Induction before due date for older mums

[Miller2021]

Hi everyone, I'm 10-and-a-bit weeks and I had my booking-in appointment on Friday, at which the midwife advised that I'm completely "low-risk" aside from my age - I'm 41 and this will be my first baby.

She mentioned that the docs prefer to induce before the due date in cases like mine, due to my age. She didn't give further details, although I can discuss with a consultant at 16 weeks, which I will. My initial reaction is that I'm not keen, especially if my only risk factor is age and everything else seems to be going well. But obviously if it seems like the right thing to do, for me and the baby, I'm not going to refuse.

Does anyone have any experience of this? Or of not being induced for their first birth after 40? How did it go?

Would recommend the book Inducing Labour by Dr Sara Wickham. She covers most things about induction in it, including inducing older mums.

Should clarify, I’m not in the same situation as you but induction in general makes me anxious so thought the book would help and it has!

@maisiedaisy64 Oh that's brilliant - thank you, I've just ordered this. Looks like my kind of book.

I’ve found it really good, just looks at the research and distills it down! Another one I found good that I saw recommended on here was Expecting Better by Emily Oster. She’s American but did a U.K. version of the book with U.K. relevant research

I'm also wondering about the answers to this as I'm in exactly the same situation as the OP.

The midwife at my booking appointment also mentioned the possibility of ELCS instead of the induction. I'm concerned about the high rate of EMCS and instrumental deliveries for first time Mums over 40 and was wondering if ELCS is the safest way to go. Obviously a (relatively) uncomplicated VB would be the best option but not sure how likely that is with the induction or even without induction.

Would also be keen to hear others experience of the different options.

The reason I was given for this by the way is that the placenta is only ever supposed to be a temporary organ and they think that in general in older women it is more likely that it fails sooner, so they don't like us going overdue. That's not to say your placenta will fail just that it becomes more likely as you get older. I chose induction, but waited until 41 plus 2 (I was 37) didn't want to risk any longer.

I’d love to know if the book mentioned is in favour of it as I’ll be 43 when our baby comes and both our previous two were late (7 and 14 days overdue). I would find quite comforting not going overdue this time if it seems sensible to induce, I don’t really know the pros and cons but didn’t particularly enjoy an induction with our 2nd.

I’m 40 years old, FTM and was under the doctors supervision throughout my pregnancy due to age and ethnicity. I was also told that they would like to induce me around my due date. I agreed and was induced before my due date which ended in an EMCS. It’s totally a personal choice but I felt that I could not ignore the advice but understand it’s a very personal choice

I was told from the outset that I would have to be induced at 38 weeks because it's an IVF baby. Apparently IVF babies tend to be smaller so statistically don't fare as well if left longer. I felt as you do but I didn't argue - I just thought I'd see how my pregnancy developed and how my baby was actually growing. Turns out he measured big all the way through so I'm not convinced I needed to be induced because it was IVF. (In the end I had to be induced at 35 weeks anyway due to a health condition, and of course I didn't quibble.)

You need to know the specific reason, like is it the placenta as PP suggests and how would you know if yours was failing? They'll probably have some statistics about stillbirth rates at certain gestations by maternal age that it would be good to know. Then you can make a more informed choice.

I was 40 when I had ds and was also advised to be induced on my due date, which I was quite happy with. Couldn't think of anything worse than being pregnant for up to 2 weeks longer than I had to be. As it happened, ds came of his own volition at 39+6.

I am 41 and a few days off my due date. Apparently a hospital consultant wants to have a conversation with me about induction at 41 weeks, due to maternal age. I've said I'm happy to have a scan to check blood flow and the usual HB checks if he goes over his estimated due date. I've had an induction before and will avoid again, if possible.

Thank you all so much for your help.

@maisiedaisy64 I've read Expecting Better and it's a lovely book, the chapter on induction advises against inducing as a matter of course (but obviously not in the case of maternal or foetal distress etc) but it doesn't give any specific advice on age as a risk factor. @Wildrobin the book Maisie recommended is about a fiver for Kindle, I'll report back once I've read it - from some of the reviews, it sounds like it's quite negative about induction in general.

@whatcangowrong @Holskey Thank you - I will ask specifically about the placenta and signs that it's failing.

@trrk Yes, I was thinking along the same lines: if it's that bad, surely they'd suggest ELCS? The recovery time worries me, but better than likely problems and an EMCS.

@MeAndZig @Shmithecat2 @Confused521 Thank you so much for sharing your experiences. It sounds like most mums-to-be are at least a bit wary of induction, so at least it won't be a surprise to my consultant when I say I'm not keen! @Confused521 good luck!

I'm 39 and had my baby a month ago, I got induced on my due date, it was really straight forward and I gave birth quite quickly. I lost a baby before and wanted this one here safe. I have read that induction can take days and still end in a section. I've also read that an elective c section has easier recovery

Just about to be induced
Just turned 40 years old

Preg 39weeks 6 today

Let's see how it goes

Last preg 41 weeks gestation
Days in labour

Was hellish

Hoping this one not as bad xxxx

Love to everyone in this position or will be v soon

I assume statistically there are more problems with older mums going over a certain time to deliver naturally, so I would go with their suggestions.

Statistically going over 40 weeks anyway carries a higher risk for everyone

Hi @Miller2021

I had this with my first pregnancy.
The consultant decided IVF plus being 36 meant I was at risk.

I was very anti induction and spoke to my midwife about it. She was brilliant and did a sweep twice before my due date (twice in the week before I think) and my waters broke the day after my due date and labour started and I gave birth two days after due date.

I was booked in for induction or c-section (the consultant had agreed to c-section before) three days after due date so I just got in there with the sweeps.

Funnily enough I now live in a different area and am now 38, also IVF pregnancy, and not high risk or under consultant care…

Good luck!

Induction is recommended as standard practice for all women aged over 40 with references to an "increased risk of stillbirth". The most recent study which is really comprehensive (looked at 17,000 women) did show a reduction in stillbirth for women aged over 35 who were induced, but the risk drops from tiny to even tinier. Likelihood of stillbirth if not induced was 0.26 per cent, likelihood if induced was 0.8 percent. So then you get the headline reported as "induction reduces stillbirth rate by two thirds" which is technically correct but not very informative. Obviously this reduction in risk has to be balanced against the increased risk of intervention that comes with induction. The study also doesn't take into account anything but age. I'm 41 and 36 weeks pregnant with my second. I am going to say no to induction at 39 weeks but may agree to do it a couple of days after my due date.
You can read the study here: journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002425

Hi, no advice but I’m in the same position, I’d love to hear why people who’ve had induction would avoid it in future. I’ve been told I’ll be induced between 39 and 40 weeks, really hoping that baby comes before that.

So does induction lead to a higher change of EMCS? I need to read more around this and the risks around induction.

I’ve been told I’ll be induced at 41 weeks because of GD. Haven’t read many positive things on mumsnet about induction, but I’m resigned to it if it’s best for the baby. Interesting to see the book recommendations

I was 41 on giving birth and induced. It went fine - I needed two pessaries and then went into labour. I felt that the doctors are the experts and relied on their judgement on this.

@mowglika it depends what kind of induction and whether you've had children before, I think. Some people find it fine. I didn't.

The pessaries didn't work for me after several days (first child) and I had to have the drip. A lot of people find being induced with the drip extremely painful though I'm sure you'll find exceptions. I wanted to die. I would do it again if need be but I wouldn't try to do it without an epidural. That was my big takeaway. I had an epidural in the end but I'd already been through hell, and it only worked on one half of my body.

I needed an episiotomy and forceps too but that only really bothered me afterwards when I found sitting on infected stitches just awful.

I almost had to go for an emcs because my baby's heart rate was dropping now and then, but I don't think that was because of the induction.

I don't want to scare anyone who is having an induction. I just wish I had been warned that effective pain relief would be needed. I thought I would be able to manage on gas and air because I have a decent pain threshold.

Currently being induced

Pessary yesterday morning
Not much happening
I think the drip is next

Will keep you updated
40 weeks today and just turned 49 years of age

Argh @Holskey that does sound frightening. I only know a couple of ladies who had been induced and they didn’t have much positive to say about it either

@Queenie6655 the best of luck I hope it’s all going super well and baby arrives safely!

I had mine at 41 and 43. I did have sections but only because I developed type 1 diabetes and the babies were large - my waters broke with my first so had him just short of 37 weeks and he was already well over 10lbs! Not chubby just long. They were keen for VBAC with second but she grew big too (in her case she was chubby). No mention of inducing because of age, and as I said, sections only due to size.

Sara Wickham has a new book called in your own time about pretty much this (and for any other of “high risk” mothers). Induction is offered not compulsory and you can choose additional monitoring instead or to just carry on as if you were 39.
You can the consultant for their evidence and rationale for what they suggest.
If they “play the dead baby card” you can immediately demand an apology and report them to PALS. The chances of anything happening are far far lower than of having a straight forward delivery.