To induce or not to induce...

[Rosebyanothername19]

I'm 40 weeks tomorrow and the midwife said last week that if I hadn't gone into labour by tomorrow they would look to get things started...

My choices as I see them are

1. Do nothing (I'll be honest, I'm ready for this baby to come now)
2. Stretch and sweep (I've heard it isn't nice and might not even work/can make labour worse)
3. Pessary induction (not sure about the use of artificial hormones)

I need to decide by tomorrow morning and I'm going round in circles.

Any advice/different options please??

Personally as someone who had an induction last year with baby #1, and is currently 8 months pregnant with #2- if all is well with you & baby, hold on for a bit longer. Due dates are not exact, a very small % are actually born on their due dates.

I’d hold off on any decisions until you hit 41 weeks, then you could always try for a sweep, go from there.

I don’t understand the pressure to induce because it’s your due date? Pressure after 42 weeks is one thing, but one your due date seems excessive.

Mine were born at 40+6 and 41+1. A due date is an estimate based on averages, some pregnancies will be shorter, some longer. Babies don’t have calendars. If I was you I would say I’m waiting a week (at least) before even having the conversation, but I’m a strong believer that baby and your body know best and will work together when they’re ready and that unless there’s some medical indication for you in particular otherwise, letting your baby get ready itself is better for both of you.

I also just don’t think sweeps work unless your body is basically ready anyway. Had a sweep with my first, had 2 days of contractions day and night before getting into active labour. I suspect if I’d not had the sweep, it wouldn’t have been so long, but obviously I’ll never know that for sure. No sweep second time, baby born in less than 2.5 hours.

There are different opinions on a sweep. My midwife didn’t feel the evidence was strong enough. I’d hold off another week.

If there's no medical need I definitely would not induce. I've had 3 babies, one was an induction and one was spontaneous labour (third was EMCS due to placental abruption) and the induction was so much more painful than the spontaneous labour. With my spontaneous labour I got to 8.5cm at home and it was still hurting less than the induction did at 4cm!

I would personally accept the sweep though, as it won't work if your body is not ready anyway. I had a sweep with my spontaneous labour, it wasn't painful at all for me. Idk if it would still be classed as spontaneous if I'd had a sweep but it was basically the same as a spontaneous labour would have been.

I had a sweep for my 1st at around 40 weeks, possibly just before. I didn't find mine painful, I had a tiny bit of bleeding afterwards when I wiped but that's it. It didn't do anything for me and I ended up being induced at 41 weeks, that was pretty quick because I was ready. I was also induced with my 2nd at 38 weeks and that was a lot longer because my body wasn't ready.

I personally would take the sweep and then wait it out!
I'm pregnant with my 3rd now and i will be trying to avoid being induced again and hopefully will be able to go into labour naturally!

Definitely option 1 and avoid any interventions if possible 🤞

I think the pressure is partially down to women having choice, but mainly from the perspective of numbers management on an already stretched service. Maybe I am cynical though!

Personally I was willing to do all I could to avoid induction op. Some have a great experience but I generally found poor statistics. Went to 41+4 in the end, wasn’t keen on a sweep even but did concede the day before DD was born as also didn’t want to go beyond 42 weeks due to increased risk factors. Whether the sweep was what brought baby on or not, who knows. But I wouldn’t describe the sweep as painful, maybe uncomfortable but I (maybe wrongly) would imagine it’s less painful than induction.

Yes I agree with you, I think it helps them manage numbers more easily. I have numerous friends who have been scared or pressured into induction and had an awful time. I didn’t have to contend with the 42 week risks though as only went to 41+1 with my latest baby. Had a great midwife totally on my wavelength and we didn’t even bother doing a 40 week appointment because I was fine and knew I didn’t want any inductions or sweeps.

Intervention usually leads to more intervention. If you're medically well and the pregnancy is low risk and straight forward I wouldn't be looking to get induced until after 41 weeks.

I had a sweep at 40 weeks and went into labour about 24 hours later.

Sounds very similar to my midwife, makes a big difference when they’re on the same wave length doesn’t it. It’s policy to offer a sweep at 49 weeks I believe but I wasn’t keen to rush DD out before she was ready. It’s crazy to me how pushy it can be in terms of inductions though, the consultants did try to get me to have one based on having had IVF but the evidence wasn’t compelling enough to warrant it in my circumstances; I’m so glad I looked into it properly myself!

I'm shocked that they're suggesting induction on your due date when there's no medical need?

They always booked induction when I reached 40 weeks but the induction date was 41+3/4. I went into labour before this anyway, had sweeps both times.

I wouldn't be comfortable with induction at 40 weeks because you are still in the normal range for spontaneous labour. When you start getting past 41 weeks then it's getting a bit long and I would start worrying about the risks then, but 40 weeks!?

No, I wouldn’t. I would accept a sweep a few days past due date and induction at 10 days past due date.

My daughter was induced after a sweep at 39 weeks,perfect labour and birth. Everyone’s labour and birth is going to be different.
I personally would want my child born by 40 weeks. This is my own personal choice.

Are they actually offering an induction at 40+0? That would be unusual without a medical reason. More typical would be to offer the sweep and then book an induction but for after 41 weeks just in case baby doesn’t make an appearance on their own before then. I’m wondering if you’ve misunderstood?

Try the sweep it may well work. Mine did with dd1

I needed an induction at 36+6 for medical reasons. I had a sweep as there weren't any induction beds available. It felt no different to any of my other vaginal examinations a bit weird but not uncomfortable or painful. This turned the sporadic contractions I had been having for weeks into regular contractions.
When I went in for induction the next day they were unsure if I would been the pessetry at all. In the end they decided to do it. I only had it in for 4 of the 24h it could have been in as it had done the job and I was now in early labour.
From an induction point of view I had a straightforward labour as my body just needed a little nudge. They did have to break my waters further along the process but this was because my labour stalled every time I lay down and I had extreme fatigue from pregnancy complications and needed to lie down /sleep a lot through labour.

I would probably go with an option somewhere between 1 and 2 and ask for an examination and only go for a sweep if your cervix feels favourable for labour.

I personally chose not to induce or have a sweep because I wasn’t happy to consent to internal or intimate examinations unless it was an unavoidable emergency. That wasn’t exactly a choice I was making but it put lots of procedures off the table unless there was literally no other option.

If you aren’t sure I do think 40 weeks is a little early to be worrying about induction without medical reasons. If you are happy with the interventions and procedures and want to get things going though it seems a valid choice too!

I had an induction at 39+5 for medical reasons (although not actually related to the pregnancy, which could have been allowed to progress naturally had the other issue not been more pressing) and it didn’t work because my body just wasn’t ready. I had a lot of painful and unpleasant interventions and it culminated in an emergency C-section because my DS became distressed.

There’s not much anyone could have done about it as that’s the way it had to be, but I would have had an elective C-section if I’d known at the time how it was going to go. In normal circumstances, I wouldn’t have considered induction unless I was very overdue.

I opted to induce as baby was massive (and she came out at 9lbs 7oz, so they weren’t wrong) and I knew I wanted an epidural. It worked out fine for me, but I reckon the epidural would be a deciding factor as once labour started, it was super intense!

I generally want to avoid intervention unless it's got really good evidence behind it but even I'd probably accept a sweep at 49 weeks! 😅

😆😆 whoops! 40*

They really need to bring the laugh reaction back!

You’re best off speaking to medical professionals. The
most important thing is that you and baby are safe. You will hear both positive and negative anecdotes.
make sure to ask your midwife lots of questions, have all the facts and then reach a decision together that you are both comfortable with. Good luck.

When you speak to medical professionals, don't forget to ask about the risks of induction too. In healthy pregnancies there is demonstrated association between induction and significantly increased need for stays in NICU, major resuscitation, birth injury to the baby, as well as complications for the mother.

https://bmjopen.bmj.com/content/11/6/e047040