Inducing older mothers at 39 weeks?

[catbertha]

As an older mum-to-be (I'm 45 and this is my first (and only!!)) I was assigned to see the consultant as well as the midwife. I went to see her for my first appointment today (at 19+3 weeks). All is fine, and she is pleased that I'm taking daily low-dose aspirin. However, she did mention that there is some evidence to suggest that leaving older mothers to carry the baby for too long could cause complications and therefore current thinking was to induce at 39 to 40 weeks for mums in their mid 40s. She's not convinced as obviously inducing brings its own problems. I'll be seeing her again at 36 weeks to see how things are progressing and discuss options.

I was just wondering if anyone else had heard about this or had experience of it?

Yes I've heard of it, I was nearly 40 having DD. It was never suggested for me and I ended up with an EMCS at 40+12 but the theory is, I think, that the risk of stillbirth is raised in older, overdue women. If I was to have another I think I would consider it. You clearly need more info though. Do you have a consultant?

You can ask for expectant management instead. So you would go to see the mw very regularly from term to monitor and basically play it by ear, judging by how things actually are with you and baby.

My friend is 41 and her consultant wants the baby here at 38 weeks due to her age

Yes, I had dd at 42 and my consultant suggested this. I was delighted and agreed. It was thought at one stage that it was a good thing to do to prevent placental failure which I think is somewhat more common in older Mothers.

Anyway, I might have read that that has been debunked. I wanted it anyway as I wanted the pregnancy over asap. Thankfully the induction failed and I got my section.

Thanks everyone - that's very interesting. It's not something I'd heard of before, but it's good to hear what has happened to others.

I'm due to see the consultant again at 36 weeks, so will see how things are going at that stage. But that's not until early January - so still a while to go!

By coincidence, I am seeing a consultant tomorrow morning to have this same discussion. Am 42, due on 22 Sep and guidelines here are to induce if you haven't delivered by due dates.

Really need to read up on this before tomorrow but my understanding is that research indicates that there's a greater risk of placental degradation for the over 40s where mothers haven't delivered by due date. I did dig out the figures and it wasn't a huge risk but obviously consultants are somewhat risk averse and I'd feel terrible if something went wrong. But it's DC4, was a bit of a surprise and has been a very straightforward pregnancy (again, relatively - can't walk very well at the mo but that goes with the territory!) and the biggest factor for me has been that my other DC were all late. And am not convinced that the risks of inducing if it's not ready to come out are outweighed by the risks cited in the research. I also had 3 very straightforward births, 1 in a MLU, 2 planned HB so am hoping my body will find its own way.

So am going to ask for management and agree to induction at 41 weeks when am pretty sure I'll have had enough anyway! In fairness to consultant, he was pretty pragmatic so I think he'll be fine with that - it's only my second appointment tho so hoping he hasn't changed his mind!

Good luck with what you decide - very interested to see that you've been told 39 weeks rather than 40 and that different authorities take different approaches - makes me a little more inclined to stand my ground!

Very surprised to read this - had first at 40, second at 43 (I'm 46 now) and I went nearly two weeks over with both. I even planned a homebirth with DC 1!!!
I saw a doctor with Dc 2 who had less knowledge than my midwife. Nobody ever said this to me. In fact, I had a large Dc 1 and had to convince them to give me a scan late on to check DC2 wasn't too big.

This is a useful bit of research to read and discuss with your consultant re: induction of 'older' mothers: www.rcog.org.uk/en/guidelines-research-services/guidelines/sip34/

I was induced at 39 weeks as a 45 FTM. I think this was mainly because they were concerned about the risk of pre - eclampsia as I had a risk of hyper tension but my large baby and my age were also factors.

I wasn't thrilled as i would have preferred a more natural start to proceedings but i guess the objective is to have a healthy baby and mother at the end so took my consultants advice.

mama, I think it's a fairly new policy, there was no mention of it when I had DC3 in 2012 - although that was just before I turned 39 so possibly wouldn't have applied. Mine have ranged in size from 8lbs 5 - 9lbs 10, the latter being my easiest birth and they've never factored that in, so am hoping jt doesn't play a part this time. My concern is just that if they try to induce when the baby isn't ready to come out, it's not going to go well and prolong postnatal recovery. Fingers crossed consultant sees it that way too!

Thanks very much for all this - really helpful! Good luck LostInMess - I hope that all goes well today.

Who knows how I'm going to feel at that stage. My current thinking is, like LostInMess, that I'd rather not have the risk of inducing early. But I may feel differently at the time! And also the article from TiredAndUninspired makes interesting reading and makes me think that maybe it is worth considering.

Thanks everyone!

Hi. Like you I'm 45 , baby due February 29th (leap year).
I'm under the care of a consultant, she also advised that they generally won't let a pregnancy go over 40 weeks if older mother. We're going to see nearer the time if we go for elcs or natural?. I too have a later scan to see how pregnancy is progressing. I feel she's pushing me towards natural, but won't be looking forward to induction, especially from what friends who have been through this have told me. Hope all goes well for you!.