Declining Induction

[Bluefilly]

Hi, I'm a FTM and am currently 9 days overdue. I'm booked in for an induction on Friday - so at 12 days overdue. But I am seriously considering declining this and going for increased monitoring. I just feel that my body has looked after my baby up until now so perhaps I should trust it a while longer and wait for labour to begin naturally. I also really do not like the idea of syntocinon, so I wondered if any mum's out there have accepted the pessary but declined the drip? I'm trying to decide what options are open to me and which are best for me and baby, so would be grateful if others could share the wisdom of their own experience on the matter, and appreciate any advice?

I was told by midwives that it's possible to accep the pew wary but, as long as your waters haven't broken and contractions cease then you can decline the drip. I don't think it's a common recommendation, but it is possible. For what it's worth, after 2 failed pessaries I was v happy to have the drip and found it absolutely fine, no pain relief required. So not everyone has a horror story.

Place marking as I may face same

Hopefully you'll go into labour naturally but I was induced recently and it was a positive, happy labour experience.

For me, the very real risk of something going wrong with the placenta or baby would be too much. The stories of placenta degradation aren't told just to scare women into induction for the convenience of the midwives...

Best in mind it's not just because people are impatient, it's because the placental function starts to decline after t+14 and the stillbirth rate increases. The choice is of course yours, but the belief that your body will look after your baby is relying on nature, which is mostly amazing but also has its flaws and not all mothers and babies get a good outcome when relying solely on nature. Have a chat with your midwife and consider what level of risk you are happy with. Chances are you will labour naturally anyway.
Also, if you have the pessary and waters broken and then carry on in labour that would be perfect, but if you don't have contractions and decline the drip you may well just sit at 2cm forever.

I was induced at 10 days over. I didn't need the drip as contractions started and I was only in labour for 45 mins (from 4cm dilated to birth). Had a bit of gas and air but was much better than my first labour which lasted 7 hours (still quite quick) and ended up in assisted delivery. So as someone said not all inductions are bad!

Thank you everyone for your input. It really is encouraging to hear some positive induced birth stories. So far all I have heard is very negative experiences and frankly as a FTM it has terrified me! We are now 10 days overdue and still no sign :(. I have an appointment with my midwife this afternoon where I will be having a second sweep (first one cervix was unfavourable), I will certainly be discussing my options in full with her this afternoon. Although I am considering declining induction I definitely do not want to put my baby at risk - he's obviously one very comfy little boy in there....

I was induced last week due to health reasons but my labour lasted 1hr22 minutes if that makes you feel any better and I didn't use any pain relief at all completely natural and delivered a healthy 8lb baby and if you seen me you would be shocked (I weighed 7st7lb full term) honestly it's not as bad as all the horror stories I think some people like to have the 'worst' labour stories.

You can refuse the drip but with you being so far over you probably won't need the drip anyway, I was only over by a day and I had the gel and one pessary

I felt exactly as you do, Blue, when I went waaay overdue with my son (also FTM, and I was almost 40, which meant everyone was twitchier). I had regular monitoring (as fluid levels were dropping), sweeps and acupuncture did nothing, ditto exercise, spending hours on a gym all/all fours, and every possible old wives' tale about hot food and sex - eventually elected a CS at 40+ 15, after the consultant decided I was a poor candidate for induction and would likely end up with a CS anyway. When I had the CS, the reason DS hadn't come the usual way emerged - he was all tied up in the cord. The CS was a pleasant experience, incudentally - in case you end up having one!

I have to say that if I were to have another child, I would not allow myself to go that overdue again. I was of course aware of the stats on placental deterioration and stillbirth then, but actually having a beloved three year old who would have died if it weren't for surgical intervention (so would I, I suppose, in earlier times), has made me realise how high the stakes are.

Check out all your options, and don't worry.

Ok, so I have had my appointment with my midwife, had another unsuccessful sweep but she has said that due to laser treatment for abnormal cells years ago I have scar tissue on my cervix so will more than likely need the pessary to 'get going' but she seemed confident that should hopefully be all that's needed to start things off. The midwife I had on Monday wasn't my normal midwife and wasn't very reassuring. But today I have discussed all my fears etc with my midwife and she has made me feel reassured. She has told me I can opt for the pessary and decline the syntocinon if I'm not comfortable with it. Thanks to all you lovely ladies and an in depth chat with my midwife I feel much better about induction and am going to go in 10am Friday as planned (unless of course baby comes before then). I'll let you know how we get on.

Not relevant for OP anymore, by the sounds of it (good luck on Friday!), but I declined the automatically-booked-in induction (booked for something like 40+11). I did an enormous amount of research about the risks, etc, and felt comfortable waiting it out a bit more. As it was, I went into labour naturally on 40+13 and DC born safely at 40+14.

Hang on, you are 40+9? Then actually you arent overdue, a normal pregnancy as laid out in guidelines is 37-42 weeks.....

Placentas do not just fail at 40 weeks, they could fail at 36 weeks, I'm just trying to find the info, but a placenta can actually function well til 44 weeks.

The other thing you could do is look at foley catheter induction, no meds

The longer a baby is left in the womb the bigger it grows, even leaving labour 3 or 4 days longer might mean a larger person to push out! They are also more likely to poo if they are in there longer, which can sometimes cause breathing trouble. It is up to the mother to decide what she wants for her and her baby, but the obstetric guidelines recommend induction at term plus 12 for a reason, in the same way that there are guidelines for a whole host of other medical conditions or procedures - evidence suggests that this is the safest thing to do

OP - I hope all goes well for you on Friday, some women do just fine with the pessary alone, but if a couple of them don't do the trick the docs will have to think of something else. Please don't worry about the drip if it comes down to it, they start at a very low dose and monitor you and baby to see how you respond. If it overstimulates you they turn it off

FTMs have their babies on average at 40+10d. SO many women worry they're way past dates, but that's because the 40w average was based on women in 1900 across all pregnancies, and subsequent pregnancies tend to on average be shorter each time--many of the women studied back then were on baby 7, 8, or more!

I had an induction. In the same situation again I'd refuse and request a c - section instead. It was 3 awful days.

I've had 3 successful inductions, with just pessaries and no drip.

Ranged between 3 - 8 hrs.

Best of luck.

I had an amazing induction, drip and all. Lovely experience, no constant monitoring, I was allowed to be active, the pain wasn't as bad as I was expecting and didn't need an epidural as most people told me I would.

Best of luck OP, hopefully you'll be enjoying squidgy baby cuddles in no time! :)

The 'fact' that first time mothers have their babies at 40+10 on average is probably a myth, based on one study of 31 first time mothers.

journals.lww.com/greenjournal/Abstract/1990/06000/The_Length_of_Uncomplicated_Human_Gestation_.8.aspx

topsy, no one is suggesting that the placenta just stops at 40 weeks but the risks do start increasing even from 38 weeks and the balance of risks at 40+10/12 is often where medical advice is to induce delivery. It is impossible to say whether any individual placenta is going to be fine at 39 weeks or 44 weeks, so advice is based on population statistics.

www.ncbi.nlm.nih.gov/pubmed/22914394

I've had two inductions, one with the drip, and they were fine. Labour was short each time and I recovered really well. I've also had a home birth and can't honestly say that the inductions were worse.

Interestingly, induction after 41 weeks reduces both the risks to the baby and the risk of a C section.
www.ncbi.nlm.nih.gov/pubmed/21501456

bluefilly, hope all goes well however this baby appears!

I had one of my DC induced. I had a drip. It was fantastic. I was all prepared legs shaved etc and had had a good nights sleep. I arrived at the hospital at 7:00 and gave birth just before 9. It only took 50minutes from having my water broken and the drip and giving birth. It was a bit full on I may have screamed a lot but the fact it was so short and not in the middle of the night like my other 3 meant I felt fantastic afterwards. It was too quick for any pain relief though. My baby was exactly 9lbs.
It was easily my easiest birth.

Having a slow drawn out birth is very tiring.

I've been induced twice. Drip both times and 3&bit hour labours each time with gas&air.

You generally only read induction horror stories online. I had great experiences and would do it again.

My birth was a horror story which I have posted about elsewhere, BUT I am glad I had the synto drip. it was an intervention I needed.

I was overdue, too, refused induction, opted for monitoring. I was booked for such a scan on term+14.

I ended up with contractions the day before, but made little progress over the next day and a half.

Turned up for the scan, still getting contractions, and placenta was fine but liquor was low.

This can mean the baby's kidneys have stopped working and so I was kept in but allowed to keep going with labour (no interventions) as per my request.

Eventually though, progress was so slow I was offered the syntocinon drip (since my waters had already gone after an ARM). I was on it for ages but he was eventually born a full 16 days overdue and weighing an eye watering 10lbs 5oz.

He was so bloated we joked he must have drunk all the amniotic fluid. His meconium poos were certainly not tarry. They were runny.

I suspect he was in a poor position and not putting proper pressure on the cervix to allow effective dilation. Going so far overdue made him big, too.

I had a lot of interventions to get the large-headed little hippo out but the synto duo was the one I was glad to have. In fact, it ran out during my long 2nd stage and all ctx stopped, so it was off to theatre for forceps.

I did have an epidural with the drip as I'd heard an augmented labour can be more painful, but the epidural failed. However I didn't find it more painful, so just had gas and air (for hours. It was a looooong labour) and was fine on it.

He was too big to push out after 70 odd hours so it ended up being a forceps delivery but the syntocinon was the one part of my labour interventions I was glad of later and still think I needed.

I actually found pre-labour ctx more painful than syntocinin ones due to his poor position, so a syntocinon drip doesn't necessarily mean a bad time.

dino i disagree, it is completely possible to check a placenta and see its functionality, with a reasonable degree of accuracy, eg with doppler, so to base it on a general population isnt accurate. It is often the NHS trust that decide the 'rules' and this is filtered to staff level.
Reading AIMS, they provide stats (no source listed) that indicate still birth occurances actually decrease slightly past 40 weeks.
www.aims.org.uk

Reading stats for hospitals in your area is very interesting also, I have access to 4 hospitals, all within 30 mins, and the rates of induction are higher in some than other, as well as forceps, episitomy etc.

Wow ladies, it's so interesting to read all your input - thank you all so much for sharing!

Topsy - I am 40 +11 today, my midwife advised that the recommendation is to induce at 40+12 with the aim being for birth before 40+14. I had never heard of foley catheter induction until your comment, and will be looking into it a bit more today.

Dino - thank you for those links, I will also be reading them throughout today.

Roly - sounds like you had an hell of a time! Glad to hear that the syntocinon was a positive aid.

I am concerned that by being induced I am limiting my chances of an active birth, which is my preference. But my midwife has assured me this is still possible I just need to make my wishes known at the hospital, I just worry that once at the hospital I'll be pressurised into things I am uncomfortable with and that the process may snowball. So I will be researching today (as way as trying to make the most of my last guaranteed baby free day) and then discuss me preferences etc with my OH tonight so if is fully aware of my wishes.

Thank you all for your kind wishes, I'll keep you updated. :) X

How sure are you about your dates? That would influence my decision - with DS2 my EDD was way earlier than it should have been - at least 5 days, so I was gearing up to decline induction until a bit later on. As it happens he arrived at 40+2 ( well 39+5 by my dates) but I was so sure their date was too early it would have given me more confidence in declining for a few extra days.

Mrscog - if I use an online due date calculator using date of conception it actually puts me at 40+15 today, last period due date puts me at 40+9 and dating scan at 40+11. It's all so confusing!

I declined induction with my last two. DC3 went to 43 weeks and DC4 42+5.

Both were fine, placenta was fine. I had extra monitoring and lots of pressure to be induced. The evidence links increased still birth to extended pregnany but there is no evidence whether this is the cause of still birth or whether extended pregnany occured as baby had already died. Its not clear at all.

With my other two pregnancies I was induced and was keen to aviod that.

The pressure I had to be induced with DC3+4 was immense, but I had a very supportive midwife. I also let them book me in for induction a few times as I found it so difficult to be assertive and then cancelled the inductions over the phone.