Induction advice

[Dvh149]

Hello,
I am 41 + 4 today with my first baby and am booked in for an induction tomorrow. I have had 2 unsuccessful sweeps which my midwife was absolutley convinced would work both times as I was already 2 cm dilated when I went for the first one and my baby was fully engaged. She said she couldn't believe how low his head was and that I hadn't gone into labour already. My last sweep was a week ago tomorrow....and I'm still here with no baby lol. I really didn't want to go down the route of an induction as I wanted to give birth in the Midwife unit as opposed to the labour ward, but my midwife is convinced they could easily break my waters and has said that should start my contractions. I was of the mind set that when he was ready he would come. What is everyone's experiance with induction or being so far overdue? I am tempted to ask if I can wait another few days and give him a little while longer to make his appearance on his own (they will let me go 2 weeks overdue before they start daily monitoring) Or am I just holding out for something that isn't going to happen and delaying the inevitable induction. I am so confused about what to do. I haven't heard great things about being induced and maybe this is what is putting me off. I am amazingly not fed up or uncomfortable but obviously want to meet him 🙂

I was induced at 38 weeks. Had DS at 38+3. I don't see why they couldn't break your waters. Mine were broken when I reached 3cm.

If you want to avoid induction just keep on the exercise ball and walk up and down steep hills. That really got things going for my induction.

I don’t think you can put much stock in the ‘when they’re ready theyll come’ etc as some babies are premature! It’s an inspirational slogan, not medical advice.

I would accept the induction - in all likelihood all you’ll need is a pessary or ARM, and you could probably still negotiate using the MLU if that’s the case. You’re also less likely to need a c-section if you’re induced before baby is very late/large.

Good luck whatever you decide x

Hi OP, I refused induction and baby came at 41+6 in the end - I went into labour naturally, but I did end up having the drip late on in labour as my progress stalled. I'm very glad I waited though and didn't have the earlier induction as I am sure it would have ended in a c-section if I had - my labour was long and my body basically just needed a bit more time to do everything. Baby was perfectly healthy. Here is a good article on this by Dr Sara Wickham: www.sarawickham.com/articles-2/induction-of-labour/

Induction for post dates alone (e.g. being 'overdue) can cause a cascade of other inteventions, stress for you and baby, if your body isn't ready, because every baby and mother is different, and some babies do take longer to 'cook'. I would say to follow your instincts on this - if your instinct is to wait a few more days, then do that - you could go in for a scan in a couple of days instead to check on baby's well-being. You can also opt for increased monitoring from 42 weeks if you wanted to rather than having an induction. Most babies do come before 42 weeks and it is extremely rare for a baby to come after 43 weeks so you have at most about a week and baby would very likely be here, with or without induction! Induction is also not without risks - so it's about weighing those up with your current situation (the risks of doing nothing for now) and then doing what you feel is right. Your midwife has no idea whether breaking your waters will be enough and shouldn't be advising you it'll be this 'simple' necessarily. She should be properly informing you of your options and the risks and benefits, not effectively trying to convince you to have an induction.

Induction before your body/baby is ready is more likely to lead to an instrumental birth/c-section. Of course inductions can also go smoothly, and you may find it just helps speed things along... but scientifically, the 40 week due date is artificial, in reality it is a due 'period' from 37-42 weeks and baby isn't overdue until 42 weeks is up. To make a decision use the BRAIN acronym - Benefits, Risks, Alternatives, Instinct, Nothing. I.e. weigh up risks and benefits, consider the alternatives, tune into your gut instinct, and then consider what would happen if you did nothing e.g. what if you waited one more day?

I'm sure you'll make the right decision. Just remember it's your choice, and you are entitled to ask questions and explore alternatives x

i found this article which is great in terms of comparative data:

www.nct.org.uk/pregnancy/your-pregnancy-week-week/third-trimester/overdue-baby-induced-labour-pros-and-cons

@Skylark1990 have I interpreted correctly that induction at term means instruments are more likely but a Caesarian is less likely? Seems an odd result!

@Cuppasoupmonster Hmm I'm not entirely sure - it's not that well written - and I also don't know if those figures are accurate. Definitely different to what I've read elsewhere. E.g. Is it saying that if induced at 39 weeks the risk of instrumental delivery is lower than say induced at 40 weeks or is it saying that if you go into spontaneous labour at 39 weeks, the risk is less if going into spontaneous labour at 40 weeks?

Induction increases the risk of needing an instrumental birth or a c-section at whatever gestation, as far as I am aware - having a spontaneous labour reduces this risk. This may be because women more often need an epidural when induced because it's usually more painful.

There is evidence to show that the stillbirth rate is higher at 37 weeks than it is at 42 weeks (I can't remember where I read this now as it was when pregnant with DC1, but it was in a book...) . As the NCT article says, the way these rates are measured is important and it can be done in different ways.... Here's another Sara Wickham (queen of induction info!) piece on a recent study.... www.sarawickham.com/research-updates/induction-of-labour-at-or-before-42-weeks-of-pregnancy-new-evidence/

Thank you everyone, that had really helped. I have tried calling my midwife today and left a message but I haven't heard back as I wanted to discuss it with her. I'm thinking of going to the induction appointment tomorrow and then speaking with a midwife there as I don't have to have it done just because I have attended the appointment. I just don't feel 100% comfortable with having the induction. Thank you.

I mean, there are always risks to everything.... vast majority of the time, in the absence of other risk factors, letting a pregnancy go to 42 weeks is going to be absolutely fine. Even after this, vast majority - totally fine.

We are bombarded with risk around birth,and it's hard to see the wood for the trees sometimes. Hospitals also like to err on the side of extreme caution (but often this is a policy that does not take into individual circumstances, it's more an 'across the board' generalised approach). And it's also good to question why certain bits of advice are given. E.g. the advice to induce for a big baby alone (in absence of other risk factors) came about after a hospital was sued because one woman wasn't advised this and tragically her baby was severely affected by shoulder dystocia. However, induction also raises the risk of shoulder dystocia and actually statistically, I'm pretty sure (though not 100%!) the risk of SD is higher if induced than it is if you have a 'big' baby and majority of babies who get SD are actually smaller than what would be classified as 'big' anyway.

But because that hospital was sued, hospitals around the country are now offering/telling women to be induced if they measure big despite the NICE guidelines saying they shouldn't.

So I don't think it's ever going to be clear cut.... we need to be informed then take the approach that feels most right to us and put our trust in that...

Best of luck @Dvh149 ! I'm sure baby will be here very soon x