How to decide when/if to be induced

[Reddy01]

Hello, I know it is all personal choice but I'm looking to see what other people's experiences may be around induction after due date. Despite it being an ivf pregnancy (initially high risk) I am classed as low risk and my growth scans have been all around 50th percentile with fluid and blood supply all normal. They offered a sweep at 39 weeks which I have refused and they are supportive of. My midwife has said roughly 60% first time mothers are still pregnant after their due date and it is all up to me how long I wish to continue without induction.

How long did others leave it past their due date and why? I am not in much pain etc as now on leave and I have tried everything possible from early on to prepare for labour but I also fear the increase risk of stillborn, although I know my individual risks are low.

Also myself and DH were born after 42 weeks (after late inductions) so I have a feeling this little one may be quite happy being inside for a while!

Any advice and experiences would be appreciated.

For me it wasn't a consideration. I wax convinced with DC1 that I wouldn't go to the due date and they arrived at 38+1.

With DC2 labour started on their due date and they were born in the early hours of the next morning.

There is an increased risk with going over your due date but I'm not sure how much that risk is increased by. Maybe you could discuss it with your MW?

If she's offering a sweep at 39 weeks, has she said why? If you don't want it then, could you have a sweep at 40 weeks?

And are you drinking plenty of Raspberry Leaf Tea? It won't make baby arrive any earlier but it should make the labour a little easier for you

My 3rd was just over two weeks late. I would avoid induction if possible so long as all else is well.

@TinyMouseTheatre it is just when they offer here. If there are complications then they offer them from 36/37 weeks here otherwise they like to wait until 39 weeks.

I dont have that early feeling at all sadly. I have been on the tea for weeks, dates, pineapple, hand expressing since 36 weeks, ball bouncing and stretches pretty much throughout, I still walk the dog for an hour or more every day and doing curb walking.

I have an appt with my midwife next week but she is saying that it is up to me, hence not knowing whats best!

@Notellinganyone thank you, did you have extra scans to check on things? Did you have any inductions in previous pregnancies? I would like to go without intervention but I do worry about the weight of risk/benefits.

I had an induction 2 weeks early with my 2nd baby because id had spotting throughout and I'd had an extremely fast labour with my 1st baby (who went 5 days over due date). And there was also possible reduced amniotic fluid, i was convinced my waters were slowly leaking and every night was scared of going into labour alone at home and not being able to get hold of anyone and giving birth alone with just my young son there.
So when they offered the induction by this point it was a bit of a relief even though it was my worst fear in my first pregnancy.
It really wasn't that bad. It helped I was already 2cm dilated when we got to the hospital so I didn't have to do the gel or the pessary. Basically went straight upstairs to get my waters popped which wasn't nice but was over quickly and the sensation of everything coming out isn't unpleasant.
I hated having the cannula put in (I needed antibiotics IV) but I imagine it depends on the HCP doing it.
I'd arrived at the hospital at 9pm and baby was born around 5am.
The only further intervention I had was the hormone drip to kick things up and that did get everything going.
I'd managed until then on just gas and air then asked for pethidine which tbh was a waste of time, if I do it again I'd just stick to the gas and air. I didn't feel any extra special pain relieving effects from the pethidine and it made me go a bit trippy in the following few days.
Gas and air is fucking amazing I love the stuff, it's not for everyone, but I got into a good rhythm with it and it really helped.
In short, I'm glad I had my induction, the unpleasant & painful bits weren't fun but they were over quickly, and i actually enjoyed some of it the labour room was lovely, dimly lit & i had my music on throughout. It felt alot more calmer and controlled than the chaos of my first birth.
Good luck whatever you decide to do, you'll get through it no matter what happens x

@Wavescrashingonthebeach aw that's nice to read. I'm glad you managed to see the positives in it. I am not worried about pain etc as my tolerance is pretty high for some odd reason and I don't think there's really any method of birth without some sort of pain or lasting injury. I'm really looking forward to baby being here, it's just all so out of your control so I'm not sure whether to submit to that or try to control it more.

I was induced at 42 weeks with my first and he was born the next day. Spontaneous labour at 41+3 with my second and 40+4 with my third, both of whom I had declined any labour inducing interventions for unless there were concerns other than date itself or we got to 42 weeks again.

My induced labour was fine, fast and intense like all my births have been, I think I was about to go into labour anyway by that point tbh!

Given that it’s an IVF pregnancy and you are 100% certain of the dates I wouldn’t go too far overdue, especially not past 42 weeks. Maybe aim for 41 weeks but if movements reduce or anything be prepared to go earlier? I no
people want lovely births but ultimately the safe arrival of the baby is the aim.

Just go with your gut. You'll know in your heart whether it's time to be induced or not. Hopefully it won't be necessary but if you do go for it don't worry about it being excess medical intervention. I think that's what alot of people worry about and this scaremongering of "cascade of intervention" that will lead to a long drawn out labour and everything from forceps to an EMCS.
I didn't even need stitches after my induction birth. I was so amazed at how quick I healed down there compared to my first birth.

@Instructions that's quite impressive just going later and past all due dates ☺️
Can I ask how did they monitor you past 40 weeks? I was told if I refused sweep at 39 weeks (which I have) then I have to wait until 41 to have another scan to check fluid and blood supply. I didn't know if maybe that was nearer the 40 weeks then I might be more confident to go longer without induction. I do think I would be more open to induction nearer 41 weeks onwards but I just don't know if it would make things better. Did you have a date in mind with the first or did you just feel enough was enough?

I was induced with all 3, well I say induced with number 2. I had pre enclampsia with all 3. DC1 was early and took about 12 hours

Dc2 they took me to labour ward to break my waters but they'd be reabsorbed and I was 7 cm dilated, no pain, baby arrived about an hour later.

DC3 was officially induced 3 days before I had them. They were giving me pessaries but nothing was happening. On day3 the doctor said I was still high and fully closed so they think I'd need a section the next day. This was about 9 am, I started contracting around 1pm and baby was here by 3 pm.

I've had mainly positive experiences of induction.

I had a sweep at 40 weeks with both pregnancies and went into labour the next day. Not sure if they will offer you one again at 40 weeks? I also had sweeps at 39 weeks both times, but I wasn't near ready.

I’ve been induced twice and went with the advice of the doctor. Ds was born 10 days after due date and dd was 11 days after. With both I started the induction process the day before they were born.

id rather have gone with the doctors advice than go with my gut and end up with the worst outcome. I just wanted my baby here safe.

@Pandasnacks yes and no, it was a natural cycle so they do know the dates better but it wasn't the usual set ovulation and I had no meds other than progesterone. So it is ivf in the sense of it was the embryo put back in a few days after ovulation peak but it's also not really been medicated so it's not too much the same. I totally see where you're coming from though and was considering this. To be honest, I was told by the clinic that 99% of ivf pregnancies here go early c section so I am kind of shocked when they said they are happy for me to decide and go up to 43 weeks all being well. Thankfully no reduced movements throughout but that has crossed my mind. Knowing that the fluid and blood supply are completely normal has helped.

Also i never had a sweep with either of my pregnancies the induced one and the none induced one. My friend had a sweep and didn't mind it at all though.

are you not in the UK?

@Wavescrashingonthebeach yes being first time I think I am over thinking a lot and just trying to do what's best for baby without really knowing!

@2chocolateoranges sadly Dr's aren't really that helpful. I've seen 2 different consultants and both have said up to me to decide and just depends if I can be bothered to continue to be pregnant for much longer - genuinely that was their words. Neither were worried if I wanted to go longer and they have left me at midwife lead. It is nice to hear that inductions have worked for many with birth resulting in the next day or so. Can I ask what type of induction you had? They have offered me 2 sweeps and if that doesn't work then I would assume it would be hormonal drip since there would be risk of infection etc. No other offer of induction is offered firstly meantime.

@PreggersWithBaby2 thank you! That helps me think I have made the right decision not going for it at 39 weeks. I always thought the pregnancy was long and this stage feels long but having to think about this decision and when, the days are flying!!

@2chocolateoranges

@CharlotteCChapel we're your inductions sweeps or was it straight to water breaking etc with all? Sounds like you were in good hands, others in this health board are pushed to make decisions around 37 weeks if they have pre-eclampsia diagnosis. Were you around the same time or did you get to leave it later?

@Pandasnacks I am in the UK and it was nhs ivf. Every clinics do different procedures and meds. Medicated cycles didn't work so we decided to try natural and I was surprised it worked!

My induction was absolutely fine and led to a very fast labour (3rd baby though). Induction was at term + 10d. Where I am they don't like you to go more than 10d over, though in my case they said they would be happy with waiting another day or two; by that time I was getting fed up and wanted it over with though. 42 weeks feels like stretching it a bit, tbh, never mind 43.

Sorry OP I wasn’t questioning your IVF, I’m totally uneducated about that so don’t doubt you at all 😂 I was surprised your NHS trusts says it’s fine up until 43 weeks as it’s against the guidelines and frankly is dangerous advice, but I no other countries vary in advice.

Whatever you decide I’d just keep an open mind, those scans can’t predict the future, they just no your baby is fine in that moment and things have been going fine. If you decide to go a way over just carry on being vigilant and happy to change your plan if something changes. I think in any pregnancy it’s best to not have too much of a solid plan as it can just lead to disappointment and extra stress.

I am going to be induced on Tuesday at 39 weeks, because of ivf and geriatric pregnancy. I never wanted to go against the induction, because of the increased risk of stillbirth. Even though the chance of stillbirth is very low, even if it is increased.

I am still hoping I will go into labour before Tuesday, but it is unlikely.

I had my first bang on 41 weeks, went into labour naturally. It was long, exhausting and painful. Second time round I was going to get an induction but they said I was dilated enough to break my waters (which was v painful). I asked for an epidural which they gave me before the oxytocin drip and it was wonderful. I had no pain, I even napped through a lot of it. They told me 90 mins ahead of time to stop topping up the pain relief so I’d feel the contractions for pushing and it was all very quick and easy. I’d heartily recommend it. The first time I was fully bought into hypnobirthing and a water birth but second time round I had so much more energy when it came to pushing. I wish I had done it first time round. But that’s just my personal experience, and I appreciate not for everyone.

@BeLemonQuoter can I ask if you have had any other risk factors for the pregnancy that they are wanting to induce you? Are you measuring big or placenta failing at all? I know those are the two main things here that trigger wanting before term if it's not a c section! I'm technically geriatric too but they don't consider that since eggs were harvested before 35?

I personally would never go past 41 weeks. The placenta starts breaking down and the risk of stillbirth goes up. Why would you risk it?

Having read your updates, if they don't offer anything between 39 and 41 weeks I personally would take the sweep at 39 weeks. Babies are considered full term and even if you have the sweep in this date, they may not arrive for another couple of days.

It just seems a bit long to leave it without a growth scan.

Sounds like you're doing everything right though to encourage LO to arrive and to have a quick delivery

Are you using "Count The Kicks" app?