Refusing induction at midwife appointment

[horchatatresleches]

Has anyone had any experience with refusing their community midwife booking an induction for them? I know I don’t want an induction. If it becomes clear that the baby needs to be born before I go into labour naturally then I’m happy to have a cesarean booked, but I’m certain an indication of labour isn’t for me. Has anyone here felt the same and did your midwife accept you decision or pressure you into accepting the induction.

When I had my son almost 14 years ago the midwife told me she had to book me a hospital appointment with a view to induction, essentially so there was proof she'd done her duty as technically induction was indicated. It was entirely up to me whether or not I went.

@horchatatresleches Her professional and employment duties or hospital policy are nothing to do with you. If it disturbs your peace to have it booked, say no. Simple. Its a service on offer that you are within your rights to decline or accept, however you see fit.

I am of the same opinion by the way, inductions fail so very often and are many times lead to csections so id choose a section over an induction if needs be.

No one can force you to have an induction, but whether that means they would automatically be comfortable booking you for cesarean I’m not sure. My third child was a difficult pregnancy and I reached the point of saying I just want a cesarean as I’ve been so ill and am not sure I have the strength for birth. But although my consultant also wanted the baby out she was very reluctant to book a c-section in the absence of a clear reason or having tried all other options. Ultimately the baby was born with an induction but even when it was being done the midwife could tell I was uncomfortable and said that if I wasn’t happy then she wouldn’t do it. I did feel quite a lot of pressure on it but it did all work out well and I had a good birth. If it hadn’t though I think I would be upset at having given into it.

I chose a planned c section over an induction (baby needed to come out at 37 weeks for medical reasons) but I had to fight for it. They initially kept ignoring me saying I wanted an ELCS and kept trying to book me in for an induction.

@selondon28 thats why its important to know your birth rights. you are within your rights to choose a section, no matter what their opinion is.

I refused induction and opted for daily monitoring when DS went overdue. When it became clear that I was likely to be a poor candidate for induction, the consultant suggested a CS rather than trying induction and possibly having an CS anyway, and I agreed.

Was the baby ok ? Very high rates of TNN or RDS in babies born at 37 weeks by ELCS. That why they now do electives at 39 weeks.

Even if a c-section is ultimately necessary babies still benefit from experiencing labour.

I was 'advised' (pressured) by consultant to have an induction which I didn't really want. I delayed for several weeks and chatted it through with a midwife and she advised that you absolutely can refuse, but the best thing was to attend the appointment all prepared and have the monitoring etc even if I decided to refuse induction. Various complications meant in the end I did get induced (and it was a positive experience). So stand firm and state what you want - at no point did I feel like anyone was going to make me do anything, it was my choice in the end.

Absolutely. It might help to have it clear in your mind what you will say. I would say "I have done my research and can say categorically that I will not consider induction but am happy to book in for a planned section"

If asked why I would say that I am afraid of the potential duration, lack of sleep, prolonged pain and potential for an emergency section - all of which would have a negative impact on my mental health.

I am totally with you. I would not have an induction now. Naively with my first I was booked in for one but had my baby the day before.

I have seen inductions go absolutely perfectly but I have also seen two emergency sections following induction. The mothers were absolutely spent at that time. It was horrible.

I was recommended an induction but it was very much presented as a recommendation and it was made clear that I could opt for a planned c-section if preferred. Also, the doctor was open to delaying the induction at my request when it came to it, subject to fetal movements being satisfactory on monitoring.

It is a choice so you should feel able to express your views to the midwife.

37+5 on the advice of a top private obstetrician and baby was absolutely fine. Babies don’t “benefit from experiencing labour” if there’s a high chance of shoulder dystocia leading to death or other terrible outcomes. I also had group strep B which the NHS didn’t even both to tell me about (was again caught privately but ultimately didn’t matter as I had an ELCS). You shouldn’t peddle such old fashioned advice. Every situation is unique.

There is plenty of research about the benefits to baby if the mother goes into spontaneous labour.

OP, it is totally your decision whether to accept an induction or not. Try not to make it a big thing in your mind, declining is as simple as saying no to a cup of tea.

MW here, we offer IOL, not force (well I ruddy hope they don’t).

Essentially, I might suggest that giving birth on Brighton pier may be a tip top idea for you. However, should you so feel after a chat about the benefits of Pier birth, you might tell me that actually giving birth on a helter skelter just isn’t really the vibe.

I might suggest that due to xyz, we would like to put some extra appointments in for a scan and fetal monitoring to keep a closer eye on baby. I might also suggest a chat with a doctor about declining the sights of Brighton Pier. However, you can decline that particular PowerPoint should you so wish to.

Whilst it does seem a ridiculous analogy, the premise stands. You don’t have to do anything you don’t want to do during pregnancy, there might be a chat about risks/benefits of your decision. But that’s mainly because we wouldn’t be doing our jobs properly if we didn’t inform you of the risks/benefits.

Congratulations on your pregnancy!

I think that if you go to an appointment and say you want to “decline” induction rather than “refuse” it, you will have a much more productive conversation.

Right but spontaneous labour wasn’t an option due to my medical situation - my options were induction or ELCS at 37+5. I chose the latter because I didn’t want to risk a failed induction and an EMCS. I found the planned one hard enough to recover from without adding in the exhaustion of dealing with a failed induction.

To answer OPs question, I’ve had two ELCs now and I personally do not find recovery easy but I have a weak immune system due to other conditions. In your situation, if you have the funds, I would seek a second opinion privately (cost is around 250-350 for a consultation on Harley St) and see what they say in terms of CS v risk of prolapse. If the risk is low and you had a decent labour last time I’d go for that. If risk is high there is nothing wrong with a CS but you have to accept it will take a good few weeks to recover properly, your partner should indeed take time off if you don’t have other help (family or paid) and you won’t have much time or energy for your toddler in that initial period.

I declined to be booked in for an induction when I hit 40 weeks.
She told me the date they would expect to want to induce me (42 weeks), and I had a follow up appointment at 41 weeks where I agreed to a sweep. She booked me back in for an appointment about 4 days later.
Went into labour 2 days later and had the baby at 41+6.

I had GD. I was told an induction at 37weeks was needed.
a few days before the consultant discussed with me and we agreed that baby could cook for a bit longer. He was born at 38+ 5 in the end as induction took 2 days - partly because of no beds.

you have a choice and can discuss with the health professionals.

This was published last year. Not sure why my opinion is " old fashioned".

https://www.sciencedirect.com/science/article/pii/S2590161324000565

https://www.nicswell.co.uk/health-news/risk-in-planned-caesareans

I had an induction and thought it was great. Obviously you have a right to refuse, but personally I'd follow whatever advice the medical professions gave me to keep my baby as safe as possible.

There's nothing old fashioned about the fact that labour stimulates the production of surfactant in babies lungs which helps them to breathe

I discussed this with my community midwife at 37 weeks as baby needed to be born early but I was terrified of interventions. After weighing up my options I decided to go ahead with induction on the basis I consented to the pessary induction but did not consent to midwives breaking my water or the drip. If these were needed it was agreed I would have a c-section. Shortly after induction they introduced me to dr who could give the go ahead for a section just in case but baby arrived an hour later so wasn’t needed in the end. Plus no intervention whatsoever and went home shortly after!

https://www.nice.org.uk/guidance/ng192/chapter/Recommendations#planned-caesarean-birth
1.2.26 Maternal choice for caesarean birth
I asked for a planned c section for various reasons. Told them I'd read the NICE guidelines and after box ticking they agreed it with no fuss. This was Jan 2022

I've had 3 inductions all for different reasons but non needed further interventions.

I'm asking next week for an elective induction due to medication I'm on and the location of hospital

wtf? Where’s the evidence for that? Dtds born at 36w in 2011 still going strong at 13 years old. Managed to survive “not experiencing labour”. Stop guilt tripping mums she making them feel bad/like their baby has missed a vital thing by having a C-section.