Can you request and Induction?

[CherriesInTheSnow]

Just wondering if anyone speaking to a consultant has had their wishes for an induction taken into account?

And, do you think I would even need to request one? Have been on consultancy care having growth scans; 30 week scan was fine but baby has shot up at my 34 week scan, and also apparently have polyhydramnios.

They have sent me for a fasting glucose test, but I know these are not as accurate. I did have a GTT at 20 something weeks and results came back clear but apparently borderline.

I'm pretty sure based on that, the huge baby (head measuring on 97th percentile ) and the excess waters that I will have GD, and unfortunately because results were clear I have been eating carbs a lot and drinking fruit juice as I really crave it, so had it been being monitored I'm sure they would class it as poorly controlled.

Due to all this I really do not feel comfortable going beyond 39 weeks at the latest. I don't have another consultant appointment until 38 weeks and I feel really in the dark, I had a normal pregnancy last time so have no idea what they do for GD; I know the guidelines have now changed to allow women to go to 40+6, but is that only for well controlled diabetes with normal growth scans?

I'm really panicking and feel like I've put my baby at risk so feel pretty shit too, I just want someone to explain my options to me and take on board my concerns based on the frantic googling I've been doing that it's not safe to go to 40 weeks :(

Sorry forgot to mention I am 35 weeks now so I also don't think there is an awful lot of time to "fix" any damage I've done and get sugars under control if there are any problems..

I think you need to speak to your midwife and arrange another GTT. I was convinced I had it but I didn’t. Although your test was clear at 20 weeks you could still have developed it later down the line so it’s best to know for sure so you can get it under control

Well they won't shoot you for asking. I was the opposite to you, really wanted to go into labour naturally but big baby, 10lb plus, his head was large in comparison to body as all my children were, Consultant wanted me to go in for induction at 40 +2, I wanted to wait till 41 weeks, we compromised on 40 + 5, I went in for induction and I was 5 cm dilated and didn't even realise anything was happening.

If it is any comfort my smallest baby was an emergency CS and the 10lb was the fastest labour, in fact 5 hrs after they broke my waters he was born and the other 3 were all 24 hrs plus. Big babies aren't always the hardest deliveries.

Good luck.

Thanks Glitter, yes I was sent straight from my routine scan round to the antenatal unit to get the test sorted as songrapher was concerned over the big leap in growth as well as the polyhydramnios; unfortunately she didn't really explain anything to me though.

I just feel like I am running out of time for this to be managed well and I have huge concerns over still birth risk and the risk of potentially delivering a large baby if I go to 40 - 41 weeks

Yes with my first I had a double episiotomy followed by 3 Fentons corrective procedures (2nd centile baby with 97th centile head!!!) so when I had my second I asked whether I sjould have a c-section which the Consultant wouldn't do as there was no medical reason to have major surgery! However he induced me at 37 weeks to ensure that I wouldn't encounter a similar traumatic birth.

I dont think I had excess waters but I too was borderline and had a baby with a massive head. I didnt have GD. Delivered naturally with no issues.
Perhaps rather ask for a test for GD if you believe you have developed that. Rather than jumping straight to induction. If you have a consultant appointment at 38 weeks they could induce straight after that if they want to.

granny that is really comforting to hear :) I just want a straightforward birth, that's all that matters to me really. I do wish I had maybe been retested at a later point in my pregnancy for GD as my mum has diabetes so was put down that I am at higher risk, though I didn't have it last time. But DD never measured either, so I don't know what to think!

Thanks ladies, it's good to hear that they will probably take my concerns into account if the baby's head is large. His femur length and AC are also quite big but his head is off the chart!

I have had the GD test; they do seem to be treating it fairly urgently as was sent straight to arrange it, and was told they would call today (had it yesterday) if results are abnormal. I think when I hear back I will ask if it is possible to bring my next appt forward to talk about this, just to put my mind at ease as I have stupidly been googling about uncontrolled GD and it has put the fear in me :/

The first place they always start for controlling GD is diet, before medication and insulin are considered, so there's nothing to stop you eating a GD recommended diet anyway.

This is really good website about birth you need to sign up (free) to get the big baby induction information. I found it really reassure when I had my big baby evidencebasedbirth.com/resources-for-parents/

Thanks for the link! And yes I have sworn off all sugar now, but am worried as I've been feeling really run down over the last few days especially; sick at night and run down to the point of having to nap during the day, especially after eating. But then I am 35 weeks pregnant! Probably overthinking all this, I'm not great at being pregnant I always worry something will go wrong at every stage, I just want him safe in my arms now :(

Glad it helped. I'm a worrier so I do understand and I am sure the Consultant will as well. Good luck and do come back and tell us how it goes, I'm hoping for a happy update.

The problem is if you're induced before you're ready you're quite likely to end up with a c-section. (It happened to me at 40+2.) So make sure you're comfortable with that possibility. Not that it's the worst thing ever.

Also can you try to eat as if you have GD? Very low sugar/carbs, lots of protein/veggies, etc. Easier said than done I know, but if you have it you will have to do it and even if you don't it can't hurt.

Good luck.

Just a quick note regarding what you said about feeling rough over the last few days since swearing off sugar/carbs. It's really common to get what people refer to as keto-flu in the first week or so of being low carb, it generally hits me hard around day 3 of low carb/no sugar.

It's your body adapting to the lack of glucose which is ordinarily made available as energy to your body very quickly after eating and having to use your fat reserves instead. Headaches are really common during this time, drink plenty of fluids. The good news is that usually after about a week you'll start to feel full of energy (well as energetic as you can get whilst growing a tiny human).

I requested an induction as I had terrible SPD. I wish I hadn't. Before having an induction familiarise yourself with what the Bishops Score is - if you are not favourable it will most likely end up with a section and I'd sooner have an ELCS than emergency any day.

Currently 20 weeks and hoping I go full term and into labour naturally. I also had massive baby but no GD in spite of being very weight. Just genes as DH was 10lb 8oz.

I have to have an induction at 38 weeks because I'm on insulin and that's the hospital policy. This baby isn't measuring big at all, and I'm pretty gutted about being induced, especially induced early.

The consultant that looked at my notes following scans showing a big baby wouldn't consider an induction and I had to wait until I was 13days overdue! I ended up having a 9lb 4 baby by ventouse, the consultant that ended up delivering her said it was touch and go for shoulder dystocia- basically they were happy for the baby to get to 9lbs 9 before considering an induction which wasn't really fair as the scans were showing smaller and I have a tiny frame- not that I'm trying to scare you but basically if I had another baby I would really really push next time to be induced earlier and never let that happen again.

Thanks so much all this is really informative and useful! And thank you for the well wishes I will update the thread too as I had trouble finding info of actual experiences since the guidelines have changed in 2015.

@sthitch so sorry to hear that, shoulder dystocia is actually my worst fear :( I am a bit worried that because this is my second baby and my first birth was very straightforward they will be happy to let me go on even if baby is measuring huge I will take your advice and be really quite adamant.

@AccrualIntentions also sorry to hear you didn't get the birth you wanted :( it must be frustrating whichever preference you have to feel out of control of your own birth, which is sort of what I'm feeling right now. Do you mind me asking which are you are in? MW didn't explain anything over phone, just said they had sent me an appointment letter our by most and not to be too worried! I am awful for phone conversations and just didn't think to ask for any more information :/ so annoying.

I already have a consultant appt on the 23rd so I am assuming something must be up if they have booked me another appt before that, I literally don't even know what the results were though, why didn't I think to ask! It's the waiting for information that is stressing me out most, it has just hit me how close a 38 week induction would be and I really need to be able to prepare

sorry, that should say what area you are in roughly - I think it varies quite a lot!

Sorry Accrual I just reread your post and realised you hadn't given birth yet!

It is a shame that given your baby is having no growth issues that they would induce you :( I was going to say maybe you can quote NICE guidelines at them but I think they can get around that if you are on insulin :( do you have a consultant appointment any time soon?

@Cherries Had one this morning...still getting induced at 38 weeks! The doctor did at least explain to me that it's because of the increased risk of placental failure that comes with GD, not just the size which is what they'd told me before. So I'm still not really happy but I do understand why they feel they need to do it. It feels way too soon though, even though I've known about this for a while.

Hope you get some news/reassurance soon - when I had my glucose tolerance test they told me the results the next day but it was a case of no news is good news, so if I didn't hear from them I'd passed the test....

I had polyhydramnios last time around and was given a sweep at 37 weeks.
Went into labour a few hours later.
If that hadn’t of worked I was being booked in for induction a week later

@midnightflowers do you mind me asking how severe your poly was? Mine doesn't seem so bad but the sonographer has not put an AFI on my notes, just a deepest pocket measurement (9.3cm). My hospital do have a low threshold to diagnose poly as well, with an 8cm threshold instead of 9 or 10. It's good to hear they can arrange them quite quickly if the needs be, I was worried I didn't have enough time with my next consultation not being til 38 weeks

Accrual glad you had an appointment; the placental function is what worries me a lot too; between that and being worried about complications of giving birth to a large baby, I have swung from being really worried about an induction to being quite hopeful that they offer me one without having to ask or fight for it.

Sorry cherries only just seen your last message!
All I can remember was deepest pocket of 14cm.
Has your consultant/midwife told you what to do if your waters break? (I had this stressed to me constantly! But they didn’t go until well into labour anyway.
You can always ask your community midwife for a sweep from 37 weeks.
Mine was happy to oblige as I had ‘written consent’ from my consultant but she was going to perform one anyway due to me having tachycardia.
Make sure you share and stress all your worries about shoulder dystocia etc to your consultant and wish to be given a sweep when you reach term.
Your mental health whilst pregnant is very important and shouldn’t be ignored.
Best of luck! Let me know how your appointment goes!

If you have polyhydramnios then I would definitely request a controlled induction. You shouldn't be left to go into natural labour due to the risk of cord or limb prolapse.

I had poly with dc2 and it was picked up at 30 weeks. The hospital was very blasé about it and left it and left it but a midwife on the quiet told me to get a second opinion. I got one from another local hospital and was admitted there and then on the spot. My AFI was so high and baby was unable to engage and just spinning freely. I was admitted until 37 weeks and was induced then. Four sweeps later things started and I got to 8cm before I needed the drip and it wasn't too horrendous. My waters had to be broken manually in theatre whilst they held the baby in position.

Everyone was convinced that this could only be caused by GD. Baby was on 100th centiLe for size and the rapid growth obviously pointed to GD. Three GTT's later they agreed it definitely wasn't that. Because they couldn't find a cause they needed to check that baby's oesophagus was connected to the stomach immediately after birth because he wasn't cycling the fluid thru just system like he should have been. This was all clear too. He was found to have a hole in his heart at 11weeks of age. That was the cause.

Now pregnancy with dc3 six years later and had to have high risk heart scans to be sure not the same issues and fluid levels seem stable so far.

Don't want to scaremonger and perhaps my situation was a freak of nature but I would be more concerned that the poly is not being taken seriously and not being managed in terms of creating an induction plan rather than just assuming it's GD.