Pressure to induce due to high blood pressure - so angry

[jezza1234]

Hi all,
Have to vent. I am 39+3 wks and have borderline/high blood pressure that has been creeping up a bit during pregnancy, which i take medication for and monitor at home. I have never had any protein in my urine or sign of pre-eclampsia, baby growing absolutely fine (50th percentile), doppler of the Umbilical cord absolutely fine, all CTGs absolutely fine, no other symptoms.

About 2 weeks ago the midwives and doctors start telling me that i’m going to need an induction at 39/40
Weeks. I ask for evidence to better understand the risks and benefits of induction vs expectant management, and after a long conversation the doc agrees that it’s fine to wait until 41 weeks, the main issue is pre-eclampsia and slightly high bp is manageable. I agree to go into hospital for regular monitoring.

First monitoring appt today. I get bp reading of 140/90 and 145/90, slightly high but the same as i’m getting at home. New doctor comes in and starts telling me that my baby is at risk of stillbirth and i need an induction.

I was so angry and upset. I said to him that that the word ‘stillbirth’ is a very inflammatory word to throw around and asked him to explain why it was necessary to have an induction now. He immediately backed down, apologised for using that word and said ‘it’s pre-eclampsia we’re worried about not high blood pressure’.

What if I hadn’t done my own research and gathered evidence? What if I was younger and less self assured and not able or comfortable challenging the assertions about stillbirth?

I have never in my life experienced the kind of pressure and emotional manipulation from medical staff that I have since becoming pregnant. I usually am quite happy accepting the recommendations of medical staff because I feel comfortable that these are based on good evidence and research. This is absolutely not the case in obstetrics, and given the different information i have been given by different doctors at different times, there doesn't seem
to be any internal logic either.

The only thing doctors seem to want to do is induce, induce, induce - yes it might be the best way to prevent the possibility of something happening, but that’s like saying that leg amputation is a great idea because it will prevent 100% of sprained ankles! I know that in some cases induction is important and useful, but rates of induction have gone up and up with only small drops in stillbirths and negative outcomes for women. That means many hundreds of thousands of women are being needlessly induced.

This is what the research is showing - but it’s so hard as a pregnant woman to stick to my guns on this in the face of emotional pressure basically saying ‘you’re going to kill your child if you don’t induce’.

Please excuse the rant - just so frustrated that the last weeks of my pregnancy have to be spent feeling like this.

I would also be asking for a c-section if I were you. I wish I'd done it. I didn't even think about c-sections when I was pregnant. I was to busy meditating and picking out birthing balls and a two-piece cozzie I could wear in the pool. I think I was very self-indulgent. When pregnant, we ARE vessels. If it's a wanted pregnancy, that's what we've chosen. It doesn't mean we're not women in our own right, but we have taken on a massive responsibility. I wish I'd talked less wank and just focused on what the more likely outcomes would be for me.

@marianellacordero686 That sounds like a really cool spell. I'd put it on the feminist forum if I were you.

I had similar borderline high blood pressure with my first baby from around 35 weeks. No other signs of pre-eclampsia. Twice weekly BP checks.
I got to 40+8 and started a long labour. I went in as pain was getting too much but the midwives couldn't find a heartbeat. Was ambulanced down to the main hospital, with soaring BP. Scan confirmed baby had died and they suspected a placental abruption. I had been in labour for 16-18 hrs by this point.
Laboured through the night on morphine. Next morning BP through the roof and was given magnesium sulphate to prevent the seizures or stroke of eclampsia.BP was at one point 200/120 - hypertensive crisis/medical emergency. Almost moved to ADU.
Finally gave birth horrifically after passing out on and off, ventouse then forceps as baby was stuck.
And that's just all the medical side of it.
Please don't ignore moderately high BP. Pre-eclampsia can be asymptotic.

I get you op - the Drs are treating you as though you have no agency in these decisions. I think it's very common obstetrics, I had to see the most arrogant consultant ever who started with 'I won't let you..'. He got the full hairdryer treatment and backed down so quickly that DH felt quite sorry for him.

I agree you need to ask about the risks of waiting and monitoring versus the risks of inducing. Nothing is risk free and you should be able to make a well informed decision.

@jezza1234 I agree with you. Too often is the "stillbirth card" pulled out alone. Ie DRs don't give you the actual figures the risk of other complications or even the risks of the action they are suggesting.
I get some posters are angry but there is a big problem with coercive language and overstating of risks while downplaying risks of other actions in obstetrics. They are now explaining all of the options and they do seem to defer to induction, early and often. The rates are increasing massively and that fir csections. The negative outcomes of those are increasing too.

Also note I am not doing my research from google and I do have medical knowledge and the right sources. Even the NICE and RCOG guidelines say don't induce for some of the reasons commonly given for inductions.

@nocoolnamesleft shame they don't also apply that to induction when they offer it. Depending on the method, it can ncrease the risk of PPH, fetal distress, uterine rupture, infection etc. Not many people I have spoken to got that information about induction.

[quote AHobbyaweek]@jezza1234 I agree with you. Too often is the "stillbirth card" pulled out alone. Ie DRs don't give you the actual figures the risk of other complications or even the risks of the action they are suggesting.
I get some posters are angry but there is a big problem with coercive language and overstating of risks while downplaying risks of other actions in obstetrics. They are now explaining all of the options and they do seem to defer to induction, early and often. The rates are increasing massively and that fir csections. The negative outcomes of those are increasing too.

Also note I am not doing my research from google and I do have medical knowledge and the right sources. Even the NICE and RCOG guidelines say don't induce for some of the reasons commonly given for inductions. [/quote]
It really isn't just coercive language. Have you read some of the awful stories on this thread? Women's babies have died.

Stop with the theoretical and listen to the doctors when they say your baby needs to be delivered. FFS

@FunnysInLaJardin
No. There are always terrible stories. Some where people actually listened to the advice or followed the doctor without asking the right questions. Did you know doctors are human and may actually not know everything or always have your best interests at heart.
I am not saying you ignore them and nor is the OP. The idea is you get all of the information and make an INFORMED choice rather than a blind one.

However, I completely agree that they push induction so much, in fact one of my friends went in twice towards the end of her pregnancy because of reduced movement, and they said if you go in 3 times for this reason they will automatically induce. So she didn’t go back despite being worried. Baby ended up being 10 days overdue and absolutely fine!

This is just crazy! Did she understand that reduced movement is one of the best indicators that the baby is distressed?? Of course a 3rd episode would suggest that it's time to get the baby out! Oftentimes the first episode of reduced movement results in an emergency delivery... Glad all went well for her. She was very lucky

Personally, having experienced a neonatal death, I would go with what the doc suggested.
I have struggled with blaming myself for not taking earlier action, and my DD was born at 37+5 by EMCS - i really wouldn't risk it further of the doc is advising you not to.

You're playing chicken with your babies health OP and you've been warned that now is the time to stop it. Thank fuck doctors and midwives are still allowed to speak frankly about things like this.

@IckyPop that is so traumatic, I'm so sorry for your loss

I was also very reluctant to get an induction, I'd read all the books and was terrified of the whole cascade of interventions. Towards the end of my pregnancy my BP started creeping up, and I had to go in for daily monitoring. It was just a bit lower than yours. I was allowed to get to 41 weeks, by then I just wanted the baby out anyway so I agreed to the induction, which didn't work. . Well, things can go wrong very quickly. My high BP turned into pre-eclampsia and then HELLP syndrome, and I had to be given a GA for an emergency caesarean. I lost a lot of blood and me and my son nearly died. I ended up in HDU for eight days and needed blood transfusions, I was very ill and couldn't hold my baby. The trauma of it contributed to some serious PND too. I was too scared to have another baby after that (although I am very happy to have one!). So please don't dismiss what the doctors are telling you, I'd hate anyone to go through what I did, or worse.

Condolences to all that have had to go through a neonatal loss.xx

@jezza1234 I experienced almost the opposite to you. I was aged 29 having a vbac which was supported by everyone in hospital except consultant anaesthetist.

I went into labour at 41 weeks (previous baby emcs at 42 weeks) was 4cm dilated by the time I got there and for the next 36 hours no progress. I begged for a section as I felt the pains did not feel like labour pains only to be told all is well and I'm just not used to labour pains.
My consultant wrote in my notes not to allow too long labour due to placenta abruption, thrombocytopenia and a few other issues but no one read my notes and consultant was on holiday, it was a bh weekend. In the end I started bleeding very badly and was finally rushed for another emcs. My baby had the cord wrapped around his neck, shoulders, arms and ankles. The registrar that delivered him whispered to the senior midwife that there was no way this baby was coming out alive vaginally not realising we heard him.
I requested and reread my hospital notes again last year and I still get chills.
You're at the very end and I wish you a safe labour and birth, nothing wrong with c sections or inductions. On my first baby, I never wanted to be induced or sectioned. I will be having my third section in 5 weeks time aged 34. Just wanted to share my story. Best of luck.x

I completely agree with you OP. My baby was small for gestational age. A number of junior doctors used the same tactics on me to get me to agree to an induction from 38 weeks onwards. I asked for more information- I wanted to know the actual risks as a percentage etc but was met with resistance and no further information. I was treated like a naughty child because I would not comply and was just told I was putting my baby at risk. Luckily my midwife sorted an appointment with a consultant who specialised in fetal medicine and he was actually able to run through the stats with me so I could make a decision and actually give informed consent. I did agree to an induction but not at 38 weeks because I was happy to accept the very slight increased risk of stillbirth compared to the larger risks of failed IOL, emergency c-section and assisted delivery with an early induction. This was my call to make.

Women do not forgo their right to bodily autonomy because they are pregnant. Of course, we all want our babies to arrive safely but there are often competing considerations and the woman is the only person who can weigh them up and give consent.

I had preeclampsia with a BP lower than yours at my antenatal check in the morning to having a BP more than210/110 in the evening. I ended up in ICU , with an emergency Ceasar, a baby in NICU that I couldn't hold for a week and PTSD.
I'm a doctor myself and it was terrifying how fast things went wrong with preeclampsia

@Maxiedog123 - but if the OP is well informed of potential outcomes and the relative likelihood of each scenario it is for her alone to weigh these risks up against the risks of induction.
Lack of informed consent is a big problem in maternity care.

@jezza1234
I haven't read every reply here but it I'm not sure you're being understood correctly.

Of course you would do everything to protect your baby! No one should doubt that!

The pressure from medical professionals is overwhelming sometimes - I really do believe there are often other reasons for induction pressure other than just the safety of the baby.

I say that because of the amount of inductions happening, it's gone so high over the years. A more controlled birth is no doubt easier for them, but possibly not for the birthing mother who is essentially giving over some control once an intervention happens.

I don't think we can ever control other people's negative talk (both in pregnancy and life in general!) best thing is to control our own reaction to it- stress and tension is the last thing you need right now so try and let any comments be water off a ducks back.

Someone commented that childbirth is 'dangerous' - I just don't agree that it is in general-of course if there's a problem it needs attention but if scans have shown the baby is progressing well then think of childbirth as a natural process and that your body is designed to do it.

I do agree that doctors should be listened to as they are just passing on risks.
I just believe that if there was definitely something wrong you wouldn't be given a choice.

But here you've been told a risk and now the rest is your decision.

Trust your instincts - and go with how you feel. Absolutely nothing wrong with an induction if it's necessary.

But otherwise your baby will never get it's own birthday wrong.

Wishing you lots of luck OP, try to relax and don't let any comments bother you at this time

[quote Helenahandbasket1]@Maxiedog123 - but if the OP is well informed of potential outcomes and the relative likelihood of each scenario it is for her alone to weigh these risks up against the risks of induction.
Lack of informed consent is a big problem in maternity care.[/quote]
Being a well informed lay person, versus medical advice is a no brainier.

Some of the language on here ‘tactics’ amongst others is shocking.

What exactly do you think that the doctors benefit by being ‘inflammatory’ and mentioning they’ve seen babies die because of X Y Z. Like the women on this thread who have experienced it. It’s just so so sad.

Personally I didn’t feel anything but safe when speaking with the doctors/consultants/midwives when having DC1.

If you compare what’s happened to allow you both to be in that room having that conversation: you just had sex, maybe a few times. They had years/decades of experiences of looking after women and babies with the goal being keeping everyone alive. They’re not ‘using tactics’ to scare you into submission for their own weird fetish of enjoying seeing women on drips/sliced open.

@Alfaix

1 in 200 is not a very small risk!

Especially huge when you ARE the 1 in 200!

I have seen a lot of conversation and push for change on social media regarding informed consent in maternity care and the way language is used, including from obstetricians and midwives themselves.