42 weeks - under pressure to be induced

[Maizie83]

Hi all,
I'm 42 weeks today and have been practising hypnobirthing, which reinforces that it's better to think of a due 'window' rather than a date (37 - 42 weeks being normal).

Since Monday I've been phoned repeatedly by the hospital offering me inductions and I've been declining, until now. By tomorrow, the baby will be technically late so we'll go in for an induction (they've suggested a pessary). We've gone in for two thorough check-ups since Monday and the baby and placenta is fine, as am I. No risk factors other than the duration of the pregnancy.

It's annoying because this week has been stressful as a result of the pressure from the hospital, when I should be relaxing. I have had a bit of a show, am having very mild contractions, and my cervix is effaced (but not dilated) so they can't do a sweep. But I just feel if I was left to it a few more days, the baby would come. I am doing this induction tomorrow because the hospital are calling me every morning, and using very emotional language about a higher risk of stillbirth (but not divulging any statistics). I looked into the statistics and it's something like 2 in 1,000 after 42 weeks - from 1 in 1,000.

Anyway, sorry for long-winded post. Anyone got any informed advice? We will go in tomorrow, but hearing your experiences might be helpful.

Thanks!

Sorry no advise but can I ask if they had been offering you sweeps etc before this week or before you were due. I’m feeling pressured to go for a sweep next week at 39 weeks. I also got the talk about increased still birth etc but my due date isn’t until 24th. There are no problems with me or the baby so I’m not sure why they are wanting to do it early and I’m also in the mind frame that I want to let it happen naturally at least until I’m over due

The hospital have a duty of care to you and your baby. That includes ensuring that you are making informed decisions about your care. The risks are very tiny as you point out, but if anything did go wrong and you hadn’t discussed the risks, the hospital staff would have been negligent.

Use your hypnobirthing techniques to relax and filter out what you perceive to be stressful energy. Did you do Wise Hippo? Could you do your cloak of protection script for example?

Both mine were late at 41 weeks and I find it amazing that you are not desperate by now to have your baby. Many people would be begging for somebody to get the baby out!
My experience of induction was no fun and unsuccessful, but I wouldn't have just kept waiting at 42 weeks.

I went into labour naturally at 15 days over with my first, declined induction at 10 days over

I had a failed induction and finally an ecs at 42 weeks and the placenta was calcified. I'd want to get an induction from that perspective. Placenta can get old

www.nhs.uk/Conditions/pregnancy-and-baby/Documents/IOL-leaflet-40plus-weeks.pdf

They use emotional language because they’ve seen from experience the worst case scenario and don’t want that to happen to you. I understand it’s frustrating but you are absolutely making the best choice for your baby. My induction at 42 weeks was pretty simple and fairly quick, there was extra monitoring but I found that reassuring (although I understand that’s not the same for everyone), I was allowed to stay active and he was born healthy at 42+1, they commented that the placenta looked aged though. Fingers crossed your labour kicks in tonight anyway then you can avoid induction that way. Either way this time next week you will be snuggling your new born good luck

IMO you are making the right decision to go in and be induced.

Hypno birthing is great, but it should never be about fixed ideas of how labour and birth should go. Hopefully the course will have given you the tools to go with the flow and stay calm, even if the birth goes in a direction you’d rather it didn’t. You can still use all the techniques for labour when being induced. I understand it’s disappointing, though.

Good luck! Let us know when your little one has arrived.

But why take the risk?

Firstly thank you so much for your responses. This all reinforces that an induction tomorrow is the right decision and i feel more positive about it now.

I've been trying to inform myself as much as possible, so as to make a decision based on information rather than emotion. Apparently the baby is more likely to get stressed during induced labour. But I'm hoping for an outcome similar to yours @Alb1 and that the hypnobirthing tools will help! It's also reassuring that my body is doing some of the prep work already.

@Comps83 they couldn't do sweeps with me because the cervix was still firmly shut (still was yesterday). I personally think 39 is too soon, but maybe at 40 weeks, or 41 (if your cervix is ready). Up to you really, but if I could do it differently I'd probably up the ante on natural labour inducing methods from about 39 weeks (acupressure/ acupuncture, exercise, raspberry leaf tea etc) because the waiting around has been no fun! Good luck!

Thanks again all!

There's a recent study from Sweden that randomly assigned women to induction vs monitoring after 41 weeks and they had to discontinue the trial because of the increased problems in the monitoring group (www.theguardian.com/lifeandstyle/2019/nov/20/induction-recommended-for-women-still-pregnant-at-41-weeks). This wasn't out when the hypnobirthing books were written, maybe this is why. I was determined I'd decline an induction after reading about hypnobirthing, but the study is convincing to me, there does seem to be an added risk after 41 weeks. (Just my personal view, obviously!)

I can’t link atm, but this is worth a read: BMJ 2019;367:l6131

Oh snap

Good luck tomorrow! You are doing the right thing by your baby. I was induced at 42 weeks and it was all straightforward.

NICE says that your hospital should be offering you monitoring or induction.
All my babies were born post 42 weeks; it seems to be how I cook them. I was a post 42 week baby too.

Baby arrived safely! Waters broke en route to induction and when we got there we discovered there was meconium in the waters.

They put me straight on the drip so as to speed up delivery. I found the drip fine as they ease you in very slowly, but it wasn’t doing what it was supposed to do. It was causing frequent, intense contractions but no dilation. Midwives put it down to an irritable uterus!

It ended in a C-section but overall a very positive birth experience in the hands of a great medical team.

She was 9lb and 1oz and her little hands and feet were flaky. She was definitely done, just a little too comfy!

Posting this in case other mums-to-be are weighing up their decision to be induced and trawling forums like I was!

I would say do it, as the meconium thing was not pleasant and there were risks attached to that.

You may be a woman who has longer gestations than normal but better to be safe. Induction was not the horror I imagined it would be at all. I think if it had gone to plan it would have been a very efficient way of giving birth and took the pressure off me having to generate natural oxytocin!

Anyway that’s my lot! Back to breastfeeding!

Thanks again for the input!

Aw, congratulations! Fab news!

Congratulations! I'm only 35 weeks but two consultants and my midwife have already mentioned inducing me as soon as I hit 40 weeks due to being 'high risk' (I had a bout of high blood pressure at about 18 weeks due to work stress that immediately bumped me up to high risk) and it's so frustrating to already feel like I have a ticking clock. I'm doing hypnobirthing but as I'm already 'high risk' I'm not expecting a peaceful, active water birth as I'd dreamed so it's nice to know that even though you were practising hypnobirthing and your birth wasn't 'as planned' you still had a lovely positive experience x

Have a look at the NICE guidelines. You should be offered as an alternative to induction some monitoring - I had a scan to check foetal and placental health as well as a a half hour of heart rate monitoring to check that all was well. My baby and their placenta was found to be functioning normally. We planned to give her some extra time. Talking to the doctor we booked in induction for 42+5 and I went into natural labour at 42+4. I had a really positive labour and a very healthy vigorous baby born on the morning of 42+5 weeks of gestation. There are increasing risks with increasing gestation length but the evidence doesn't suggest a single cut off. I was pleased with my decision to opt for some more days of monitoring.

@Maizie83. Congratulations.
Glad you had a good experience. I actually had mild ptsd (or whatever they call the birth version) after my induction and c section, so glad your experience was better . There was also meconium in my waters when broken and they still induced me for over 12 hours before leaving me a couple of hours before c section. They didn't seem worried about meconium and I think it is quite common

Congratulations OP! Hope that you have a speedy and smooth recovery.

The tragic results from the Swedish study add even more weight to the research that led to NICE recommending induction between 41-42 weeks, and from 38 weeks for women of 40 and over (approx).

Research by SANDS showed that stillbirth rates dropped in CCGs that routinely offered term inductions compared to those that didn't.

I had a number of discussions with registrars about this when I was pregnant following the death of my first baby. They wanted to 'leave it to nature' and I was very clear that nature didn't always get it right, and that by remaining pregnant after 40 weeks, I would remain in the 'at risk of stillbirth' group, which I wouldn't if not pregnant iyswim.

Finally, consultant agreed to induction at 39 weeks, which was very straightforward. Although it would have been so much more reassuring to have it confirmed that this was possible from much earlier on, rather than desperately hoping that someone would listen to me, and giving me yet another thing to get highly stressed about during pregnancy.

There should be more discussions with women from much earlier in pregnancy about this, as it often feels like badgering when it's only mentioned post 36 weeks. A friend of mine was 'booked in' for an induction at 38 weeks - well-intentioned, the midwife wanted to ensure that she had a slot - but refused because it hadn't been talked through with her and she didn't understand the reason and risks.