People refusing induction against medical advice

[bollocksthemess]

I’m pregnant and I’ve been in hospital quite a bit lately, I’m in hospital now with a bit of high blood pressure, been here overnight but should be let out today.

I can’t believe the number of women I’ve overheard who don’t want to follow medical advice about having their baby.
There’s been over the last couple of hospital visits:

The lady who was 42+2 and was refusing induction, and walked out of her appointment without being scanned when the consultant said there was no benefit to her baby staying in longer.

The lady who came in at 38w with reduced foetal movement, was scanned and induction recommended, and was refusing induction even when the consultant explained that she was at term and the recommendation for reduced foetal movement at term is to get the baby out.

Today’s lady was in last night with pre-eclampsia at 37+5. Induction recommended. She wants to labour in the pool but obviously you can’t if you’re induced. She wants to go home and see what happens.

I just don’t understand it at all. I’ve had quite a bit of anxiety around this pregnancy and not being able to tell what’s going on with the twins, and while I’m trying to keep them in as long as possible there comes a point when they’re safer out than in.
I’ve seen more medical people in the last few weeks than in my whole life, I’m the sort to never even go to the GP and I’m usually of the wait and see mindset.
But Jesus, when someone who does this for a living tells you your baby needs evicting surely you’re just grateful that we have such good monitoring and get your baby out where it’s safest?
I know nobody wants to be induced, but I just want my babies to be safe, however they come out.

I agree, I was induced due to obstetric choleastasis. I really wanted a water burth but giving Borth to a live baby was ultimately more important to me.

Birth**

Its a symptom of a larger problem - women dont trust the professionals. Having been on mn a few years and read some shockers, I cant say I blame them.

Ugh, people like you are why I hate having discussions on the ward. You shouldn’t be listening in to other people’s conversations, and to then post them online to criticise their choices is beyond the pale.

I agree you can’t help but hear everything on these wards! I always felt the other way sad how quick they are to induce labour, of course if that’s what’s needed but they do seem to induce very quickly, which can lead to c sections, problems bf, etc, birth is risky. 42 plus 2 her baby just needs a little longer to be ready and by going naturally may have better chance of natural birth? 38 weeks, sure baby will be fine but they may want to be in for 4 more weeks. I don’t know I’ve had emergency section, v bac by waters being broken, planned but unwanted section. Birth as far as I’m concerned is all crap and although I think midwifes are amazing I think pregnant woman are treated terribly in the nhs. Maybe one day we will all get our own room before and after birth instead of struggling in a ward at an extremely difficult time. No wonder they don’t want induced sitting in hospital in a mixed ward unable to sleep for days waiting to see if it works or not then ending up in a section after days of no sleep.

In the cases where IoL is medically indicated (pre-eclampsia for example) then I wouldn't hesitate, although I would probably ask for a cesarean. Induction is so often recommended because it is blanket policy for GD, small babies, big babies, high BMI, low BMI, maternal age, ethnic background etc and therefore not necessarily appropriate for the individual and also potentially harmful. As someone already pointed out, induction carries it's own set of risks and the system doesn't make it particularly easy to assess these risks to ourselves and our babies objectively. The women you overheard have probably found it quite difficult to justify making decisions about their labours to doctors and other mothers. With my first, when I eventually got my named consultant in the room to ask if she could medically justify an early IoL, she admitted she couldn't; that it is "just hospital policy" (based on, as it turns out, not very much evidence-based science!) but, by that time, they had scared me too much into going against their advice. They told me, he could die, I could die, ny placenta would die etc...Surprise, surprise, baby was back to back and I ended up with a three-day long induction with epidural and forceps delivery, problems with breastfeeding initially and an all round terrible experience and I will regret agreeing to that induction for the rest of my life.

I recommend reading Dr Sarah Wickham's "In your own time" as it might go some way towards explaining why not every pregnant women laps up any offer of medical intervention.

I can see both sides - I think too often doctors and midwives fail to properly explain things and allow women to make their own informed choice/risk assessment. Doctors think about a standard patient and look at risk on a population level but individual risk is more nuanced than that (I’ve had a lot of conversations with a lot of doctors about risk).

And it’s this sort of attitude by medical professionals which has led to this sort of positive/natural birth movement promoted by everyone from NCT to Instagram mummys to hypnobirthing coaches. Of course that’s all good too (I did a hypnobirthing course and found it very beneficial - but I was also induced and took pain relief) but I think they take it a bit too far sometimes and cause some women to be completely against all intervention in all circumstances.

I’m always hearing about induction “horror stories” but really nothing in the world is more horrendous than losing a baby (and I speak from experience on that front).

I’m being induced next Thursday!
I’m actually quite happy about it. Booked this morning. Obstetrician offered me it as baby is big & we have weighed up the risk of him getting stuck if he continues to grow to 41-42weeks. He is 96th percentile which is still ‘normal’ but with their margin of error for growth scans, potentially much bigger.

My SIL refused an induction for big baby and waited until 42 weeks, he got stuck which ended in emergency C section and traumatic experience for her. I don’t imagine my experience will be easy, but I take the view I can make choices that will reduce the risks for baby & me. Xo

@birdglasspen I disagree about being treated poorly by the NHS. In the last 24 hours I’ve had:
Bloods run twice
Urine dipped and then run by the lab
Three heart traces done on the twins
A scan this morning to check the twins growth and placentas
About a million blood pressure checks
Seen the consultants three times.

Plus I was able to go home yesterday for a couple of hours between finding the problem and being admitted and sort some things out so that I wasn’t stressed about not being at home.
I’m still in, just waiting for the consultant to review my notes and hopefully let me go home today with a plan.

And, don’t forget, there’s hardly anything wrong with me, just some slightly raised blood pressure!
I’m so impressed with the care I’m receiving. The hospital has a great reputation locally so I’m not surprised, I just feel so fortunate to have all this available.

Just to be clear the positive birth movement and the NCT do not promote 'natural' birth. They promote informed decision making and that means using evidence based info to inform women of their options. When you delve into the research the risks Vs benefits of waiting Vs induction are really complex and are not presented to most women offered induction. The term natural birth isn't used by most NCT practitioners. Most use something like straightforward birth as it's less value-laden.

I might have been less enthusiastic about an induction if I hadn't been so poorly after having DD. I went from a trouble-free pregnancy to a bedbound, hospitalized mess for a week. I didn't want to end up like that again. Back in the old days, I'd have probably died, tbh.

Childbirth is risky for both mother and child. Luckily, I had a lovely OB/gyn who did discuss things properly with me, so I had a chance to think everything over and decide.

@EvilEdna1

Just to be clear the positive birth movement and the NCT do not promote 'natural' birth. They promote informed decision making and that means using evidence based info to inform women of their options. When you delve into the research the risks Vs benefits of waiting Vs induction are really complex and are not presented to most women offered induction. The term natural birth isn't used by most NCT practitioners. Most use something like straightforward birth as it's less value-laden.

Well the woman running my Nct class didn’t get that memo!

@Cameleongirl I’m hoping to have an experience like yours next Thursday- it’s my first baby so I have no prior experience but when we went over the risks of having a big baby, I would rather an induction than a distressing birth where he gets stuck. My midwife didn’t agree with the obstetrician offering me an induction but all you can do is make the choice that you think will reduce the risk for you isn’t it. Hoping my experience is positive like yours! Do you mind me asking what type of induction you had? I am having a balloon as this gives the most gradual onset apparently Xo

I've refused induction before and if baby ever did need to come ahead of time I would always refuse induction and opt straight for a section.

Many women have previous experiences with maternity provision in this country that means they are distrustful of doctors/midwives advice. Women who have previously had invasive examinations without their consent or unnecessary medical procedures understandably may be reluctant.

Properly resourced women centred care that explains decision making processes, offers alternatives, risks and benefits and supports women who have been through birth trauma can help rebuild that.

I have a chronic illness and spent many years being misdiagnosed, given incorrect treatments, etc etc, with significant consequences to my health and quality of life. I'm sorted now, but those experiences stay with me.

I don't automatically trust doctors. I advocate for myself, and I don't make decisions before I've got all possible information. I won't be pushed into doing anything.

So while I don't think doctors don't know what they're doing, I don't assume they do know what they're doing either. I ask questions and listen to the answers. I want data incl absolute risks for me personally and I'm likely to read the studies the data comes from. It's scary how many maternity interventions are recommended in the UK based on studies the NHS itself says are of poor quality/low reliability. (Read up on the replication crisis in medicine)

So personally I'm not opposed to induction in principle, but I'm going to need a bloody good reason for that or any other intervention. And sadly, all too often doctors don't like giving those reasons, or they don't actually know them because they're following a flow chart to fit the average patient and don't know the actual risks involved in what they're recommending.

I had an induction last year and I would refuse one and instead have a c section. The induction process put my life at risk.

I was booked for an induction by my hospital at what they thought was 41 weeks, but it was a surprise pregnancy and I didn’t find out about it until late, so we were very unsure about real dates.

I really didn’t want to be induced at that point, and all my instincts were telling me not to. When I called my community midwife in tears about it, she thought my instincts were worth listening to, and got the hospital to postpone it for a bit longer and just get me in for monitoring.

I can look back with 100% certainty that refusing that particular medical advice that I was given by the hospital was definitely the right thing to do.

“ I can’t believe the number of women I’ve overheard”.

Neither can I! How about you stop eavesdropping and judging?

The problem is that in the last ten years the induction rate in the UK has increased 62% from 21% to a whopping 34%! And yet the stillbirth rate has also gone up slightly from 3.4 to 3.9 per 1000. There’s no evidence that induction actually saves lives. Especially when you consider that it comes with a range of additional risks in itself.

I was induced at 38w based on hospital policy. It was due to gestational diabetes and there were no clinical reasons aside from it being their policy. I refused induction on the basis that my baby was growing well and I was well. I explained that if they felt my baby was in danger that I would consent to an ELCS instead, knowing that there is a 50% chance of induction ending up in CS anyway. This was refused using the actual words "it's not like posh spice you know, you won't have help after a section. You should at least try to give birth normally instead of having the baby ripped out of you in a section" - an actual hospital consultant said this to me (PRUH in case anyone is interested - they ignored the feedback I sent in) i was gaslit and coerced into agreeing to induction and other procedures I had also refused on the grounds that there was no medical evidence for them.

In the end, I was induced against my wishes, which ended in a crash section under general anaesthetic. I did not get to see my baby until I came round, and he was washed, dressed and fed by that time. He was 7lbs and in no way needed to be induced early. I ended up with PTSD from the experience and in therapy.

So whilst I trust some medical professionals, I don't believe I should trust hospital policy makers who do not put the best interest of women and children first and I think all women should be aware of what all of their options are, rather than the options dictated by "policy".

The reason why interventions have increased in the UK is because first time mothers now are on average a lot older and more obese than previous generations, leading to higher rates of complications needing obstetric intervention.
Also, while every mother has by definition to be a primigravida once, fewer mothers are having second, third, or fourth pregnancies, which are usually lower risk.
These factors mean that one would expect a rise in inductions, forceps and sections.
It is not some conspiracy by us nasty doctors to spoil your jolly birth experience!

Rates in the UK have increased disproportionately to some other western countries though.

No one thinks it’s some kind of medical conspiracy. But coming up with standard policies based on population level risks (and the end of pregnancy tools you have available) to individual women whoosh individual circumstances might differ radically is not the best way to approach anything. Especially not when more individualised judgements are applied before the threshold number of weeks in the policy but after that it’s like ‘computer says no’.

Thanks to mistakes made by medical professions during my first labour, I no longer put blind trust in HCPs.. Doctors have other considerations besides the welfare of individual mums and babies, cost being an example. With the mum who refused an induction at 42 weeks, yes the risk of stillbirth does go up, but the risk is still relatively low, another option is daily monitoring.

Doctors were really pressing me to get a csection with DS2, funnily enough when I cancelled it, they managed to get hold of the notes from my first birth that I was told were unobtainable and after 2 consultants looked over them they decided that I was absolutely fine to wait it out a bit longer.

If people 'knew their bodies' and what was best, what is the point of the doctors/ nurses? After all can't you just will your body to do the perfect labour?

6 weeks ago i was one of the women in triage saying no to an induction. And I am medically trained.

In the heat of the moment, when something you dont expect to be happening to you becomes a reality your sense of calm disappears and you cannot process things correctly at all.
I was sent to triage as my blood pressure was high and i had a trace of protein in my urine. After alot of monitoring, antihypertensive medications and more checks I was adcised by a consultant that i needed to be induced immediately.
I shut down and went into denial mode. I didnt want it. I wanted a calm and natural waterbirth when baby was ready to come.
I had a really long chat with the consultant (once i stopped crying) and talked through my options.
They allowed me to go home to get my stuff before being admitted to a ward. They said they wouldnt induce immediately but start in 24-48hours.
All of this made me feel a bit more comfortable.

I had my induction but nothing was straight forward resulting in haemorrhage, blood transfusions, urinary catheters, blood pressure drops, crash teams being called twice and now, 6 weeks later im still suffering and have a retained placental fragment that needs attention.
It hasnt been a fun experience.

Your perfect birth is pushed from day one by your community midwife but nobidy sits down and talks to you about what happens should things go wrong.
While not ideal, i understand why people say no to induction as I have been in the position of being terrified and poorly informed.
Sometimes more information and a gentle hand old from hospital staff will help people make informed decisions.

www.google.com/amp/s/www.independent.co.uk/news/health/women-die-operation-male-surgeon-b1986757.html%3famp

Another point to consider is that the medical profession as a whole is inherently sexist. Obviously most pre/post natal care is carried out by women, but when you start introducing inductions/complication risks you bring more males into the room. With stats like the above can you blame women for being cautious?