Getting a bit sick of being told I'll be induced at 40 weeks & that it's not up for discussion!

[ScarlettInSpace]

I'm 40 & after a long 6 year journey am currently 24 wks pg via IVF.

Fit & healthy, normal bmi, normal blood pressure, no complications to date, despite the heartache getting here it's been a pretty text book pregnancy so far, she's been a pretty active baby for the last 6-8 weeks!

They pulled my due date forward by 3 days at my 12 week scan due to measurements rather than date of ivf 'conception' which is fine but I still feel a bit like my true due date is the scientific one if that makes sense?

I've been told now by 2 midwifes & 1 doctor that they will induce me on my new due date, and apparently this is not up for discussion or something for me to consider - all they say is that's what they will do 'because of my age', end of conversation...

It's driving me a bit mad to be honest!

Can Anyone shed any light/help with some advice really?

of course if there were complications or there was an immediate health risk to either of us I'd not think twice but I feel like I'm being forced into a medical intervention without being given any choice, or even any information! NHS website says 42 weeks for induction & that it's entirely your choice, which is totally different to what I'm being told

Sorry I think that turned into a bit of a rant

This is a really unhelpful and counter productive way to discuss the risks with you. Aside from anything else, I would suggest contacting the Head of Midwives and telling her how things have been presented to you as it appears that these midwives aren't confident to talk about risk and need some support or training.

Check out the NICE guidelines re management of late pregnancy in women of 38 or older. (I can't remember the name of the document but have a Google).

As other posters say, it's an intervention to consider to manage the + risk of still birth in 'older' mothers and the + risk of placental degeneration. It's absolutely your choice of course, although the only good thing about this is that they've mentioned it early and you've got plenty of time to research and think about it.

I would also ask to speak with someone senior who feels more confident to have a sensible, open conversation about it.

Best of luck and many congratulations!

They should be discussing the reasons with you. It's totally unacceptable to insist on an intervention when the patient has not been fully informed of the reasons for doing so, the risks of doing the intervention and the risks of not.

I felt pressured into an induction at 41+5, although I was 31 years old and had no risk factors so the scenario is different. I argued it out with them, and said I was very happy to be seen by the consultant and then monitored at home. We found a middle ground that we were all comfortable with. I'm a senior health care professional though and am well used to stating my case with medics.

I'd ask to see the midwife or consultant and be talked through all the risks. That way you can make a much more informed decision.

The gut reaction you had against the induction has a valid foundation, don't dismiss it. You will have already spent a lot of time thinking about how your works, where your strengths are in planning your birth. Your baby's well being is more important to you than anyone else. You will also have been calculating how you are best able to care for baby when she/he arrives. Something that was said to you doesn't fit with all of the above and you need much more information to factor it in.

When someone then takes up the surprising position that you want to do your baby harm, all sorts of thoughts rush in (will my baby be taken away from me?). It is very confusing and usually leads to silent compliance, which is not best for baby.

Ask the questions again, you need to know for the well-being of your baby.

"How your body works"

I conceived naturally at 39, had a trouble free pregnancy etc but because I was going to be 40 by the due date I was also told I'll be induced on my due date. I couldn't have been more grateful tbh. Aside from the medical aspect (increase of stillbirth, degradation of placenta etc), not having to tolerate another 2 unnecessary weeks of pregnancy filled me with joy! As it was, ds came of his own volition at 39+6. I went for an unsuccessful sweep at 39 weeks too.

I don't think your medical guys have acted that professionally and should explain to you more explicitly BUT they're not inducing you for fun. It's for your and your baby's safety. Good luck.

Some birthing units are more medicalised/intervention based then others.

Educate yourself with the facts. The percentages. Discuss with the head midwife.

Also, if you do decide to be induced (and it might all be academic if she decides to put in an appearance at 39 weeks for example), also consider acupuncture to help get your body ready, if you're into that sort of thing

I felt exactly the same with dc1. I measured small for dates throughout my pregnancy and I don't believe I was as far advanced as the scans suggested. I also hadn't reached "that" point in pregnancy where most mums proclaim that they've had enough and need baby out! However I was 31 yrs so wasn't booked in for an induction until 42 weeks. But I still felt baby wasn't ready to come.

When they time came however, the hospital was full and had had to close for new admissions . I had to go in daily for monitoring and was finally taken in 3 days later - so officially 43weeks by then! Baby was still covered in vernix.

With dc2 I was huge and still now really believe he was ahead of dates. He was induced at 42 weeks but I could of done with him coming at 38! When born his skin was very dry and wrinkly and he was a huge 10 pound!

However, both my inductions went well. There were no complications. It was great having a date to plan too.

Even in this day and age pregnancy is not an exact science, so the professionals have to go by research and statistics, you really need to consider this.

I didn't find the hospital staff I saw were very patient when it came to explaining my choices, but I did have a lovely local midwife at my gps who I was able to discuss my worries with, which really helped - might be worth you looking into?

I agree with pp - acupuncture is worth considering - i had it pre-pregnancy and in the early weeks then again from about 36 weeks. I do feel it made a difference

I'm currently overdue by 16 days and im feeling the pressure to be induced from every midwife I see even though the doctor is happy for me to wait being otherwise low risk.

Risk of stillbirth is the reason theyd want to induce you but I disagree with above that your baby/body will be ready at 40weeks, it could be nowhere near ready and that could make for a failed induction.

It sounds like they are being totally unprofessional, they are supposed to warn you of the dangers of induction as well as the risks of not.

The rates of an unexplained still birth is as follows:

37 weeks - 1:645

38 weeks - 1:730

39 weeks - 1:840

40 weeks - 1:926

41 weeks - 1:826

42 weeks - 1:769

43 weeks - 1:633

(Note that the rate at 37 weeks is almost the same as at 43 weeks)
Cotzia C. et al. Prospective risk of unexplained still birth in singleton pregnancies at term: population based analysis, British Medical Journal, Vol. 319, pp 287-288 1999.

Indigo are those stats for women over 40or everyone?

It will be the stillbirth stats and I would go along with whatever they say.

Have they explained the risks of induction? The likelihood of it leading to a c section? Personally I would opt for a c section over induction, no doubt if you ask for a c section you will be told no.

I had a Vbac where the consultants/ midwives etc put great emphasis on uterine rupture (yet offered induction - which can increase the risk of rupture). My next pregnancy was a footling breach - not one mention by any medical staff about the (high)risk of cord prolapse and what I must do if I went into labour to prevent baby dying. Far higher than the risk of uterine rupture in my previous pregnancy (which was 14 years after my c section). Someone said ‘they didn’t want to worry me’. Yet they whittled on and on about uterine rupture 3 years earlier.

If you don’t think you are being listened to ask to speak to the supervisor of midwives or consider hiring a doula for the birth. Sadly pregnant women are often told what they can or can’t do.

I wanted to be induced a week early with DS2 as I was so scared of stillbirth I was 40 with countless miscarriages behind me and the thought of losing my son was too much to bare. I had a sweep at 39 weeks and he was born the following morning. Best thing I ever did 👍

Not read the full thread but I think the main issue here is how the HCPs aren't giving you all the information for you to make your own informed choice about induction. Of course it is up for debate as this is your body and your pregnancy. More than likely, if they would have approached this differently I.e. Due to ABC risks it is recommended that if baby isn't born before your due date then you are induced on your due date. How do you feel about this?
But what has happened, is they have taken away your autonomy and completely disempowered you by telling you what you are doing. It always surprises me how this often happens in maternity care but not so much in other areas of medicine. They should be empowering women and not telling them what to do without explanation.
I have never experienced this - I have always been given all the information to make a completely informed choice.

missed out from the 'more than likely' sentence that you may have agreed with their rationale if approached differently

I had dd at 40 and was due for induction at 40 weeks. They were too busy though so she came naturally 8 days late and I got my water birth. It's all about risk factors. If you tick enough boxes they recommend it. I think first baby is another risk factor and there are probably others. Just try and go with the flow.

Indigo - that report is like comparing apples and oranges it's nonsense in this situation

Look at the royal college of OG report 2013 - incidence of still birth age iver 40 is significantly higher as gestation reaches 40 weeks and at 41 weeks it's 3.5 times higher than those ages less than 35 and more than double those aged less than 39

It's a serious issue and basics on still birth are totally irrelevant here

Genuinely thank you all for replying, it really has helped me be clear it's not the action that's the issue, it's how it's been handled.

I've had to research, fight, question, appeal & push back on everything over this whole long journey, I don't know why I thought it would change now!

Hopefully I'll see my actual midwife at some point (next appt is with a third temp cover) so I'll be able to ask for an informed conversation & feel consulted rather than just told what to do by people who it feels like are just ticking boxes. On reflection I think this has been a big part of the problem. Even the consultant appt wasn't with the consultant, it was with a member of his team who just ran through a checklist of Q&A and wouldn't answer anything off script...

I really like the suggestion to ask for the risks associated with doing & not doing, rather than just the reason for, that feels like it opens up a much better conversation.

Thanks again I feel a lot better