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.

I believe current NICE guidance is for induction at 40+5 after a big study in the US found that it was safer by that point. I was induced with my 1st (but at 39wks), and it was a bit of a car wreck generally.

I’d accept an early induction again, and I’d definitely ask for an induction at 40+5 as I’m an anxious person and I'd just be glad to know that bb was coming, even if the birth wasn’t the best experience for me again. But that decision is very personal and everyone makes it differently.

@DGPP all depends on the risk factors really and personal choice. It is something I am considering hence the post. It's amazing how many are born 41/42+ and that's why I'm a bit stuck as I know that dh and I were both over 42 week mark after being planned induction/section but times have changed quite a bit. It is funny how everywhere does things differently and there doesn't appear to be a right/wrong.

@TinyMouseTheatre too late as past the 39 wk mark now 😂. I get midwife appts weekly to check heartbeat etc and had my scan just after 39 weeks so I'm not too concerned that the placenta is suddenly breaking down after a couple of days. I did the counting kicks very early on but stopped as I just went with my gut. If I'm honest, I have more movements now than ever. I don't think I really go 10 minutes without noticing a movement unless I'm walking/doing something distracting but even then there's always something. I was also told not to count (controversial I know) but more told to figure out times when baby is active and inactive. I don't necessarily like either way. It's fine if you're day to day is the same but I started to panic at weekends when I was busy as I wouldn't be sitting feeling the movements as I'd be busy. I have learnt specific times when activity is greatest though and it's impressive baby is still in there after some stretches!!

@ANiceCuppaTeaandBiscuit 😂 love how your name somehow matches the image in my head of how your second birth went in comparison! I am definitely open to all options expect forceps unless really needed! I was forceps and I've had eye problems ever since (only one in family with sight issues so we blame that 🤷‍♀️)

@Melusina123 I had that duration in my head for some reason, midwife may have mentioned it. I do think anxiety does get the better of me and I don't think id necessarily want to go over the 41 weeks unless I knew for certain in my heart that I could...considering I'm posting this after 39 weeks makes me think aim for another week or so! If only things were so much more scheduled and robotic 😂

@Reddy01 actually there is a right/wrong. Please read the academic studies on why going siginificantly overdue risks your baby’s health and/or life. Am baffled why you anyone would choose to increase the risks around what can already be a risky time

@DGPP the world would be such a different place if that were true. Better or worse, I'm not sure. The studies are good but can be biased and don't often have 100% fair constants. The increase risk of stillborn is not just weeks orientated, it's race, age, pregnancy risk factors, area/country dependant and many more. It is sad that in today's age we don't know more and that we aren't allowed many human studies to find the ideal as it puts others at risk. Everything is a recommendation and there is choice in the matter and I'm asking others opinions and experiences to make my own. We don't always fit into the statistics criteria. It's like inductions, all my friends and family that have had it - it never worked and they've introduced other risks from having it meaning further interventions were required to safely deliver baby. The only common theme I see in this area is that c sections are asked for more than inductions as they tend to be quicker and many prefer them to the inductions. I'm not against them myself but it's weighing up the pros and cons that we aren't always told but are sometimes lived and experienced.

Out of interest how old are you OP?

Personally I would take an induction any day over the risks associated with going more than 2 weeks overdue. I wish there was more positivity around them hence why I shared my story in such detail as I feel there is so much scaremongering and fear over inductions.

@Pandasnacks 35

@Wavescrashingonthebeach there really is so much scaremongering and I've had a lot of it with it being ivf also (mainly from others not medical folk) despite all the natural pregnancies I know ending up being higher risk, it's crazy. 2 weeks over does seem long, I'm impressed with others that go over as a first time parent as there is a lot of pressure, even if it's just from family constantly messaging...!! I wish there was no 'due date'. Due weeks maybe 😂

I'm not too keen on the idea of "due dates" either- 2 weeks either side is totally normal but obviously there are significant risks associated with being either very early or very late.
But like I said I didn't even need stitches after mine! In fact 7 days pp me and partner ended up DTD that's how recovered I was (so sorry for tmi) and baby although small was absolutely perfect 😍

Oh yes the constant messaging "Any sign of baby?" "ANY MOVEMENT?" Arggh! It drove me crazy with my first. I think I kept my due date a secret with my 2nd for that reason haha.

I was diagnosed with gestational diabetes at 24 weeks and needed medication to control my fasting sugars (overnight blood sugars weren’t coming down enough). If medicated for GD my trust doesn’t like women going beyond 39 weeks and so I knew that was always a possibility. There is information on the GD website if I had wanted to challenge that.

At my 36 week appointment, they were finally happy with my numbers and booked an induction for 39 weeks. That was actually 36+6 and the Thursday but on the Saturday (37+1) I had a period of reduced movements. I’d also had a hypo in the night. We went to the hospital, baby passed the CTG but the GD team weren’t contactable and we were there all day waiting to talk to a consultant. Consultant said the only thing really was to offer an earlier induction at 38 weeks as I already had one booked for 39 weeks. There wasn’t a medical need to bring it forward before that.

I took the earlier induction. The consultant was surprised and obviously expecting me to fight it but I was fed up of being pregnant. I had PGP and GD. I wasn’t sleeping. That incident with my blood sugars going haywire and the brief reduced movements was just too much, I just wanted baby here. I was prepared to go through the process of an induction, knowing I would be in hospital and monitored if anything went wonky again.

I was happy with an induction and actually started to look forward to it. We knew when to get cover for our dogs, my husband finished everything up at work (I’d already finished) as if you would going on holiday and so everything was handed off. I wasn’t prepared to go on the drip though. I haven’t known any good inductions from the drip and if the other processes haven’t worked, I personally felt there would be a reason and the drip would just prolong things. I was going to as far as getting my waters broken and 4 hours to see if contractions started and then I was going to ask for a c-section.

I had an attempted sweep at 37+6 but they couldn’t reach my cervix, so they weren’t very optimistic about my induction. I called up the morning of 38+1 to see my time and they asked me to come in about 1pm which we did. They did some pre-checks and then inserted the pessary at 4pm, my cervix was still unfavourable. Played some games with my husband on the ward that night and in the morning woke up about 5 and the pessary had come out a bit (it’s a bit like a tampon). I asked for them to reinsert it. At 10am we went for a walk to the onsite costa and back to the ward just before 11. As we left Costa I had a contraction in the hospital corridor and I’d had two more before I got to the ward at just gone 11. My contractions were 3 in 10 minutes straight from the off. At 1pm the contractions were building and I asked them to take the pessary out (it wasn’t meant to come out until 4pm) and 2pm my waters broke and they didn’t do an exam after that until I was on delivery. I got to delivery at about 5pm and I was 8cm, they gave me gas and air. I asked for epidural and pethidine but it was too late but they did give me a codeine about 8pm. From about 8.30pm to just before 10pm I slept, well, dozed, in between contractions. I’d feel a contraction starting and have gas and air until it subsided then doze again for a few minutes. Midwife told me it was time to push and if I didn’t she’d put me on the drip (which I wasn’t happy about). Baby was born just after 10.30 on 38+2 with no further interventions needed. The whole process took 31 hours from pessary being inserted but from first contraction to baby arriving was less than 12 hours.

Baby is doing very well, she is in the 47th percentile and growing fine. The placenta is doing well. I am doing well too, without sign of any preeclampsia, diabetes or any other complications.

However there were some alarming results throughout the pregnancy.

First of all it started as a twin pregnancy, but we lost the other baby early on (9 week) and I had some heavy bleeding at the same time.

Then on the quadruple test, baby had high chance for trisomie, but amnio reassured us that she is healthy, however we have had higher chance for placenta failure.

Then we had a scan to check on the placenta at week 24, because of the above, and they found everything OK, except that the umbilical cord had only one artery, not two. So that again increased the chance of growth restriction.

But that is all history now, and everything seems fine now

I was induced at 38 weeks with my first due to a suite of complications (gestational diabetes, my kidneys failing, slowed foetal growth) and ended up with a c-section after labour failed to progress. If I had been having an uncomplicated, low-risk pregnancy I would have put off induction for as long as possible, probably up to 42 weeks. I would have asked for additional monitoring rather than induction unless induction was indicated by symptoms or other concerns.

You're absolutely right though that there is no right or wrong way to do this, only what you feel comfortable with based on your discussions with your medical providers.