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.

Evidence is linked above.
https://www.nicswell.co.uk/health-news/risk-in-planned-caesareans

Yes (3 years ago), low risk pregnancy. It was fine. She booked me in for monitoring at the hospital instead. I would recommend asking for this if it's not offered - it usually ends up being the same day you'd be 'booked in' for induction, and it will give you much more information with which to then make a plan.

(oh, and after the monitoring I asked the hospital midwife for a sweep, which kicked things off - happy days!)

I had an induction and thought it was horrific compared with my natural birth. I should have had a c section. I think you’re wise op

My community midwife rang me at 9am on my due date, (I'd just sat down with a coffee, everything was ready) and she said, right we need to get you in for a sweep.

She tried to breezily enforce an appt and got irritated when I declined politely. I wasn't overdue, my blood pressure was fine, I wasn't overweight, baby wasn't measuring large, no issues at all. She tried to insist, I declined again, more forcefully. She argued, I hung up on her.

I wanted to be left alone. I didn't want fuss. I was nice and calm. I didn't want fiddling with. I just wanted to potter.

That was on a Thursday. I woke up on Saturday morning with pinging in my back, that progressed gradually and I went to hosp on Sunday afternoon. DS was born at 7.50 on Monday morning.

Your midwife does not get to decide. She can offer advice, you do not have to accept it. If you are worried, check with your GP, they tend to be factual and not have an agenda.

It’s completely old fashioned to push a C-section when doctors (not randoms on Mumsnet) have advised a c-section and ignore the myriad of dangers that natural labour pose to both mother and baby - have you missed the hundreds of newspaper articles about women whose babies were injured - some fatally - because they didn’t get c-sections and doctors insisted on natural labour?

Obviously a natural labour is ideal in ideal circumstances but many women, me included, sadly did not have ideal circumstances and are grateful for modern medicine enabling them to give birth in the least risky way possible.

Im utterly perplexed why you’re hellbent on continuously posting while ignoring what I’ve repeatedly said, which is that I was advised to give birth early for medical reasons (for me and baby) and after advice it was agreed ELCS was safest for me and my baby. And so it proved. You need to let go.

I assume you mean to push a vaginal delivery ?

I think what confused me was the term elective as in catagory 4. If your baby needed to be delivered early then it wasn't truly elective I suppose.

One of the worst cases of RDS @ 37 weeks I ever saw was the wife of an obsertrician- that was elective too. If someone had wanted to deliver my babies at 37 weeks by c- section I would have asked for some steriods to mature their lungs.

I think it is misleading to suggest that it is a done deal that babies born late pre-term by CS will be ok. There are significant risks of respiratory comprimise which are reduced by a woman labouring.

I don't believe in vaginal birth at all costs but c-sections are not without risk.

@Neurodiversitydoctor you are pushing an agenda. Not sure why, don't think anyone is forcing you into a c section. You don't need to ask for steroids, if you need an early CS they're offered. 37 weeks is borderline if you need them and I'm pretty sure pps doctor will have known more about the risks than you think you do. The risk of CS are discussed with you in advance if there's time. The risks of vaginal birth are not.

OP you can ask for CS to be booked in for 41/42 weeks instead of induction, so if you don't go into spontaneous labour by then you have something locked in. Be prepared to stand up for yourself though.

By children are 18 & 20 my childbearing years are behind me. But I did spend 10 years working in NICU/SCBU.

To be entirely fair I think what you say is technically and clinically correct if the midwifery carenin labour is optimally tip top.

When DS1 was born at 36.3, spontaneous labour, the midwife blamed a dropping heartbeat on a faulty belt - twice. The third time, DH opened the delivery room door and blasted "I want a doctor in here and right now". Cue a senior midwife appearing and the emergency button being hit, heralding the appearance of about a dozen people.

DS1 was posterior and had the cord wrapped around his neck. He was too far out to be pushed back for what should have been an emergency caesarean. I was hoisted onto a birthing stool, and given one more push as the Dr got the forceps ready. The midwife cut the cord whilst ds was still inside. I don't know how I did it but I got him out with that one push rupturing a blood vessel in my eye and suffering a prolapsed bladder and some sphincter damage (neither of which the NHS gave a toss about so thank goodness for health insurance).

The baby was very "blue", took minutes to resuscitate and had an apgar score of 6 after 5 minutes. He had to spend the night in SCBU. Fortunately all was well.

Do forgive me but I think a caesarean would have been better and safer than what happened to me and that was in the halcyon days of 1994.

When pg with dd (after a tragic, expected and well managed loss at 27 weeks) she was breech and big and turned two days before a planned section at 38 weeks. I felt I could not justify surgery that was not necessary but with the promise that the baby would be delivered by a very experienced midwife - unconditionally. The obstetrician agreed and the Head of midwives came in for the birth. At 41.5 weeks I had had enough and was induced. I had the pessary and refused to have my waters broken. After 8-10 hours they wanted to put up the synticynon drip which I agreed to providing I had an epidural first. My waters broke waiting for the anaesthetist and labour was well underway by the time the epidural wasnin. The drip was never started. DD arrived swiftly and calmly. It was a very cathartic birth.

My care with dd was obstetrician led and I saw only a consultant throughout the pregnancy. Mutually respectful conversations took place and there was no nonsense chatted.

My advice @horchatatresleches do not be advised by a midwife, please request to discuss any decision making with an obstetrician. Secondly, if you are induced you can insist on an epidural before they put up the drip.

Did your NHS trust even test you for GBS? Most don't test as standard (NICE guidelines) and as a result in our case DD1 developed GBS sepsis and needed two weeks in NICU / SCBU. It was awful. Luckily there's a big study going on at the minute where about 30 hospitals have now implemented a GBS testing programme as standard to see if it helps reduce the number of babies getting a GBS related infection.

I don’t see how @Neurodiversitydoctor is ‘pushing an agenda’? My last pregnancy was high risk and I was in my 40s. I knew baby would need to be born early (37/38wks, I was told). I naively assumed the OB would say I needed a C section due to my age and high risk ‘because it was safer’.

So, I was very surprised when she told me that vaginal delivery was safer both for me and baby. I was so surprised that I questioned her a lot. She said that a C section would need to be done later (39wks) and that babies born by C section more frequently had breathing difficulties. I’m embarrassed to say that I was so surprised that I interrogated the poor woman despite her being one of the top OBs in the U.K.! Anyway, she showed me figures that clearly indicated she was right. She also said I was entitled to choose a section but, if so, it’s likely they’d give me steroids beforehand to help baby’s lungs.

Obviously, if there’s a reason vaginal delivery isn’t advisable (shoulder issue or whatever) then that’s a different matter, but without that, yes, surprisingly, the lung issue is correct.

I’ve had 2 babies by c section at 37 weeks (1 was 36+4) and both were fine

Insist on a planned caesarean instead of induction at the appointment, that's what I did. The midwife was not happy, kept telling me only a doctor could ok it and it would be a long wait. I told her I was happy to wait and he came to see me a few minutes later and agreed with me. I also insisted on waiting until 42 weeks instead of 41. They made me sign a waiver and off I went.

I had my daughter naturally in a birthing pool in a midwife unit the evening before the caesarean was booked. One hour after I was due to book in!

My recollection (almost a decade ago now) was they did test me but didn’t tell me - it was only when I took my notes to a private appointment with a midwife she mentioned it. I might be wrong though and maybe she was the one that tested me too - I can’t remember now.

Re steroid shots, I had one for my first baby but not the second as they’re no longer recommended.

As I said above, obv a vaginal birth is ideal in ideal circumstances but once there are other issues it’s a question of weighing up risks and the risk of breathing difficulties after 37 weeks can easily be outweighed by much more serious issues. The people on here are pushing an agenda by repeatedly saying vaginal birth is better - it’s only better if the risks of other issues to mother and baby are minimal.