IVF pregnancy 38 weeks, early induction for no real reason?!

[PorkPieandPickle]

Hoping for anyone with knowledge of IVF pregnancies to advise me?
I am currently 38+6 and have had 'consultant led care' throughout (because of ivf/ohss issue) but have had nothing wrong and fairly 'textbook' pregnancy.

Had horrible consultant yesterday, she made me feel stupid, started talking about induction- and when I queried her as still pre-term, she said they don't let IVF pregnancies go overdue ?? she was saying like 'someone must have already mentioned this' and 'why do I think I'm having consultant led care' (?!)

She was quite rude IMO. Made me feel like a failure she actually said 'your body didn't naturally produce a pregnancy, so we can't rely on it to naturally go into labour' What????! Did they inject a placenta into me?! No, my body naturally grew one, like it grew my baby!!!!

She wanted to give me a sweep while I was there yesterday, and I declined it and said I wanted to give things a chance to start naturally. She said a sweep was natural, but snottily said i had the right to decline if i wasn't prepared... I still declined- I wasn't mentally prepared for it, and had driven myself there without DH etc.

Anyway, the upshot is, I have to have a sweep next Wednesday, 4th (at 39+5) And if that doesn't work within 48 hours, they will want to admit and induce me.

I feel totally overwhelmed by them suddenly moving the goal posts?! The early induction substantially reduces chances of the natural water birth I was hoping for... Not the end of the world, I know, but I would have thought this should be mentioned before now?!

Sorry for long post, any experience anyone please? Any other IVF-ers been told similar?

I'm watching with interest. I was pregnant after IVF earlier this year (although I mc'd) and was horrified by these sorts of stories. I finally wanted to be "normal" after years of being fiddled with! It seems to differ from hospital to hospital.

I think in your shoes I would be asking for the evidence that letting an IVF pregnancy go to/over term is riskier than for a non-IVF pregnancy. You can't make up your mind without knowing what they are basing their advice on.

And it is only advice. You don't "have to" have a sweep.

No advice for IVF pregnancies I am afraid but just wanted to reassure you that no-one is able to move the goal posts except you!

Sounds like an awful consultant but find out your facts on the risks etc and if you want to wait for your labour to start naturally then you can.

You can decline all sweeps, inductions etc until you are ready.

Can I ask how old you are? You don't have to tell me!

It's just that this exact same thing happened to my friend and they put a lot of the reason on her age (she was 39). They just kept telling her that she was an older mother and that coupled with having an IVF baby made her high risk if she went overdue but could never really give her any evidence and weren't prepared to wait and see if she did go overdue. She did eventually give in and let them induce her at 38 weeks but she still says now that she wished she had said no.

Just remember you don't have to be induced and can ask to awesome one else if you aren't happy.

Good luck x

None of what she's said sounds correct! I've not been through IVF myself but have friends who have - two had planned c-sections (7 - 10 days prior to due date) due to the factors that had required them to have IVF in the first place (both had womb surgery prior to getting pregnant) and two went into labour naturally and required no medical intervention.

If there really are no other issues with the pregnancy then in your shoes I would put in a complaint about the consultant and refuse to see her again as she sounds bonkers!

Bloody hell what a rude cow. I'd be tempted to complain - that's totally inappropriate.

I'm consultant led purely because of IVF which I have to say I was quite surprised about. In practice it's involved an extra appt after the 12 and 20 weeks scans and since everything has been textbook, that's it. I'm currently booked for a home water birth so no indication so far of this induction policy at my hospital.

In your shoes I think I'd ask to see another consultant. And remember that ultimately it's your choice. I'd probably be asking what evidence there is to back up the induction at 40 week policy and why very few other hospitals do it.

Good luck - I know it's really difficult challenging the 'white coats' but I think this is one time where you should.

Thank you for replies. Yes, I sort of realised I could refuse, but she made me feel so stupid that I sort of lost my common sense and thinking ability if you see what I mean? She just made me feel like I should have known all this and it was all decided and I was just the silly woman who hasn't been listening?!

I don't want to refuse if it puts my baby at risk, but I don't see any reason why I'm more at risk than anyone else... I'm 34, and it's my first sustained pregnancy. (None- IVF pg mc at 12 wks 10 yrs ago.)

Thanks for the support, it does help to have people remind you you don't have to 'do as you're told' I find it hard with some medical professionals- they are very hard to argue with :S in hindsight I wish I'd had DH with me, he is far better at dealing with arrogant idiots!! But everything been so routine I told him not to bother with the last couple of appts- typical!!

I have a dd (7m) through Ivf . What she said is not true!

I went nearly a week over. Unless there was a specific medical reason you or baby could be in danger you should not be being induced just because you had Ivf .

Go and see your mid wife and get a second opinion. I wouldn't want to be induce for no reason at all. The labour is more painful .

highglove could I ask if you paid for your Ivf or it was NHS?

Mine was nhs but at private clinic and after a flurry of scans up to ten weeks I was released to the nhs. And what a bloody difference in service there was!

Nobody can force you into giving birth apart from your own body. So she can waffle on all she wants and be nasty.

Take somebody with you next time.... I went with a friend who wanted to try for a vbac and they were trying to push her into a section and she wasn't good with pushing for what she wants. She got her way but I think the doctor could have cheerfully kicked me up the backside out of the door.

Well my IVF baby is now 12 and taller than me but I certainly wasn't told that. Family history of going overdue and my consultant thought I probably would too. I didn't in the end - waters went at 39+3 but I was induced next day as nothing was happening and they were afraid of infection obviously.

OP this sounds like a crazy policy and you really have my sympathy. I'm in London (under Kings), this is my first pregnancy, IVF, I'm 34 and it has been entirely uncomplicated so far. I am due next Weds, but if baby is late I will not be offered induction any sooner than any other mum to be (so 41+3 or 41+5 depending on which is a weekday as opposed to a weekend). Like Highlove (hello again Highlove!) I am planning a home water birth. The only time IVF will 'rear it's ugly head' is if I'm induced via pessary- this is done on an outpatient basis usually, but depending on the consultant they might want to keep me in. I keep reminding myself that all these interventions are entirely my choice and I can refuse all/any of them if on looking at the evidence, I'm not convinced I need them. Good luck and I'm sorry this is causing you stress at what should be a very relaxing time! Xx

I had IVF for our pregnancy. Once we'd had our 6wk scan, we were released to the NHS and were treated just the same as everyone else. No extra appointments and no mention of not being "allowed" to go over our due date - we had a textbook pregnancy. We were early as it happens. Waters went at 39+4 (I think) and then we progressed through to labour. It was a difficult birth but that had nothing to do with it being IVF - DS wriggled himself into the wrong position.

She sounds like she doesn't know what she's talking about.

Sorry you had to deal with a rude consultant

IVF pregnancies are no different from 'natural' pregnancies AFAIK wrt to labour and delivery.
Some consultants may feel that an IVF baby is a 'precious baby' (as if other babies were not?!) and as the risks of the placenta failing increases with the length of pregnancy may be more proactive to encourage getting the baby out.
Normal pregnancy is from 37 to 42 weeks.
You are not overdue until you are over 42 weeks.
Many first pregnancies (which yours is for all intents and purposes) go over the due date.
You can have 'expectant management' in the lead up to your due date and beyond which entails v regular (in some centres, daily) scanning and CTGs to ensure the baby is still happy inside.

FWIW, sweeps are kinda 'natural' (as is the Black Death; I don't think natural is necessarily better than... what? ?artificial ?sciency?), but are only possible if the cervix is favourable ie allows at least one examining finger inside the opening to sweep the membranes which then realises a cascade of hormone which encourage labour. A sweep is not an induction and will only work if the body is ready to allow it to work IYWKIM.

Good luck, not long now

Hi porkpie I have no experience of iVF but had lots of good advice on here in the summer when I was under pressure for induction on due date as I am over 40.
Your consultant sounds horrible.
In the end mine was fabulous much to my surprise!
Anyway remember you are actually only being 'offered' induction - the,choice is yours - though clearly they don't make us feel like that.

The following links helped me frame my decision -

WHO guidelines
I can't actually see mention of IVF as a reason but only scanned quickly.

Birthrights
I found some excellent info on here you could contact them for advice too.

Good luck. you deserve to have a say in how you give birth to this precious baby if there is no medical reason for the induction.

I am 32 weeks pregnant with an IVF pregnancy.

I'm under midwife led care despite having had a previous EMCS and being 38 years old.

I've also been told I can have an VBAC and will be allowed to go 10 days overdue before they do anything.

I've seen a midwife 4 times so far in this pregnancy, and had 3 scans (one at fertility clinic, 2 standard NHS ones).

They couldn't be less interested in the fact it's an IVF pregnancy and treat me like any other 2nd time pregnant mother.

I'm always amazed how different care is depending on where you live

I just don't understand why the embryo reaching the womb through the cervix rather than through the fallopian tubes a few days after conception would have any influence on the birth eight and a half months later. It baffles me why some drs think it is a special case.

What a horrible thing to go through. A professional in obstetrics should never express an opinion like that. All decisions that need to be made, whatever the reason and background should be made jointly between the doctor and woman after a thorough and detailed explanation, so you can make an informed choice. If there are no other background issues, such as increasing age, then induction based on fertility treatment is not routine and not practiced in the majority of places. Ask for a second opinion, if only to meet an understanding and professional doctor. Good luck.

DC2 was an IVF baby. I had consultant led care for a number of non-IVF related reasons, but there was never any talk of inducing me early. Did you see th actual consultant or an registrar. I had an horrendous appt. with my consultant's registrar in which he patronised me while clearly having no idea at all about my medical history.

And the comment about not relying on your body to go into labour?! She's just made that up. I would complain if I were you.

A interesting discussion going on here. My DD (nearly 2) is IVF and I was encouraged to induce to prevent going over 40 weeks and my consultant was brilliant, the way he explained it was that due to the egg implanting slightly earlier/later (I forget which) than in a natural pregnancy there was a slightly higher chance of trouble in waiting for nature to do its job. As it happened I wasn't very bothered by it because I wanted DD out as far away from Christmas Day as possible! .

But at the end if the day, your consultant has very bad communication skills and needs to be reminded, quite firmly I think, that you are the one in charge here! You will, of course, listen to medical advice, but it's your body and you are an intelligent woman who knows what is right for her.

I would strongly advise asking for a second opinion. If there is anything medical you are ever unhappy with, get a view of another consultant. I was once advised by a consultant I needed a major operation, and after getting a second opinion where by they strongly advised me against it, I realised it was unnecessary and I could self manage my condition. 10 years later it was the best decision I ever made.

I am sorry you are having to go through this though, she should not have made you feel like this. Stick to your guns and seek out some more advice.

God it's good to talk!! I was feeling so stressed after DH left for work this morning, and it's so good just to hear people talking about this- feeling so much more normal and calm about it.

It was a registrar I saw I think. Tbh, they keep you waiting that long for an appt (usually 1.5 hrs late) that I am often just grateful to get in and see someone without registering who it is!!

I do think she was very authoritarian / high handed, and didn't really explain anything. Obviously I know from reading, but she didn't even explain what a sweep is or anything- and certainly didn't give any justification for early induction.

There seemed to be no chance of discussion, she was dictating what should be done, and making me feel like a naughty girl for not knowing. I was just shocked - still am- but feeling more in control now.

I am seeing my midwife on Monday and will discuss this with her, and will take DH with me next weds. I think I will go ahead with the sweep ( because it doesn't seem to have any negative points) but obviously ask to see a different doctor!! I do not want to agree to induction before 41 wks.

Liveinthepresent- thanks for the links, off to do some more reading!!

Humphreyscorner- we had private IVF and then NHS care- it feels like being dumped in a swamp!! I appreciate that I have been given consultant care, but actually most of the appt's are no different to a mw visit, and the doctors don't seem to know why they are seeing me!!

And yes, I will think about putting a complaint in about the doctor.

Hi euro - how are you? In answer to your question - I was told by a consultant that IVF typically pushes women up the 'risk scales' in case there is a medical reason why the conception couldn't happen naturally which may then impinge upon the birth, but a) I can't think for the life of me what such a reason would be and b) as we both know, by and large the reasons for infertility are unexplained and/or they could be male-factor which would have no bearing whatsoever on the woman's birthing! I find it all very baffling.

Thanks MrsHY1. I'm good thanks. In the early days of IVF#4. It has been a helluva year! How are you?

I can't think what the reason would be either. If there has, as someone mentioned above, been womb surgery before IVF, that would be a relevant factor but lumping all IVF in together seems daft.

Out of interest to the two posters above it is male factor infertility- DH had a vasectomy after children in his first marriage... No other factors.