Older mums - advice needed . Should I accept induction at 38 weeks or wait until 40?

[littlebellsmum]

Hi
I'm pregnant with my 3rd child, after having two normal pregnancies and births. The only difference now is that I am 40. So, I had to go and see a consultant, who said that some consultants prefer to try and deliver babies for older mothers at 38 weeks to avoid an increased risks.

I'm not sure how I feel about this and would love to know what other "older" mothers have decided and if they have been given the same advice

Thank you!

What examples of "increased risk" did the consultant give you?

I would ask for another opinion. Age is no reason to induce at term, let alone earlier, unless there are problems.

Hi, I'm 38 and expecting DC2 on 25 January via elective section for various reasons, mainly due to a horrific delivery with DD.

My consultant wouldn't deliver this baby before 39 weeks, NICE guidelines recommend 39 weeks because of reduced risks to the baby (risk of breathing difficulties/time in SCBU etc).

I would ask for a second opinion.

Hi, I'm 40 aswell, baby #4 due in May (twins of 17 and "little" one of 11). My consultant has said that they would be slightly concerned if i went over my due date due to the (slightly) increased risk of placenta failure. I plan on talking about this with him further closer to the time.

how many weeks are you?

I am 40 in a few weeks and had DS3 9 weeks ago - so not actually seen as high risk in this respect which apparently changes on your 40th birthday but there is a small increase in the risk of placental insufficiency. That said, my understanding was that this was a problem that was related to post maturity, not delivery at term, so I would second the idea of finding out more before you accept that as induction too early might lead to a CS if the induction doesn't work and you need to consider that too.

I would ask for another opinion too. I am pregnant with number 4 and am 40 too and having a home birth as seen as very low risk as last pregnancies and births have been straightforward (last two at home). Seems a bit odd to me, and who wouldn't want to avoid an induction if they could?

Dont just accept an induction if there is nothing wrong.Consultants love to give you the risks about not inducing but not as open about the risks of induction itself-if you are healthy, your babies are healthy and you are happy to carry on then make an informed decision yourself.Your baby will come when it is ready, trust your baby and your own body-i am 38 wks with twins and have refused an induction because there is no reason at the moment.You have a choice please dont feel pressured to do something you dont want to without a valid reason.

I was 39 when I had DS last February. He was induced as he was 12 days OVERDUE. I can't see that being 40 is that much different to 39 so think that 38wks is a bit unnecessary, providing everything else is find and normal.

I was age 40 when I had my third child, as a homebirth.

The inducing early older mothers is very "old school" now. There is a very slight risk for older mothers of the placenta failing, more than younger mothers. But it is a slight risk and definitely not worth the risk of inducing too early! If they are concerned about the placenta, then they should scan you and look for blood flow and growth signs. If these are poor then advice might be given to deliver early - but only if this is found.

I am pregnant again, will hopefully be 42 giving birth and will no way be induced early without medical reason.

I hope you don't get more pressure to be induced unnecessarily.

Induction can be quite a horrific experience for mother and baby in my experience. If you and LO are healthy and placenta working fine then i would dig my heels in and ask to wait but be closely monitored.
FWIW i think different authorities have different policies. I was never advised on induction and my 3 were born when i was 40,41 and 42. However i was eventually induced due to other factors

I had dd1 when I had just turned 40 and am due dd2 next month when I will be 42. Dd1 arrived the day after she was due - but I was doing all I could by natural means to ensure that she didn't hang around as my mum had just started chemo. I had a scan last week as I have a fibroid but the doctor said this wasn't an issue and as my bp is low and everything else is fine I was now considered low risk. We asked about induction and he said this would only be connsidered if I went 10 days overdue- same as anyone else. We live in London and at my hospital they see a lot of older mothers. I get the impression from comments made my other Mumsnetters who live in other parts of the country where older motherhood is less common that their medical practitioners are more inclined to treat those of "advanced maternal age" (don't you just love that phrase) much more differently than they may need to be treated.

I dont see the connetion between age and early induction.

I had my 3rd at 40. He was born at 40+6, natural delivery. There was never any mention of early induction.

There was concern over his size, as my other two had been biggish babies, and I had some sugar problems towards the end of each pregnancy, but there was never even the least suggestion of doing anything other than waiting for spontaneous labour. Because of his size (5kg at birth) I would have gone for a sweep at 41w - but certainly no earlier!

Having big, robust, babies, at term, is an indication of a healthy placenta.

Hi, I'm being induced on my EDD (next week)

I'll be 42 in 3 weeks - my consultant gave me the option if being induced at my booking appointment although he didn't try and persuade me either way,he did say that their could be an increased risk of the placenta failing in "the more mature mother".

Anyway having been induced twice before,due to GD,I have no fear of the induction process - in fact the sooner this baby is out the better !!!

Thank you for all your responses - I'm only 22 weeks at the moment and so have lots of time to look into this and get second opinions etc. And I am only just 40!

The consultant was not pushing me one way or another and we agreed that he would see me at 38 weeks and we could decide then. His concern is around the slightly increased risk of placenta failure. I don't think it's the area as I'm in Surrey and the midwives have commented on how many older mothers there are locally.

It may never get to a decision anyway as DS was born at 37 weeks naturally.

I'm quite ambivalent about it - obviously I'd rather avoid induction and go the the birthing centre that I have planned but on the other hand, I want a healthy baby.

Thanks again - obviously I'm not going to go over term and you've given me lots of good stories about why I don't need to do this

At my 38 weeks appointment at Queen charolettes (last week) I was told by my MW that I would need an induction due to my age (& risk of placenta not supporting the baby) & that I shld wait to spk to the doctor.

While I waited for the doc a nurse came out & told me to go home & come back at 41 weeks.

Eventually I was allowed to see a doc.

After scaring the pants off me - it seems that it depends on who your consultant is - even within a hospital.

Consultant (X) gives inductions at 38 weeks to mothers over 38 years old.

While my consultant (Y) advises inductions for mothers over 40.

I'm 39 so consultant (Y) is suggesting I wait for 41 weeks +12 days before induction - which seems an age in comparison with the recommendation of consultant (X)

It staggers me that within one hospital they have different policies in operation.

And how do I find out which one is the most appropriate? How do I decide the risk of being over due - when clearly the consultants within Queen Charolettes can't agree?

Hi littlebells this is just what I wanted to ask but I'm only 27w. I'm 43 and had to see the consultantant at 16w (the mw did suggest I could opt out and not see him) he said they don't like women over 40 to go over 40w. I panicked(sp?) about this for 10 weeks as i had a nice calm birth with dc2 and was hoping for the same again. I think my plan is to insist on being scanned for placenta problems before I accept induction and if there are any problems at all to take the induction and if not to wait. But plan A is for dc3 to arrive before 40w like the other 2 did. I had dc2 at 39.75years old and no one was bothered. How many weeks are you littlebells?

What exactly is an abruption and is it more likely to occur in women over 40?

I would say 38 was a bit too early, espeically if you are having a small baby.

I had my 2nd baby at the age of 42, the doctor recommended induction at 40 weeks because of a higher risk of stillbirth. I accepted, not just because of the risk, but also because I have an older child who would need looking after while I went into hospital to have the baby. So I could arrange for my parents to come and stay the night I went into hopsital.

The new baby was only 5 lb 13 oz at birth so I'm glad they didn't want me to be induced any earlier.

It was really good to be able to make proper arrangements and to know that I wouldn't be allowed to go overdue as I had had enough of being pregnant by that time! The induction was quite straightfoward. I went into hospital Tuesday afternoon (22nd May).It took 2 doses of pessaries to get me going and she was born at 9.30 pm on 23rd May. Labour started about 4.30 pm so only took about 5 hours. She did get the cord round her neck and there was a worry that I woudl need a ventouse, however I pushed hard and out she came safe and well! I don't know if that would have happened without the induction though.

I've heard that interventions like venouse are more likely in induced births but don't know if that's true.

It's up to you but I would say that it's better to wait another couple of weeks and let nature take its course, you may go into labour naturally during that time, and being induced if you go over say 40 weeks. It depends what the doctor says the risks are.

Hope this helps!

Thanks LunaticF I'll be a bit more informed now when I talk to the consultant.

Hi I saw my consultant last week and we, amongst other things, discussed induction (DC#4 due end of May, I am 40). He stressed that each expectent mother is different and any advice to be induced prior to or on EDD was based on how the current pregnancy was pregressing, the health of the mother and what her obstetric/previous pregnancies/deliveries had been.

He signed me off to have a home birth if thats what I decided. However, he also asked me to book myself an appointment with him at 39+ weeks to reassess and discus induction as (apparently I was to ignore my twin pregnancy) my DC#3 had been induced due to being overdue.

Ihad my DDs at 41 and 43. With DD1 I was overdue by 12 days (was due to be induced that day). I raised this issue with consultant and MW both times and they said that in the absence of other issues there was no need to be induced any earlier than a younger mother. I wasn't even offered extramonitoring once overdue with DD1 (until my waters broke). This wasn't in a hospital renowned for it's lack of intervention either! Interesting the different approaches taken.

I am having the same dilemma but more in my head than with the doctors! They say if over 40 and FTM then best to induce before 40 weeks due to higher risk, apparently if it's your first baby your body/placenta may not always 'know' what to do - not sure how true this is, it's not like everyone's first isn't born healthy and alive! But in any case I'm booked for induction at 39 weeks and even I started questioning if it should be 38 due to slightly higher risk from that week onwards (I'm aged 41). But I weighted up the risks of that still low risk with the much higher risk of an induction not working at 38 weeks and then going in for a C section and the latter won out! I'll still be very nervous in that 38th week though....

@Joseve this is a very old thread. They now want to induce you at 39-40 weeks but no earlier or later.