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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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Original poster

Induction at 39 weeks due to maternal age.

94 replies

fluffyraggies · 11/12/2013 14:17

I am an older expectant mum, 34 weeks + 2. I have 3 teen DDs, so not first time mum.

Went for a consultant appt. yesterday and she suddenly started talking about how they 'like to induce at 39 weeks with AMA (advanced maternal age) and that i should expect to be booked in for an appt. for medication, a sweep and waters broken' in early Jan.

It's to do with lowering the risk of a still birth.

I know what's best for baby is paramount, but i'm in shock as no-one has mentioned this at all up to now! I knew nothing about it. I'm now worrying myself about still birth, C sections (which are more common in induced women apparently) and the fact that i can't find any firm info about risk to baby with induction at 39 weeks vs risks if i say no and try to go into labour naturally. I'm inclined to 'do as i'm told' and let them induce me, but i'm fretting.

Any wisdom? Anyone else been told this, or been through this please?

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MediumOrchid · 11/12/2013 14:19

Do you mind telling us how old you are? This does sound a bit strange!

Original poster

fluffyraggies · 11/12/2013 14:22

I'm 44. 'Text book' pregnancy so far. I'm in the midlands. (been googling and i think different areas have different policies regarding methods of induction).

OP posts:

MediumOrchid · 11/12/2013 14:33

That sounds ridiculous to me, though I'll admit to knowing nothing about the science and risks of it. Induction at 41 weeks and I could understand it, but 39, a week before you due date?? Can you get a second opinion from somewhere?

meditrina · 11/12/2013 14:34

The risk of placental failure increases with length of gestation and with maternal age.

It sounds as if they want to manage this conservatively, because although the risk is small the consequences are devastating.

That said, perhaps you should ask the consultant on what evidence or guidelines the recommendation is being made for you. And what changes, in terms of risk at 39 - 40 - 41 weeks.

You might decide you do not want to go over. But that's not the same as deliberately going under.

Irishmammybread · 11/12/2013 14:47

I'm seeing my consultant after my 20week scan tomorrow and it's one of the questions I was going to ask.
I'd also heard about the risk of still birth increasing with older mum's who go over term.
I'm 45 but will be 46 by the time my due date comes round in April. We have 3 DC, 20,14 and 10 and they've all been late( between 4-14days over).
I'll let you know what I'm told tomorrow!

Original poster

fluffyraggies · 11/12/2013 14:50

Thank you. I'm due to see a consultant again on 6th Jan. About a week before the induction by my reconing. I'm finding my care throughout this pregnancy a bit patchy and slap dash on the whole really and don't know who to talk my concerns through with. I'm sorry to say my MW is almost impossible to get hold of, doesn't tend to reply when i try to contact her and is very vague about questions i've had when i do see her.

My appt. yesterday was meant to be at 24 weeks (so 10 weeks late!) but i had 'slipped through the net'. It seems i should have been under a consultant throughout. I just cant get my head round the fact that i've never heard of this induction at 39 weeks thing. I lurk around the pregnancy forum and MN in general, and am a googler for preg. info., but this is all news to me

OP posts:

Original poster

fluffyraggies · 11/12/2013 14:53

xposted with you irishmammy. Do let me know what they say. I was going to add that i've just finished an NCT course and a couple of the other ladies in the group are 'older' mums. We covered induction on the last session and nothing was said about AMA induction.

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panicmechanic · 12/12/2013 00:21

Hello, I was induced at 37 weeks due to my age and sadly I did have a stillborn with a previous pregnancy. My consultant felt that it eliminated unnecessary risks and could control a situ if there was an issue. My DD was delivered with no issues. I am 12 weeks pg now and have an appt with my consultant on Friday but I fully expect her to suggest the same plan I am now 42. Hope that this helps

missnevermind · 12/12/2013 00:48

I Was 42 when I had my DD. Fourth child, two teenagers and a toddler.
I was booked for an induction in the week before my due date. It failed. Twice.

I went into labour week later. So around my due date

But had a stop start labour over a few days Ending in an emergency C section.

I had never heard of failed induction not leading to A C section at a leisurely pace.

I am also in the Midlands a very large teaching hospital.

All I can say is I was very happy with my treatment. But. Make sure that you know exactly what will happen and when. If it is a failed induction what will they do When will they do it etc.

I think without the failed induction my labour may have been more straightforward But I had had concerns towards the end of the pregnancy.

Original poster

fluffyraggies · 12/12/2013 15:29

Thank you both. Any insight or experience into this is very helpful, and panic i'm sorry to hear of the loss of your first baby

That's good advice about finding out exact procedure in the event of things not running smoothly.

I have calmed down a bit today. I think i was rather shaken by the whole still birth risk thing being high enough to warrant intervention at 39 weeks. Just hadn't heard of it before. Chatted to some of my NCT group today. One of them is 41 and further along in her pregnancy than me and she has had nothing mentioned to her about induction. ?? (different hospital)

Trying to step away from google!

OP posts:

Swanlike · 12/12/2013 15:43

I had a baby earlier this year at the age of almost 42. I moved areas when I was pregnant. The first hospital consultant tried to pressure me into induction at 39 weeks, the trust where I moved to was happy for nature to take it's course as my pregnancy was normal with no complications and my daughter was born naturally at 40 + 8 and is fine.If you have no other health issues and no history of still birth, I would question this policy. The stats on stillbirth in older mothers are very out of date - from the 1930's I think and so do not reflect medical advances and improvements to health. Remember that the consultant can only recommend a course of action, you can refuse if you don't wish to follow those recommendations.

Irishmammybread · 12/12/2013 18:04

Hi fluffy !
I had my scan today(21 weeks) and spoke to the consultant.
The hospital would recommend booking me in for induction sometime between 38 and 40 weeks.
I go back at 28 weeks for a further growth scan and will see the consultant then,and again at 34 weeks and they will decide on a date for induction from there.
Having had several pregnancy losses(though all first trimester) I worry about every little thing so if they say induction is safer I'll go with that!

peeapod · 12/12/2013 18:21

are you being given the option of a elective c section or an induction? imo you need to be given the facts about how likely an induction could end up in an emergency c section and if you want to take the 'risk' (and obviously the comparison between an emergency c section and planned).

Just trying to give you other things to think about and weigh up.

7to25 · 12/12/2013 18:29

Hi, I was almost 45 when I had my sixth child. My consultant wanted me to be induced at 38 weeks and I refused and had to go for scans every two days until I got fed up and was induced at 40+5. I wish really I had been induced earlier but thought I would go on my own, wishing to avoid an induction.
All was well. He told me I had a few hours till he came back from his clinic and then I would get a section. I was holding my son in my arms when he came back.

MotorcycleMama · 12/12/2013 19:39

Hi fluffy I can't offer any wisdom, but am in a similar situation as you (I'm 42, but unlike you this is my first baby) and have been told that I will be induced at 40 weeks, possibly sooner, due to my age. I have been rather freaked out by this, but feel compelled to go along with what they say, as I would hate to put the baby in danger. What I am trying to find out now is whether I can go straight for C section if membrane sweep and pessaries fail to progress me into labour. I hate the sound of the syntocinon drip, and fear I would just end up with an emergency CS if the sweep and pessaries fail, which I would rather avoid.

I wish you all the best with the remainder of your pregnancy and birth, and would be really keen to be updated how you get on.

Shellywelly1973 · 12/12/2013 20:02

Hi op.

Im 40. Was 40 in September. Im 33 weeks with 6th dc.

The hospital im booked into has a policy of inducing all mothers of 40 & above on EDD. Monitoring twice weekly from 37 weeks & literally if anything is discovered your induced.

Currently my baby is breech. If she doesn't turn I will have a c/s.

Otherwise I've decided I will decline everything. The idea of being induced is abhorrent to me. Its not an option unless the baby's in real trouble. I've got an appointment on 6/1. I will only be attending if the baby is breech.

Yes im selfish but you know its my body & my baby so my choice.

You need to do whatever you feel is the best for you.

Best of luck.

Original poster

fluffyraggies · 12/12/2013 21:04

Thanks again. Thanks to irishmammy for coming back.
peapod - it was induction. She never mentioned C sections. I only became alerted to the links between induction and c sections when i got home and started a bit of research into it online.

Consultants words were more or less these - ''we'll have you in before 39 weeks. We'll check your cervix, and if it's not ripe you'll have a hormone pessary. That stays in for 24 hours. You'll have to stay in hospital from the time the pessary goes in. After that we'll give you a sweep and break your waters''.

:( I hate the thought of them breaking my waters.

All my instincts are screaming noooooooo. But when words like 'risk of still birth' are being bandied around it makes me feel i must comply.

I'm going round in circles!

OP posts:

Flisspaps · 12/12/2013 21:13

I'm that this has been presented to you as a fait accompli.

Early induction should be discussed along with expectant management, and risks and benefits of both courses of action.

The Consultant should not be telling you that they will do X,Y and Z on such-and-such a date and expect you to just agree without further ado. Where is the informed consent?!

Poppy954 · 12/12/2013 21:13

Fluffy, this is the most recent research I think. This was posted on another thread on here a few
Weeks ago. There is also a large scale trial going on for first timers over 35.

www.rcog.org.uk/files/rcog-corp/1.2.13%20SIP34%20IOL.pdf

Poppy954 · 12/12/2013 21:14

There is certainly huge difference in policy between hospitals from what I've read. I'm 31wks and facing the same dilemma.

Shellywelly1973 · 12/12/2013 21:20

The consultant I seen at 19 weeks didn't discuss my options. She outlined hospital policy and as I didn't disagree she wrote in my notes that I had agreed to blah blah blah...

Original poster

fluffyraggies · 12/12/2013 21:21

Reading all your replies again, and motorcyclemama you said:

''What I am trying to find out now is whether I can go straight for C section if membrane sweep and pessaries fail to progress me into labour. I hate the sound of the syntocinon drip, and fear I would just end up with an emergency CS if the sweep and pessaries fail, which I would rather avoid.''

Can you explain/do you know the difference between 'going straight for a c section if the pessarys etc fail' and 'an emergency c section after the synto. drip' please?

OP posts:

Original poster

fluffyraggies · 12/12/2013 21:22

xposts, hang on i'll have a read ...

OP posts:

seatfor5 · 12/12/2013 21:30

Hi Fluffy I am Pg with my 4th DC but am only just an "older mother" at 36.

I thought I would let you know that being induced is not always a bad experience! I have been induced for all three of my PG and will be again at 38 weeks with this one as I have GBS & GTT (which also has a risk of stillbirth)

With DS1 I had a pessary the evening before the next morning they broke my waters at about 11.30am then I went on the drip at about 2pm to have him in my arms at 7.30pm (only having Gas & Air) DS2 same method but my waters were broke just before I had him rather than early on. DS3 was my easiest birth I had a Pessary fitted at 12 noon by 6pm I was having contractions so was taken to the labour ward! they broke my waters as he was born at just after 8pm

The more babies you have had the more open your cervix will be at your due date like a balloon once stretched it doesn't go back lol! so the likelihood would be you will only need one pessary.

The way I look at it is I know when I am having my bud, I dont have to panic about who will have the kids if I go into labour in the middle of the night! I will be in the best place if something happens :)

ohmeohmyforgotlogin · 12/12/2013 21:34

They could do careful monitoring of placenta etc. Talk to AIMS. Sounds like they are using rhetoric to scare the shit out of you. Stats show one thing but every case in individual. You don't have to do anything you don't want to.

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