None of it. It will just be what your baby needed to happen to be born.

You can make sure that you get skin to skin contact ASAP and nurse when you are both ready to. There are lots of good things that will happen when you meet your baby. Lots to look forward to.

There are some things that you can't help (like when your baby is ready to be born) and some that you can (like how much you snuggle up to your baby once you are both together and healthy, or whether you take stuff - books/puzzles/music etc to help you manage the hospital stay). Focus on the stuff you can choose.

I know you are kicking yourself for going into hospital when you were anxious about your baby's movements. But you did what you had to do to look after your baby and if there had been something wrong then your swift action could have saved your baby. It may still have been your baby's way of letting you know it wanted extra monitoring and help getting out later. Please don't regret it. :)

Excellent post by spiritedwolf, Lady. Have a good read of what she has said. Thinking of you and sending "spontaneous onset of labour" vibes.

hmm also i found out today that the mother who started the Count the kicks campaign lost her baby at 39 weeks. You did the right thing reporting your concerns about movement.

I think anyone going to the hospital at 41 weeks with reduced foetal movement (imagined or otherwise) has the absolute necessity to be monitored daily, and immediate delivery by any means considered. If the consultant had nodded at you, listened sympathetically, patted your hand and smiled, and told you to go home and not worry, and something did happen to the baby, you would have the right to be all over a law suit.

The consultant's job is to make sure your baby is safe.

Additional monitoring is a pita, I know. I had to drive myself to the hospital every day from 38 weeks for v similar reasons to yourself and sit so they could get an hour on the monitor. In the end they decided to go for elcs on my due date, and dd1 is now healthy and happy. I had reduced foetal movement with dd2. She was vbac2 and we are 3 years into a medical negligence case as she has cerebral palsy due to hypoxia. She's still healthy and happy, but I am afraid I veer less towards bedside manner and err towards clinical evidence and caution these days.

Bedside manner goes a long way, but I would much rather have a thorough and cautious clinician. If it helps, I trusted my midwife implicitly - it was the same one that had carried out my antenatal care from 28 weeks. She was adorable. Ultimately it makes no difference to outcome.

I'm mildly curious why you weren't using the count the kicks charts etc if you kept forgetting whether the baby had moved or not? It doesn't really matter, but it might have helped to reassure you.

Let the professionals do their job of keeping your baby safe, and trust them. Try not to get hung up on control or bedside manner - labour and birth is a flexible occasion.

Hope your induction goes well.

I had an induction at 42 weeks due to 3 times too much water being around the baby. I had planned a home water birth using hypnobirthing.

The induction itself wasn't as bad as I'd feared, I still used my hypnobirthing techniques and it only took 4 hours. I didn't need an epidural.

You will be fine. Good luck

So... have you had the baby?! What has happened? How did it all go? Were you induced?