Induction at 37 weeks 10th percentile

[Isma23]

Hello,

I would like some advice please as I am pregnant with my first baby. I have had a growth scan at 31 weeks and baby’s weight was 23% percentile. I had another one at 37 weeks + 4 days because I feel her movements are less strong than before and percentile dropped to 10%. The doctor told me I need induction the day after urgently. I called the day after for them to tell me there are no beds available and that I should call later. They called me to say there are still no beds available but that I should come for a doctor to see me. When I saw the doctor (another one) he actually said that there is no issue with growth. He verified the flow to the brain and through the cord and said as for today baby is fine and we can skip induction today but he can schedule me for induction tomorrow… he said according to him induction is not necessary and that I may come everyday for monitoring if i have concerns about movements and come for a scan in 2 weeks. So basically they are throwing the ball in my court. Now I don’t know what to do, do I wait or do I go for induction tomorrow? How can we go from “ you need urgent induction to you can come and we monitor you and check again in two weeks” . I am lost, i have to give them an answer as to accepting induction or not by tomorrow 8.30…

Consultants disagree. I saw three and they all broadly felt the same but had different ideas about when to press go. My view is very much coloured by having an early C section after growth problems, but I think if you’re here now at 37 weeks then you’re unlikely to make it to safely going into labour naturally m, so why not just get it over with when you know baby is term and healthy? Things can change quickly in utero.

I would speak to your medical team again and ask them what they think your options are today, but also in a week’s time, in two week’s time etc? Would they recommend your going to term naturally or is the question about when to induce?

You should also ask yourself how you feel about a C section and if that’s positive, push for that.

Hello OP.

I personally would ask to talk it through with the a consultant again. Pros and cons. Advantages and disadvantages. Is it necessary? Why so? Why the change? What are the risks?

I had my first baby a year ago. She was a small baby and kept dropping on the percentiles although she was fine. I was told by multiple consultants in the last 6/7 weeks I would need inducing early as "small babies don't cope well with labour and contractions". I delayed the induction until over 39 weeks and just had increased monitoring. She was always fine thank God. One consultant told me if he'd have seen me before he'd have induced me at 37 weeks even. When she was born she was just under the 10th percentile. As the conaultant predicted she didn't cope well with contractions at all her heart rate when crazy and I had an emergency c section very swiftly.

Talk it through if you are not sure and don't feel you have all the right info to make a decision.

It's a well known fact there lots and lots of unnecessary inductions and sections! Sometimes they are just not necessary.

See how the doctors evidence and explain their rationale.

Only you can make that decision and we are not qualified to give you medical advice so you definitely need to speak with a consultant again. Personally from my own experience DD had growth issues spotted at 36w scan so I had failed induction at 37+2 and I ended up in EMCS with no time wasted. I wouldn't feel comfortable waiting at your situation but that's just me. Whatever you choose to do I wish you good luck! 💞

I had DC1 spontaneous at 36+4 and DC2 induced (3rd centile) at 37+4.
I noticed the difference being over the 37 week mark: there'd be no harm in baby coming now.

I chose to wait those extra few days with DC2 and it was the best decision for me. Baby was healthy and is ok at nearly a year old now.

I'd say give a few days. Do the monitoring and give yourself time to adjust. Discuss with consultants what the latest they'd/you'd be comfortable with.
(I didn't want to go past 38 weeks)

There's no wrong answer at this point.
All the best meeting your new baby!

Thank you so much for your answer @Sleepygrumpyandnothappy, according to the second doctor I could come for monitoring everyday and come back for another scan in two weeks which will be my due date anyway.. I asked for a c section and he scared me out of it saying it comes with a lot of complications, infections, blood clots. I am so lost, I have a feeling I should wait and monitor day by day but at the same time I feel, what if something happens to her and it is too late because of me..

Thank you @scoobysnaxx - I will go for monitoring tomorrow and ask again. I had a feeling they just wanted me to go home because they didn’t have enough beds. It is the doctor’s explanation that made no sense to me, he said baby is good today so we can, not induce her today but I can offer you induction tomorrow if you want because it has been suggested to you already. He also said there should be an error somewhere because baby can’t go from 23%percentile at 31 weeks to 10% percentile at 37 weeks..

Thank you so much @Olika for your answer. I think I will spend the night thinking about this situation. Hopefully I will make the right decision.

I had my baby at 37weeks due to slow growth. My baby was born 9th percentile, weighed 5lbs 4oz and healthy. He’s now nearly 4 and fine and healthy x

I was in the similar situation to you for my first - I had weekly scans due to other health concerns from 32 weeks and baby didn’t grow much between weeks 35-36. Was advised by the consultant (he was one of the most senior at the hospital) to reduce risk, the baby has to be delivered by 37 weeks via c section, as the baby is safer out of the body than in. I wouldn’t take the risk as things can change fast inside especially when there is conflicting opinions.

My c section was totally fine - ridiculous for the consultant to scare you by saying all that. I have had 2 c sections (scheduled not emergency) for both kids and no complications, no bloods clots no infections - was walking fine by day 3-4. I would push for the c section also, as a lot of the time people end up with emergency c section anyway which is 10x worse. A scheduled c section is very calm.

baby was born 2.8kgs and very healthy

My baby went from 25th to 13th according to the scans from 32 weeks to 36 weeks - was born at 9th percentile

I was induced at 37 weeks with DD, she weighed 5lb 6oz and is a very healthy nearly 3yo now. The only negative was she struggled to get rid of jaundice and had to have light therapy 3 times in the end. But otherwise she was absolutely fine.

Only you can take that decision.

However, I had a similar scare, 82% at 32 weeks and 31% at 36 weeks. I was seeing a private OB, she ordered a test every 2 days, a CTG one day, 2 days later a Doppler, after other 2 days again a CTG and so on until 37.3 weeks.

One side she said that if Doppler (fluids ultrasound) is fine, baby should be fine. However, she preferred to deliver as soon as possible but at full term which was the 37 weeks. I agreed, I believe safer outside than inside because at 37 weeks they are full term. Long time before I had decided for elective C section.

I also had issues with feeling the movements. I could have had a CTG in the morning, but then in the afternoon you may feel reduce movements, so have to go back to hospital again.

Could you get an earlier ultrasound? They could have made a mistake when measuring; otherwise, in your shoes, I would ask to deliver the baby at 37 weeks.

Bet nobody has discussed all the risks that come with induction with you though have they?

I would start doing some serious research before you end up with a distressed baby, in a cat 1 section, PPH, and a lifetime of birth trauma. Plus all your subsequent pregnancies put at a higher risk of abruption.

The saving babies lives care bundle has destroyed maternity services and has traumatised so many women.

I honestly despair.

I think if you’re here now at 37 weeks then you’re unlikely to make it to safely going into labour naturally

I also think it's unlikely to be a straightforward final few weeks. You'll be offered induction a few times. As soon as growth and reduced movement were issues for me I knew it wouldn't result in a vaginal birth I so wanted - at least not without me declining medical advice and without me pulling my hair out as I tried to make the difficult decision/felt guilt about whether I'd made the right call etc.

It's a very personal decision only you and (less so) your partner can come to. Fundamentally, it lies with you of course.

I personally went for the induction at 39 weeks which I had a feeling would result in an EMCS as it was just too early. I just had to give it a try to see if my body responded well to it. It didn't. But you know what? Another three weeks waiting would have been very stressful (and not helpful in trying to birth spontaneously!) for me with a small baby and reduced movement, not to mention potentially risky! I had an amazing birth in theatre despite it being classed as an emergency (I'm sure it would have been better than the instrumental/episiotomy I would have had otherwise) and a huge weight was lifted when my daughter was here, in my arms and safe.

FWIW, I'm due again soon and I'm having an elective to avoid history repeating itself and because the problems I had were because of my pelvis which is the same and which I now know about. I didn't first time round hence tried the induction. The induction wasn't horrendous for me - contrary to what many who did NOT have an induction will tell you - but it can be very long and therefore you're shattered before you even get to being really dilated.

Good luck OP.

Forgot to add growth scan predictions turned out to be pretty bang on for me. I know it's often not the case though.

Hello ladies,

just an update- I went to get a third opinion and the doctor sided with the specialist saying baby is just a small baby and is not in danger. I will have a dopler in 4 days and another growth scan the week after when I will be 39 weeks. She said she orefers me to wait until my body is ready to give birth or at least nearer the time to try and avoid an emergency c section.

Hi there, it's a labour ward midwife. If your baby was born at 2.8 kg at 37 weeks there was no intrauterine growth restriction. There might have been other reasons why the Consultant recommended a CS, however intrauterine growth restriction is not one of them. In my experience, some Consultants are more likely to offer a CS even though they are all meant to sing from a same page. A CS is not a terribly nice operation.

The baby was predicted to be approx 4kg at 28 weeks actually but yes other midwives have said 2.8kg is very good for 37 weeks. The ultrasound flat growth line + very low Papp-a + age factor (>35) led the consultant to make the decision in order to derisk (obviously I could have insisted no to everything and no to c section but why risk it). The c section was fine and was very orderly.

Having said all this, it’s up to the OP what she wants to do as it’s her body and she knows the situation better than anyone else

I had an induction at 37 weeks after being told my baby had stopped growing at 4lb and needed to come out urgently.

I knew they were wrong. I could feel her through my stomach and could feel how chunky she was. I just knew, but I had to go with their advice.

She was born 6lb 4oz, they then admitted they'd been wrong.

You didn't have to go with their advice 😊

They told me she might not make it if I didn't, it was a really traumatic time but ultimately I did have to go with their advice 😔

@PepaWepa I'm really sorry that you were scared and coerced by your obstetrician.

Scaring a woman by telling her her baby will die is not the same as providing evidence and facts which allows her to make an informed choices about her care.

And this, is the exact problem.

@PepaWepa hasn't presented anything that suggests facts and evidence weren’t discussed by the medical team, which included the worst case scenario. She admits she’s the one that “just knew”, not the doctors. On this occasion she was right. She also made a decision to act on the advice given. Great, no harm done.

Just an update, I went to do a doppler scan last friday and baby is fine. I talked to a midwife who asked us what we wanted to do as in wait for the growth scan next friday or induce if I still have episodes of reduced movements. We said we will wait for the growth scan. I will be 39 weeks +4 days. Baby kicks more during the night but sometimes she is very quiet so I am a bit confused everytime she is quieter than usual. The mifwife said that eventually if there is reduced movements they will suggest induction after my scan. Hopefully it won’t take too much time as I will be full term. I hope I will go into labor naturally by then.

Only just seen your update. Glad to hear the scan went well. Hopefully bab will choose to make an appearance by themselves soon.
You've done great to get this far.

Good luck with the next part and enjoy meeting your little one 💐