Can I refuse to have my labour induced?

[bobthetomato]

Sorry this is very long, but I wanted to include all the relevant information:

I have three children, and am 19 weeks pregnant with my fourth. My oldest is almost seven, youngest is 20 months old.

All three children were conceived very easily. Completely trouble-free pregnancies. All three labours began spontaneously and progressed quickly and without complications. My first labour, from the first contraction to delivery, lasted just over five hours. Second and third labours lasted under three hours. Fast, but smooth and very positive experiences.

I've had natural births for all three, partly because everything has happened so quickly that there was no time or point in considering any sort of pain relief or intervention.

My first three children were born in Scandinavia, but now we live in the UK, and I was keen to have a home birth this time.

On my booking in appointment, my midwife informed me that I was "high risk," and was going to be put under a consultant. The only reason being that I turned 40 just before the baby was conceived. I was a bit but didn't make a fuss, thinking that procedures vary from country to country, and they're probably just being extra careful.

I went along to the consultant, and he informed me that they will be inducing me at 40 weeks, due to a statistically higher risk of stillbirth for "elderly" mothers like me, when their pregancies go postdates.

I said that I didn't want to be induced, to which he replied that it's my decision, but that it would be safer.

Now, I don't doubt that consultants are well-trained experts in their field.

I also don't doubt that there are genuine reasons where an induction is necessary. However, I don't believe that simply being 40 is one of them.

It doesn't seem to matter that I've had three healthy, trouble-free pregnancies and births over the past seven years, and that I'm in excellent health, and the baby seems fine, too.

The only thing that counts, apparently, is that I'm 40 now, and therefore my body has had a look at the calendar and is now incapable of birthing another baby without a very invasive procedure.

I was even more irritated because the consultant wrote in my notes that the plan is for me to be induced, despite my objection.

I don't really know what the procedure is, but is it possible for me to opt out of seeing the consultant for any further appointments? He told me that he wouldn't be doing anything different from what the midwife does. He'll also just check my blood pressure (which, by the way, was 116/70 at my last checkups, so no problems there, either) and listen to the baby's heartbeat.

So, in other words, the only thing I'm getting from my consultant is pressure to have an induction which I'm dead set against, unless there is a clear and present danger to the baby or myself. He's not actually giving me any "care" that's different from what my midwife gives.

My question is: how do I go about opting out of seeing the consultant and being induced?

You don't have to do anything that you don't want to do. Yes, he is right, the risk of stillbirth doubles at age 40, so induction is usually offered to try and reduce that risk, at about 39 weeks. However, if you have all the information, you can make an informed decision and are well within your rights to decline.
It might be an idea to transfer your care to another consultant who you might feel will listen to your wishes more, although you will probably not need to see them very much more now anyway.

They definitely can't compel you to be induced, although they probably will pile the pressure on. He has probably just written 'plan is' to mean HIS plan is, to cover his back. When the time comes he will then write it as you declining his recommendation rather than a joint decision. You can definitely request another consultant but unfortunately there's no guarantee they will be anymore supportive due to the culture in the nhs.

google AIMS the organisation about choices in childbirth. They can do more frequent checks on the placenta to ensure everything still ok till natural labour kicks in. It is your choice.

You absolutely do Not have to do this. Tell them you want a medical reason why YOU need an induction, not just because you are over 40. That's just statistics.
A friend is being pressurised in exactly the same way ATM, only to be induced at 38 weeks. She's very conflicted. It makes me angry.

It doesn't matter how supportive he is, you can decline anything you don't agree with. I'm having a home birth after csection, I had to meet with the supervisor of midwives to discuss the risks and make a birth plan, including no vaginal examinations during Labour etc, was all fine.
With induction, yes the risks double, but from 1 in 1000 to 2 in 1000 at 43 week's, I don't know about the stats for over 40's, I'm probably going to have the induction/booked for c section fight next as I am now 40+3 by their dates, , but only 39+5 byline, which are right! So I just declined to book an appointment with the consultant until I'm 42+1 And will take it from there.
I have booked a Doula, which has been fab for support and taking away the fighting for things aspect, plus I saw a registrar early on who was useless, so swapped to a consultant she recommended, it's been plain sailing since.
I recommend looking at the AIMS website and their booklet, 'am I allowed?'

Good luck, if you do go for Home birth I hope it all goes well, by the sounds of it it would be perfect for you.

Sorry, meant to say too, they would find it very hard to induce labour for someone that doesn't turn up at 40 week's, or doesn't take their clothes off! Just sayin'!

I'm having monitoring to keep them happy from the end of my 42nd week till I'm 42 weeks by my dates, if I need to, it's just an hour or so in the day assessment unit, a listen to the baby and blood pressure etc, a scan during that week if I want it. Much more cautious and sensible route than induction as far as I'm concerned, as induction and csection, especially after previous csec, have their own risks.

Ah my mother could have written your post! When her 5th DC was born she was treated like a dinosaur and was most irritated.

Definitely refuse the induction if you don't want it- you may be 40 but you don't mention any ill health- two people can be 40 and in very different conditions.

For what it's worth, I had an induction and only needed the first stage to induce labour- I had an excellent spontaneous labour with my first and only had the induction for social reasons- it was actually a really good experience in the end, and I was most surprised. I think having already had a good labour and being ready to give birth meant that it wasn't that painful or drawn out.

My mother had her first home birth with her 8th child aged 43

In your position I would also definitely be refusing induction, and offering to go in for monitoring from 41 weeks, and I would stay at home to give birth (unless an emergency developed in labour, of course).

I hadn't heard of age being used to push for an induction - and given your obstetric history, their attitude seems crazy. They are covering their backs regarding the (tiny) statistical increase of risk, but you are absolutely within your rights to refuse.

I'd second the recommendation to contact AIMS - their function is to liaise between patient and medics, to hopefully improve communication.

Same here. Am currently 26 weeks but will be 41 years old when DC3 arrives. They plan to induce me at 39 weeks if I haven't gone naturally before. Not exactly happy about but keeping an open mind for now. I was thoroughly fed up when DC 1 and 2 by the time I reached 37 weeks so will see how I feel when the time comes. I think I would personally rather be safe than sorry, although no reason why I would go beyond term - DS born at 38 and DD 40 weeks.

Just say NO. I ended up being thrusted towards a consultant care route despite my explicit instructions I would not terminate my pregnancy due to genetic factors and that I would carry to term regardless.

Consultant wanted an amino, I said no, consultant wanted blood tests I said NO, consultant kept telling me I was being difficult. I kept telling consultant I know, I don't care. They did a shocking job at inducing me stopping and stalling the induction due to staffing levels forcing DS in to distress, I ended up calling them all incompetent cunts at the top of my voice in a ward and driving up the motorway and turning up at a random hospital with my notes, explained to the midwives no intervention just let me labor, they agreed, supported me no medical involvment.

I had a passive agrresive phone call from the consultant. Told him to shove his phone up his arse. DS hasn't seen him for his checks and we've gone private for karyotyping on DS to see if he carries the same harmless balanced chromosomal translocation as me.

Thanks for all the encouragement and the stories.

Yes, I do know that the risk of stillbirth doubles for women over 40 past 40 weeks, but it's still a miniscule risk. Going by numbers alone, there's a far bigger risk of further interventions if I do go ahead and get induced.

I'm definitely being made to feel like a dinosaur! I had no idea I was over the hill until my booking visit.

Your story made me shudder, Ginger. So glad your son arrived safely.

I'll have a look at AIMS.

Sorry, meant to say too, they would find it very hard to induce labour for someone that doesn't turn up at 40 week's, or doesn't take their clothes off! Just sayin'!

Good point, missmakestuff! A friend of mine had a wonderful home birth with her second, after having had an emergency caesarian. Hoping things turn out well for you, too!

CSLewis, that's great advice.

It does make me angry that women are being dictated to without being given the full picture. I know that the consultant is just doing his job to minimise risk, but I can't stand the mindset that views pregnancy and childbirth as a medical problem, rather than a natural process.

Thanks for sharing your perspective, Littleturkish. I guess when the induction drugs are working with your body rather than forcing it into something it's not ready for, then it can work well, like it did for you. I worry that your experience is the minority, though!

he did yes, I just knew I wasn't safe where I was and it was hindering my labor psychologically I think, DS arrived safely and happily after a 6hour labor total and 3 pushes. the obstetrician that came to see me after birth at New hospital was in disbelief at what hospital A did and said you did well to trust yourself and leave, it's not the done thing to stop and induction and reverse it once its started due to staffing levels. DS is perfectly fit and healthy, no issues have arrisen at the moment.

If I ever fall pregnant again I'm point blank refusing care from hospital A and will go to hospital B 40minutes away by car.