Declining induction

[Fuzzyhippo]

Very early days, only 10 weeks. I had my first midwife appointment yesterday and was told because my last baby was induced due to IUGR, I'd be high risk with this pregnancy and will be pushed for an induction at 36 weeks. I've been put under the consultant care, which is a shame as I've always wanted a home birth, but since I've been high risk with all of my babies, it'll never happen now. The size estimate was way off, but he was predicted to be on the 2nd centile at his 34 week scan, with no progression for 2 weeks after. I was told I HAD to be induced, no choice given. So I felt slightly forced desite telling them I'd like to go to term. This time I'd like to decline the induction and try for a natural birth, but I feel they won't let me?? I have major unresolved birth trauma which still feels so fresh to me, so the thoughts of being in the same hospital, same theater, same horrible obgyns who humiliated me throughout labour, it actually terrifies me. I tried talking this through with the midwife, but she had no concerns over my thoughts at all. I've always had a holistic hands-off approach, which I was lucky enough to have last time despite being induced (no pain relief, gel induction so no pitocin, natural water break, delayed chord clamp etc). But I feel as this will be my last I just want something to go right for once!! 😂

I'm so sorry you feel like it's not in your control, I felt the same at the start of this pregnancy too. I'm pregnant with my first but I was told at my booking in appt that they'd want to induce me due to age and IVF. I'd arm yourself with research, I'm currently reading In Your Own Time by Dr Sara Wickham. The fear based world of having babies has made it harder for a lot of women to have the births they want.

I'm not anti-induction, but I am anti choices being taken from women 'just incase' (like babies size which can be wildly inaccurate, Mum's age, etc). I'll be refusing induction unless 100% medically necessary. Also, if your midwife isn't on board then request another one.

Can you not request an outpatient induction? Personally I wouldn’t want to risk jt

I totally get an induction when there's a medical need for it, but the fact that they're wanting to do it because my last baby was measuring 6.0lbs at 36 weeks seems a bit unnecessary to me. My first was over 7lbs at 37 weeks, so it doesn't mean this one will be small. I just don't want to go through all that intervention if it's safe for me to carry on to term

What’s the reasoning behind induction this time? I had an IUGR baby in my last pregnancy who actually was on the 2nd centile, I’ve been told that I can go to term this time as long as there are no worries with growth. I’m having extra growth scans and dopplers and taking low dose aspirin. As long as this baby grows fine I won’t need intervention. I would wait until you see the consultant before worrying in all honesty.

I was induced with my daughter, currently 29 weeks with my second and got the same speech about this time. I would really really recommend doing your own research, book a birth debrief to get all the details & chat it through with the hospital, and then get in touch with the PMA (I think they are in every hospital now, Professional Midwife Advocates). You can speak to them and request one of them come with you to your consultant appointments to help you advocate for yourself.

To be totally clear though- you are the only person who can decide. It’s not up to the hospital to “let” you, it is completely your own decision. That does mean accepting there are risks, and sometimes induction is needed, but it is always always your choice so please remember that.

She said it's purely because there's a high chance this baby will have IUGR too, which I don't feel is right as my first was in the upper 7lbs range. I'll have the extra scans, but I thought they decided at 34 weeks if I'll be high risk. I didn't think it was even possible this early on to determine risk factor, but maybe things have changed since

This experience is more what I'd expect. They should be aware of the risk from previous pregnancy and monitor accordingly to keep an eye on it, only inducing if issues arise, you might be fine. I think it's a very blanket approach to advise for an induction at 36 weeks when you are only 10 weeks and no issues have actually been identified with the current pregnancy.

It’s risk v reward. Of course it’s totally possible that your baby will be fine (and I hope they are!), but they’re looking at the potential risks to you and baby. The NHS is on its knees, it doesn’t offer procedures for fun. There will be a medical need for it

I am classed as high risk due to the previous IUGR and also my induction ended in a csection, I see a consultant at every appt but to be honest at this point they’re more interested in my previous section than small baby! As he’s currently growing normally I think they’re happy to let it be unless growth slows down. I would be declining induction if there are no indications in this pregnancy though.

Edited to add my baby was 5lb 7oz at 39 weeks when born so he was very small.

I don’t have advice regarding what to do, however I was due to be induced and heard horror stories (some say true some say not) so I tried everything to make her come before that, what worked for me was using clary sage oil, I put in in my bath and rubbed it on my belly, I also walked up and down the stairs constantly, for an hour - that evening I went into labour, could be a coincidence but I’ve heard many people swear by clary sage

I had suspected iug with my first, she was also breech. They wanted to c sec that week, they made it sound like I had no choice and it was hard but I'm stubborn as shit and point blank refused.
There was lots of basically saying I'll kill my baby, and lots of negative statistics (which I understand some need interventions for safe delivery) but my instincts said she was fine.
Estimated to be below 10th but ended up on 25th at 6lb 3oz (and second baby who had no issues, but did have more scans due to first being suspected iugr was only a bit bigger than that)
You have to be so so so stubborn to the point of being rude and not give a shit about what they think of you.

Unfortunately, there really isn’t always a medical need for it in my experience. Sometimes it’s simply because as you say, the NHS is struggling, lack of staff & organisation means if they are having a quiet but well staffed week then they try to push for inductions rather than risk having a busy week next week and also have to have inductions.

I need there to be a consultant at this birth for various reasons and so my consultant at one of my early appointments said we should schedule it for X date now “because I’m available that day”. I had taken a midwife advocate to that appointment thankfully who immediately shut that down and pointed out that there is ALWAYS a consultant in the department and pointed out that actually although technically high risk due to issues with my last birth I’m currently (touch wood) having a totally normal and healthy pregnancy with no active concerns and not a single thing to suggest an induction will be needed.

I’m not saying it’s always like this and some inductions absolutely are needed, but that is not always the case.

Midwife here. Your midwife is talking rubbish, frankly. Yes, with a previous IUGR baby they will want to monitor growth more closely and offer extra growth scans, but there is no reason to assume IUGR will happen again and even if it did, to say you’ll be induced at 36 weeks without any indication for that at the moment is bollocks.

Also, it is absolutely 100% your choice what monitoring and interventions you want to accept or not, you have agency and shouldn’t be bullied into anything you don’t want. Ask to be referred to a consultant midwife to discuss your care pathway, she will be able to help you sort through your individual risk factors and make a plan A, B and C. And if this baby grows fine and blood flow to placenta is good, there is no reason you can’t have a home birth if that’s what you want. They’re jumping the gun way too quickly here, given you’re so early in the pregnancy.

Sounds a lot like my experience OP. My first was a spontaneous vaginal delivery at 41+3, he was 7lb 3 but on the 8th centile. So with my second, I was having growth scans from 33 weeks - my 37 week growth scan predicted his weight as 5lb. 9 and he had only put on 3oz between scans. They brought me in for induction the next day at 37+1 which was the most horrendous experience and ended in am emergency section 5 days later, he was 5lb 6.

I am currently 36+2 with my third and having growth scans again and told them from day one I will not be induced. Under no circumstances. My midwife has been on board from day one and the agreement is I have until 41 weeks for baby to come naturally and if he doesn’t I’ll have an elective around 41weeks.

My preference is vbac but if they have any concerns re growth they will just book me in for elective. My midwife and consultant have agreed and I’ve never had any disagreement or opposition from anybody about this plan. As it stands this baby looks to be growing fine at the moment so I’m hoping he comes of his own accord before 41 weeks.

I had two inductions for entirely different reasons, one baby wouldn’t come out (41 weeks) and one baby had to come out (IUGR, 35 weeks). Both times decisions weren’t made until the critical point. I would ignore what your midwife says and relax, you have a while to figure out how this pregnancy is going to look, and whilst it’s (I think) more likely you’ll have IUGR as you had it once, there’s no absolute certainty you will. The staff when I had DC2 were very surprised to hear I had no IUGR with DC1 and that he was late.

Came to make sure someone said this.
agree 100%.
Also re trauma from last birth, can you access some support for this? Psychologist/counsellor? Regardless of what type of birth plan you end up with this time, that would be helpful - and if induction is recommended to yiu (later - with actual reason) then you don’t want to be making decisions out of fear.
congratulations on the pregnancy :)

My experience was similar to @Oceandriver (although I didnt need an induction in the end with DD1 as she came spontaneously before the induction was due to take place). Also suspected IUGR. But certainly with DD2, no discussion was had until way way into the pregnancy, I had extra scans and as she was growing normally it was never mentioned again - they more concerned about her being breech until 39+1. I had a spontaneous vaginal birth at 39+3.