Induction - unsure what to do?!

[Clizzie84]

Hi ladies, so I'm 37+1 today. First baby and IVF pregnancy. Had a very anxious pregnancy due to struggling to feel baby move - dashed up to the hospital 7 times since 26 weeks. All monitoring has always been spot-on and growth scans show baby is growing well.

Anyway... this morning was trip number 8 to the hospital. Monitoring again was all fine. Then the shock came... was seen by a doctor who offered me induction towards the end of the week.

He said he was concerned due to the sheer amount of episodes that I've had; I did explain that looking back now I think a few of them were probably just me being overly anxious. He then said he was just looking at the notes he had in front of him and that (paraphrasing here) if I didn't take the induction and something then went wrong it would reflect badly on the hospital. That upset me then as I felt he was more concerned about the hospital's reputation than about me or baby. I asked if I could at least discuss it with my other half at home (he couldn't come into the hospital due to the Covid-19 restrictions) and luckily that was agreed to. I need to go back Wednesday morning for more monitoring and to make a decision.

I really don't know what to do now - if they'd told me baby was in some kind of distress or growth had stalled then obviously there would have been no question of me not taking the induction. But I'm reluctant to agree to it when the MW told me the trace looked "beautiful" and baby was "happy as Larry" where he is. I don't want to force my body into anything before it's ready to do it and risk having to labour without my partner due to Covid restrictions just because somebody is concerned about a hospital's reputation.

Has anyone ever been induced under these circumstances please that could let me know their experiences? TIA

What a bizarre reason for intervention. You need enough information to be able to weigh up the risks and benefits of an induction of labour. I would ask for a second opinion. Hopefully you will be able to see a different doctor who can explain your options.

@BrokenLink That's exactly what I thought - to me there doesn't seem to be a legitimate medical reason to be intervening. I've agreed to the additional monitoring purely to buy myself some time to think it over - otherwise I think he would have kept me in and done it today if he could have done!

Hopefully I'll see someone different on Wednesday with a better bedside manner!!

Might he possibly have been saying that if he didn't offer the induction it could reflect badly on the hospital? I definitely have times in my job (not medicine) where I have to make people aware of an option they have, for completeness, even if I don't necessarily think they'll want to take it. Could this be something along those lines?

Have they offered a scan to check growth, I know scans are not 100% accurate, and to check placenta and cord blood flow?
I was in a different situation as I was overdue, debatable by how much and didn't want an induction, hospital didn't have room even if I had, and I had monitoring and then a scan. There was nothing wrong on the monitoring it was just an extra precaution.

Once a baby is term (37 weeks) it is generally policy to offer induction after a number of episodes of reduced movements - because it's much easier to monitor a baby that is out! And act quickly if something does go wrong.

My older DC came spontaneously at 38+3, younger was induced at the same point partially because of reduced movements but also because he was measuring right at the top of the scale for head and abdomen size and I'd had trouble with his much smaller sister!

I think also they'd be concerned with frequent reduced movements that had been "normal" you might dismiss something that was something due to lack of self confidence.

Some trusts routinely induce at around 40w for IVF pregnancies anyway, so it wouldn't be that early by the time you get scheduled. Mine was a bit of a pain as I saw the consultant on Wednesday and he pressured the ward to "find" slots for 2 inductions he wanted done asap (me plus someone else from the same clinic) so I only got a bed in the ward rather than a private room.

I'd also say that my induction was basically the same as normal labour only I got to avoid spending most of active labour in the car being sent home and heading back in!

I was induced at 38+2 after 3 bouts of reduced movement. I think with my hospital, at the time, it was offered if you reached full term and had reduced movements. They also did a scan after the 3rd bout to check all was ok. Have they given you a scan? I would expect them too after so many occurrences. Induction can take a long time, something you might want to bear in mind if you cant have anyone with you at the moment from the beginning. But ultimately I was happy to have the induction booked in xx

I believe that he has acted correctly and although you are honest about your own anxiety he has to take the reports of reduced movements on face value. I believe most hospitals have a policy of this once 3 or more reports of reduced fetal movrment are made. Maybe he worded it slightly badly but I don't think he was wrong. If you want to avoid the induction for a week or so, perhaps you could ask for more frequent monitoring and then see how you feel in a week.

@Persipan It didn't seem like it at the time but I was very emotional at the time and not really thinking straight, so it's possible I may have misinterpreted.

@fedupandlookingforchange I had a growth scan last Wednesday, all normal and no issues. Baby is right between 50th and 90th centiles. I don't think they'll let me go overdue due to this being an IVF pregnancy, so I always knew induction was a very real possibility. Just reluctant to go for it before 40 weeks with no legitimate medical reason to do so.

As PP said it’s pretty standard to offer induction after multiple episodes of reduced movements. This is because reduced movements can indicate that the placenta is failing.

I was induced at 39 weeks exactly after going in for second episode of reduced movements. Before we headed to triage joked with my husband about should I take my hospital bag - I did. Initial checks all went well and was due to go back to following day for a scan just for reassurance. My blood pressure was a little high during all the obs so they kept me in a little longer just to monitor it. None of the midwives or consultants seemed overly concerned as bloods were all clear.

Shift change happened and the nightshift consultant came to see me right away to tell me he wanted to induce me as soon as a spot was available. An hour later legs are in stirrups with the cook balloon being inserted. The following morning the midwife who’d been looking after me the previous day came to see me to say how shocked she was id been induced and to pass on her apologies to my husband for getting his hopes up for a Burger King after we had headed home last night which obviously didn’t happen!

I'd say the Dr was right and it would reflect terribly on the hospital if something went wrong and the hospital hadn't offered interventionnafter 7 episodes of reduced movements. And quite right too - induction should definitely be on the table as an option at this point.

The Dr phrased it poorly but I can see what was meant.

I was offered induction after 4 episodes of reduced movements. They told me the best indication of babies health is their movements. There may be a reason they can't detect and once you reach term they'd definitely offer induction. Yes everything is probably fine but they wouldn't be doing right by you and your baby is they didn't offer to induce you with that many episodes of reduced movement.