induction at 39 weeks?

[Angelyogini]

Hello,
I am scheduled to be admitted to the hospital tomorrow due to small baby size which was only picked up up on the 35+6 scan.

I had weekly midwife/consultant appointments since and a growth scan which showed baby staying on his line, but below the 10th centile.
Two days ago i was told they will start induction with dilapan and the next day they will break my waters.

I am very scared labour might not start even after these interventions as with my first my water broke spontaneously but had no contraction and was given a pessary 24h later which led to a vag birth a few hours later.
On top of that, the hospital did not put my mind at ease or instill confidence this week: they seemed seriously understaffed and overwhelmed with loads of births (examples include the fact i waited 2 hours to attend my last appointment because they were overbooked, not being given a time to attend the hospital tomorrow as there is a chance no room will be available which means admission could be postponed to Sunday or later, which begs the question if this intervention is really necessary, and changing the induction plans last minute).
Any advice from anyone?

I was induced at 37 weeks for a small baby! Nothing happened so we were stuck waiting for a bed on the Labour ward for a few days to break my waters as those coming in in active labour took priority which we understood but it was very frustrating! They wouldn’t let me go home and I had a massive meltdown that I was stuck in some kind of limbo!

Overall once they finally broke my waters everything went well and super quick but was I completely fed up of hospital food so made DH go to the chip shop for me!

I was induced at 41/42 weeks just because he was so late and the same thing as above happened. They got me ready but those in active labour took priority so I was just waiting and needing to have a the baby checked every 8 hrs which meant I got no sleep as everyone in the ward was on a different schedule so I woke up with everyone's checks. It was so busy there was also women in the ward who already had their babies so they had tons of visitors during the day and babies crying during the night etc. I went in on the Tuesday, had all the pessaries and ready to go on wed but no space for me in the labour ward until Saturday! Was also just left in limbo and understandably they couldnt tell me when there would be space. My advice is take a fan, earplugs and a facemask and try and relax as much as possible. I had some complications but I think if I'd had a bit more rest in the lead up to the birth things would have gone a bit better. I was honestly so sleep deprived when I went down to the ward I was falling asleep while they were explaining the induction!

How small are they saying your baby is on the scan? Have you had a more recent scan?

I was told my baby was off the charts massive and if they didn’t induce he would get stuck. He was born 7lb13.

Are you petite? Was your first baby small? Some babies are just smaller than average (that’s how percentiles work) if baby is tracking and in proportion this might not be an issue. What’s the placenta blood flow like.

You’re right to question, if they are willing to delay you until the weekend or beyond then there can’t be any immediate danger.

Tey to raise your oxytocin levels over the next day or so. Do everything you love and see what happens.

You don't have to accept the induction. If the baby is tracking along the line then it's just 'small' not growth restricted. Induction before they're ready can be really stressful on the baby, leading to complications so surely it's better to keep them in to grow a bit more so they have more reserves to deal with the labour.

It kind of baffles me that babies are induced for being too big or too small. As long as they haven't stopped growing and are still on the chart for the week they're in surely some just are bigger or smaller than others.

I had a big baby with my first, I measured over the top centile line at my midwife appointments consistently and nothing further was suggested. He was born 8lb 13oz but grew to be enormous very quickly and has always been off the charts for his weight.

I'm pregnant with my 2nd now and have had growth scans because they thought this baby was less than 10th centile. Scans have shown she's 34th centile and 40th centile but everything appears to be in proportion and she's following her line roughly so that seems fine.

Can you not just ask to wait until your due date since you're so close now?

I’m wondering why they gave you a scan so late, is there another issue or did you get a private scan? I gave birth to my first in Germany with private healthcare, I’m having my second on the NHS back in England and I was horrified when they told me there are actually 0 scans after 20 weeks. I’m going to pay privately for late scans but I do wonder how all of these inductions are happening in the UK for big/small/breech babies when no one is even scanning them!

I had an induction at 40 weeks due to reduced movement, - 5 sodding days i was in hospital, in labour, but waters didnt break. I was in the pre natal ward and it was horrible. The food was good though 😆. I was rushed to labour ward ln 3 occasions. Then back up! On day 5 all hell broke loose and I ended with an emergency csection. I never wanted the induction, but they told me baby could be still born, so I freaked out.

Hi all and thank you for your replies, they've been really enlightening!

I am sorry i didn't log back in sooner, i tried to avoid the computer as to do more active/relaxing things in preparation for today. As you can see though I am very anxious, up since 3 am.

I will try to reply to all Qs in a single pos
t.
After 20 weeks I only had midwife-led appointments with all tests coming back clear (urine, glucose, pressure, tape measure...). My hospital does a 36 week scan as a top-up. I had mine at 35+6, which picked up the baby's size, and then a growth scan on 37+4. On both, baby is plotting on the 6th centile, with good dopplers for blood flow to the cord and placenta. The last midwife appointment at 38+3 though showed fundal height remaining the same at 36.5cm.

When I called the hospital again I was surprised to know if i had refused the induction they would have schedule another growth scan and more observations but would let the pregnancy progress, potentially up to 40w. Little bit lost here.

My husband and I are not particularly big, with normal bmi (albeit after my 1st pregnancy i am close to the limit; ), normal sized clothes (S, M), and relatively active. My first baby (37+3) came out 2.7kg, around the 12th centile, and I remember people commenting he was the smallest baby they had seen. He was above the 75th on his 2 year reviews, so all progressed well.

Their concern is if there is any deterioration with the placenta and baby is deprived of oxygen, blood, nutrient he will be very distresses and unable to progress with the birth and they might not have time to act. They recommend dilapan as it wont stress baby a lot, something that is usually the case with hormonal inductions. Problem is I am now in distress, I cannot see how this will help with labor.

I was induced at 39 weeks for gestational diabetes, second baby. Nothing happens for a while when you’re induced so try not to worry. If they’re struggling with staffing they will register you but not even put the pessary in til they are ready. Take books, an IPad loaded up with tv and films, lots of snacks.

i had a pessary put in at 10am and wasn’t properly regularly contracting til 8am the next morning, then progrsssed quite quickly. Went up to the delivery suite about 11am, waters broken and baby arrived at 3pm. Gas and air only. SO EASY compared to my very difficult first birth (non induced) which took 3 days and all the intervention imaginable including epidural and assisted delivery , and a week long NICU stay.

compared to that my induced birth was an absolute joy

thanks for the reassurance!
With my first, I had a pessary 24h after my waters broke and contractions were unbearable within 3 hours. Midwives did not believe me, had to get the new shift in and baby was out maybe 30mins later.

Second baby - I had suspected PROM at 32 weeks. Was picked up with tests because i had brown discharge. I’m convinced the tests were not correct but was advised I would be induced at 37 weeks and did the standard hospital stay/antibiotics and then monitoring and bloods every 2/3 days. I was terrified of being induced and I asked if I could go beyond 37 weeks and they said they don’t like to (risk of infection) but ultimately it’s my decision and we worked together to come up with a plan if I wanted to. That meant daily monitoring and bloods after 37 weeks and they said not to go beyond 38 (but again I felt that was a discussion for when I reached that point)

unfortunately I had more brown spotting at 36+4 and they were concerned it could be an infection at which point I decided I would be induced as I didn’t want to risk it.

I started on the gel and the doctor said to me it was very very unlikely I would need anything else as this was second baby. And she was right. From gel to my daughter being born was 7 hours.

I would say if you don’t want the induction now then push pack and ask them how they can support you to get to 40 weeks or 41 weeks and then assess again.

Make sure that’s well noted on your history. I found contractions much less painful second time round until the very business end but my first was positioned back to back until after the epidural was placed and they could turn her - so not comparing like with like. But, I do think your body remembers what to do so everything is slightly easier the second time

Let us all know how you get on x

Over scanning is not good. They measure belly for some and offer growth scans to those obese and unable to measure belly accurately.

I am a radiographer and 3rd trimeater scans are very inaccurate.
They told me my 1st was SGA and I told them to sod off (nicely) he was 8th centile but born at 6lbs which is average there was no amniotic fluid issues, no placenta issues, he had a tiny waist thats all. Like his Baba and he is atill that way today - becuase you know all humans come in different shapes and sizes 🤯 he has tall daddy long legs but tiny waist and is healthy and fine and a very bright boy.

So it is BS unless there are other concerns.

Growth scans notoriously inaccurate. Lots of failed inductions this early on lead to emergency c section , obviously many cases do require the medical intervention but sometimes I think it’s best to wait and see when baby is ready. They put lots of pressure on, scare tactics, only to delay it if the ward is busy anyway? It’s very confusing xx

Exactly. And so far no contact where i was supposed to be called first thing in the morning.
I'll wait and see, and keep you posted.

To do them justice, they called in the am and i managed to be there before noon.
Currently waiting in the induction ward. I was monitored and everything looked fine so was given dinoprostone pessary a couple of hours ago. I have some cramps and soreness down there and also can feel the baby move more (well, this could be because of eating a lot). Not much else happening.

How did it all go OP? Hopefully you’re in a lovely baby bubble xx