Please tell me what I need to ask the consultant about induction

[Doughnut100]

I am 37 weeks pregnant with my first child. I was told by a consultant that I would be induced at 41 weeks rather than 42 if I had not yet given birth by that point.

The reason he gave was that I had a medical history, and if there is ever a medical history they would like to induce earlier rather than later. (My medical history is 2 miscarriages, one ectopic pregnancy, and subclinical hypothyroidism that seems to be under control as I take medication and have my thyroid levels checked regularly, and they have been within the normal range for the whole pregnancy. I am 36.)

I came away and asked my midwife why exactly pregnancy loss/hypothyroidism means I have to be induced earlier. She has made a telephone appointment with me to discuss it with the consultant.

I really don't want to be induced. I want to try my best to have as natural a birth as possible (but I am of course prepared to eat my words). Hopefully I will naturally go into labour before 41 weeks so this won't even be an issue!

Obviously I will do anything to ensure the safety of my baby and I won't go against medical advice. But I would like to really understand the real risks and benefits to me of inducing at 41 weeks.

Could any women suggest questions I should ask the consultant at the appointment? This is all so new that I don't really know what to ask to make sure I understand.

Thanks in advance.

Obviously the person who needs to advise you is your consultant, who I know you are going to speak to. So please take my non-medical advice as just my own views!

As you have had a complicated history, sadly including losses, they want to err on the side of caution.

The longer a pregnancy goes on, the more possible risks rise, as the placenta (potentially) stops being as effective.

It's unlikely to be directly linked to your m/c or hypothyroidism if well controlled. It's just about ensuring the best outcome for you.

At 36, in medical terms, you fall into the 'elderly primagravida' category too.

Re 41 weeks - in Ireland (where I am) it's very standard not to be allowed to go more than 10 days over your due date. It seems to be more allowed to go to 42+ weeks in the UK.

Good luck with the new arrival!

Thank you for your response @EarringsandLipstick. I spoke to a second consultant today who moved the date even earlier to 40w3d! It's just based on my age - 36 - not my medical history he says.

I'm pretty upset. He didn't listen to me really. If the level of risk is calculated so differently in different places (apparently in France it's 43 weeks) I kind of feel like I'm being pressured to have an induction based on very subjective interpretations of the evidence. I asked for the actual statistics and didn't get them.

The thing to remember is that you don’t ‘have’ to do anything. The doctors will advise, but they cannot insist, the decision is up to you. Your role is to take all the information to make an informed decision. It might be worth contacting AIMS (Association for Improvements in the Maternity Services) for some information, I know other women who have been given really useful evidence based info to help round out the info given by the doctors, which can be one sided. I may be wrong, but I am guessing the doctor didn’t talk about the risks of induction.

I was induced with my first at 40+13, simply for being ‘overdue’. The induction wasn’t a nightmare, but looking back I would have made a different decision if I had not been led to believe I had no choice. I intend to wait a little longer with this one assuming all remains well with me and baby.

That being said, if the doctors were able to provide me with convincing statistical evidence that induction was the safest route, then I would obviously follow their advice. Just remember it is your decision.

Hi OP,

I’m currently being induced at 39 weeks! I’m 41 (no judgements please from any other posters who don’t know my history) and I have had high blood pressure for the past couple of months. I have been really well looked after by weekly visits to the community midwife. They advised early on that I would need an induction to be on the safe side. I wasn’t keen either as I’ve read a lot of stories about how inductions can go and that one intervention can lead to another which may end up with a C-section. I also wanted the baby to come naturally when ready as far as possible. But like you I would do anything to make sure the baby is not at risk and have followed the medical advice.
I didn’t get induced on the first day they suggested it and have come in 2 days later after various tests showed me and baby are stable.
So far I had a sweep a few days ago, a pessary and 2 x prostaglandin pessaries (I think they are called). All I’ve felt is some cramping. As a FTM they’ve advised the whole process can take longer.
Are you being checked regularly by your community midwife? You could ask for more regular check ups and explain you would prefer to wait before an induction and see what they advise.
I would say listen to the advice as you’d said you would but don’t feel pressured especially if you don’t feel you have all the facts. Ask as many questions as you can and need to. Ask the exact reasons for needing an induction. What are the options? Could you have a sweep or 2 first before starting anything else in terms of induction?
I have been advised to stay as mobile as I can, walk around and bounce on the balance ball. Try not to be sitting for long periods of time. That will hopefully help get the baby into position.

I wish you the best of luck.

I would ask about different types of induction:

• can they do a mechanical induction with a balloon / break your waters and see if you go into labour natural?
• can they do a Pessary and again see if it starts a more normal labour?
• when would they start Pitocin and can you have that as the last resort?

Definitely ask about different routes for induction it doesn’t need to be jump straight to pitocin and ask what time frame they would accept. If they broke your waters can they leave you 24hrs bouncing on a ball / long walks?

Couple of days after that, my water broke while I was lying in bed doing pelvic floor exercises! Beautiful baby delivered vaginally in water at 38w2d.

Congratulations OP!! Glad you got the outcome you wanted.

@AnxiousFTMFriendlyAdvicePlease hope your birth went well! X

@Soulstirring

Congratulations OP!! Glad you got the outcome you wanted.

@AnxiousFTMFriendlyAdvicePlease hope your birth went well! X

Thank you for asking @Soulstirring. DH & I have a wonderful baby girl we are so thankful for. The journey to get there wasn’t quite as expected! The induction got to the drip stage and I made it to 2cm dilated with mild cramps only but then they started getting very concerned about both me and baby. They said the baby’s head position was unstable I think they worded it and it would be dangerous to carry on in case the baby got into distress. They were also concerned about my BP and felt I definitely now had preeclampsia. So I went for an emergency C-section. But me and the baby are doing well and the recovery from the operation has been much faster than I expected. I am very grateful for the care I received.

@Doughnut100 - Congratulations on your lovely baby. I’m very glad to hear your news.