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.

If you thought that your NCT practitioner was promoting straightforward birth to the detriment of giving evidence based info on interventions and pain relief etc, you should me a complaint about her. The NCT has a rigorous complaints process. Unless it was years ago of course.

I can see it from both sides.

I was offered induction from 40+6 with my first baby and I just didn’t understand why.
I was healthy, baby was fine. I felt really pressurised by the midwife & doctor and like I wasn’t being given the information to make an informed decision myself.
(did finally consent to induction at 42 weeks, although it failed and Gaby was born by c-section at 42+5!)

Second baby I had complications in my pregnancy and was told they wanted to deliver at 37+5. The implications of waiting any longer were clearly explained to me and I agreed immediately.

Two of my friends begged for ELCS and were induced instead and then in the end still went for c sections as it still didn't help. By the time they got the emergency c sections, the unnecessary pain they went through had already traumatised them and also nearly lost the babies. The push for induction in some circumstances should be pushed for a C-section instead from the start and not leave women in labour for hours and hours.

I was 41+5 days and booked in for a induction but thankfully gave birth exactly 4 hours before my induction appointment so I didn't need it and it came naturally because it was his time and I knew it. From the start I knew my due date would be the week my dc was born in anyway but in the scans and the way my due date was calculated it looked like I was overdue. I think the option for elcs should always be available and for me I would rather get a elcs than a induction because 50% of time you would need a emergency c section anyway. What's the point of risking the mother and baby and making the mother go through all the pain when she's 50% likely to get a elcs.

Sorry that was in reply to Fleur405 and should have said 'make a complaint'.

I agree with you OP. I was induced with my first baby at bang on 37 weeks due to a sudden change. I had zero hesitation in agreeing to it.

Obstetric care is a bit of a minefield, and HCP'S walk a very thin tightrope a lot of the time.

They're not psychic, and they don't have a crystal ball, they have to work with the clinical information they have in front of them at the time.

Scans, monitoring, CTG's etc only provide a snapshot of information, where they can say that at that specific moment in time, all was well. Or, all wasn't well and an induction/LSCS was advised.

At some point, decisions must be made, based on guidance, experience and the clinical picture.

Personally, I'll never forget the two women I have cared for, who blamed themselves for the death of their babies after declining induction (43 weeks and 44 weeks) . However hard it is, I will never let my own experiences or choices show to my patients, and will give them honest risks vs benefits but my god ill remember them forever.

@USaYwHatNow how awful. Why did they decline? For different reasons or the same if you don’t mind me asking?

Perhaps they have had bad experiences with previous inductions. My own induction went horribly wrong and I ended up having an EMCS under general anaesthetic. If I ever have another child I will be requesting a planned section from the beginning. I couldn’t go through a pregnancy knowing that an induction could be waiting for me at the end of it.

I can't agree. Medical professionals can't force women to make decisions about their own bodies and pregnancies.

As someone who nearly died as almost the direct result of an induction at 40 weeks, I'll be waiting until at least 42 before considering it again if I have another DC.

Surely it's farcical that every single woman, with all our differences and individual pregnancies, has a 40-week gestation period? Especially given the frequent inaccuracy of early dating scans.

@fibeee my experience was like yours. GA, severe haemorrhage, ended up in intensive care separated from my DC due to covid and had multiple blood transfusions along with kidney failure

@danorak I’m sorry to hear you had such an awful experience. That sounds truly horrific. I hope you are recovered now.

My EMCS seemed to go smoothly but I had a difficult recovery with slow healing and multiple wound infections. Also was at the start of the pandemic so getting medical attention after the midwives discharged me was a nightmare.

I’m not trying to spread fear. Several of my friends/family have been induced with no complications. However my own experience was so traumatic that I fully understand why some women don’t consider it an option unless necessary.

@wizzywig

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?

🙄 so you don't go to the doctor when something hurts? Or something isn't right?......

"Knowing your body" is important. This coming from someone who did a PhD in patient monitoring. You cannot measure "how" a person feels! You cannot measure the intensity of their pain! Doctors have to listen to what the patient is saying.

The issue is that medical advice is not consistent and can vary even within the same hospital. Lots of hospitals just have blanket rules and that’s problematic. I was 42 weeks plus 2 with my third. I had independent midwives and there was no pressure to induce. If I’d gone over longer I would have gone in for a scan and taken it from there. I suspect if I’d been in the system there would have been enormous pressure for an induction by that stage- with my first they tried to book an induction- just in case- before my due date had even come! It’s not as straightforward as accepting advice .

Totally agree. I had multiple miscarriages and my dd was an IUI baby. I was under consultant led care. I’d hoped for a natural birth and had hired a private midwife for my midwife care and to act as a doula. I was recommended induction at 39 or 40 weeks. The midwife tried to dissuade me. I went with induction and highly medicalised birth resulting in an EMCS. I couldn’t have cared less. I just wanted a healthy, live baby after years of ttc. I didn’t give a flying fuck about the birth experience! With ds I was under consultant care again and went straight for a planned c section at 39w5days.

It’s because it isn’t always safest. There are risks to induction and it increases the chances of other interventions being necessary whereas when your body is ready, it’s a lot more likely to be straightforward.

Personally, I’d never agree to induction. If baby had to come out it would have had to be a c section. Natural labour or C-section, no in between for me.

It’s not always individually evidence based, the decision as to whether to induce, it depends what your trust’s policy is.

It’s not as simple as induction = safer. I would want a lot more info about my individual case before making a decision.

I did decline induction and baby was monitored. Had she not been ok in there I would have asked for c section.

@Babdoc

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!

Granted, you're not out there to ruin life for birthing mothers but that still doesn't make induction appropriate for everyone - even if they happen to be older first time mums. Studies I have come across can't even seem to agree on the definition of an older mum!

The main reason inductions are on the rise is because of NHS policy, based on NICE guidelines, which are not always evidence-based. They also focus on short-term outcome (getting the baby out alive) and IMHO not enough on the introduced risks of intervention. Also interesting note, there has been an increase in inductions but no decrease in stillbirths.

Honestly, no one can be forced into any medical procedure. As long as they know the risks and benefits of said offer of induction, and they decide not to take that offer, then it’s up to them.

Induction isn’t without its risks, and it’s a long uncomfortable procedure. I wouldn’t agree to one without a decent reason.

@Goopamz

I don't think it's appropriate to pass judgement on other women's decisions regarding their own body and medical care. Every woman is entitled to take on board the advice and make their own choice.

This.

I refused induction for a while. I was offered induction purely based on the fact I was over due date and no other medical reason. I read up on the risks of induction v risks going over 40 weeks and for a while felt that, with monitoring, it was safer for my baby to wait. When I then decided the risks had swapped over, I agreed to an induction, which subsequently failed and I had a cascade of intervention ending in an emcs. I do have a healthy child, I'm not anti-intervention, I do read scientific/expert advice and I made decisions based on what I felt was safest at each stage.

I'm guessing from your post that you haven't actually given birth before? I tell you, go through a traumatic induction experience and then you can judge whether it's unreasonable to decline further inductions.

I have read up a lot about it, before making my evidence based decision that induction because my baby was 'overdue' was not something I wanted to go through again.

Scan dates can be wrong (I was certain mine was 7 days early) not everyone gives birth at 40 weeks (some countries term is 41 weeks). Induction is absolutely not a risk free, certain to get the baby out safer, option. It's nieve to think so. I'm glad so far you've had a great NHS maternity experience but sadly some of us really haven't. We weren't listened to, we were ignored, we did have things done to us we didn't want and therefore I don't trust their judgement any more and I will absolutely will not consent to a procedure unless I think there is a valid reason for it with a sound medical rationale. I do question the doctors because there isn't a one size fits all for birth and often women are pushed down a route of intervention without proper risk assessment for them personally.

I’m totally with you here. I’m over it

@Confused521 you're right. Also the evidence isn't there because of the guidelines that have been followed for a few decades. Any pregnancy going over the due date was immediately sent to CSection (my birth!).

Apparently in communities with less medical intervention (they mentioned the Amish in the article) it is much more common for pregnancies to go to 42 or even 43 weeks. We don't have the data because we're not allowing it. I read a lot of medical articles a couple of years back and there was evidence to suggest that it was ok for a healthy pregnancy to wait until 42 weeks before induction. Knowing this, I was shocked at the bullying I experienced, especially in the NHS (I gave birth in another country as well, not Europe, private hospital, more traditionalist).

I refused induction. I was overdue but not by as much as they thought based on the 12 week scan (I knew when I ovulated). My mother’s babies were all late, so were my sister’s, and my first was late too. It is clearly genetic for us. I did a lot of reading and found that the studies done into the risks of going up to 42 weeks were not conclusive by any means, and also provided no way of taking into account individual factors such as genetic predisposition. My view was that the evidence of increased risk for me and my baby simply wasn’t sufficient to take on the potential risks associated with induction. It didn’t help at all that the two consultants I spoke to refused to acknowledge or discuss those risks. Even when I stated clearly that my concerns were not about my birth experience but about the risks to the baby, and requested that these be explained to me, both consultants stuck to browbeating me with statistics about stillbirth and saying that I was prioritising a nicer labour over my baby’s safety. Given that I know of someone whose baby died as a direct result of an induction (though her circumstances were highly specific to her) this evasiveness did not reassure me. It was also made clear to me that in all likelihood I would need to wait several days between insertion of the balloon catheter and breaking my waters. Since I was pretty confident I’d go into labour within the given time frame it seemed pointless and possibly dangerous to interfere with the process. Sure enough, baby arrived a few days later at 41 weeks exactly by my count (41+4 by scan dates), which was also when my first arrived. Like some PP I would have acted differently had there been a clear medical reason for inducing. But induction is not risk free, and the professionals are quite reasonably only able to advise based on highly generalised guidelines. I have also had several personal experiences of the medical professionals making some demonstrably poor calls. Doctors are marvellous and we are lucky to have the NHS. But they are not infallible and it is not unreasonable for women to do their own research and reach their own conclusions, particularly if the doctors refuse to discuss the situation in a sensible, adult way.
Incidentally I also agree with those PP who have chided the OP for listening in on ward neighbours in vulnerable moments and then ridiculing them and their concerns on a public forum. Poor form.

@sjxoxo. I didn’t use the balloon, I went straight onto an Oxytocin drip, which brought on strong contractions. I opted for no pain relief at all as I felt the drip was enough medication to contend with-so it bloody hurt! But he popped out quickly, a few stitches and I was done. Three hours from when I was hooked up to the drip, but full-on labour was barely 30 minutes.

I think my obstetrician felt that speed was of the essence with me, as I’d hemorrhaged badly with my DD
(even though she was out in 6 hours).
I need to be sewn up fast.

I hope yours goes quickly too!

@danorak

I can't agree. Medical professionals can't force women to make decisions about their own bodies and pregnancies.

As someone who nearly died as almost the direct result of an induction at 40 weeks, I'll be waiting until at least 42 before considering it again if I have another DC.

Surely it's farcical that every single woman, with all our differences and individual pregnancies, has a 40-week gestation period? Especially given the frequent inaccuracy of early dating scans.

@danorak. It shows how different everyone’s experiences are, as I was the exact opposite. DD was a non-induced vaginal birth with a severe hemorrhage and landed me in intensive care for a week; DS was a drip-induced induction, over in three hours and I went home the next day.

I know I was lucky and my obstetrician was fantastic, she made the right recommendation for me personally. Not everyone is so lucky and I can’t understand why inductions are sometimes allowed to drag on for hours. The whole point is to get the baby out quickly.

I was in hospital today and there's the opposite issue here. Lots of women being told they need induction but there's no beds at all. So lots of hysteria and ranting witnessed as they have no idea how many days they're going to have to wait.

I had a horrible experience with my first birth so I'm dreading being told I need inducing again.
I ended up having to leave today without seeing a doctor (after 6hrs) as they were closing the day unit I'd been sent to and there was no sign of anyone coming to see the patients.