Consultant pushing for induction at 38 weeks!

[curlyLJ]

Had my 36wk appt today and my consultant is 'recommending' induction at 38 weeks due to the fact I had some unexplained bleeding between weeks 31 and 33 (3 small bleeds with no pain).

Baby is fine - also had a growth scan today - and I am fine, so I don't understand his reasoning. He wants to see me in 1 week and will examine me, but he has already said that if my cervix isn't ready, then the induction is likely to result in c-section - which I don't want unless I really have to.

Obviously he is a professional, but this is only his opinion right? I am inclined to decline but not sure what to do, or if this is wise...
Has anyone else experienced this?

I don't understand; why didn't you ask him to explain his rationale?

I haven't experienced this exact thing but Consultants like inductions because it makes their admin easier: that's why midwives and so on will start pushing for sweeps quite early. They want you off their books. I'd check out the AIMS website if I were you - they're very helpful (www.aims.org.uk/) A Harvard study from (I think) 1993 suggested that they'd actually got the length of the average pregnancy incorrect and it's more like 41+ 1. Equally, in France they let you go over by up to a month I believe. If their reasons were so medical you'd expect the two countries to be a lot closer with such things!

what were his reasons? think you need to come up with a list of questions eg you'd like some stats to evaluate risk to pregnancy and research based evidence.

Thanks for replies. I wil check that website out.

LittleSilver, I did ask why, but all he said was that if the bleeding had come from the placenta, it might prevent the baby from getting everything it needs to develop properly.
He then seemed to contradict himself, because he said that all the scan results were normal and growth was spot on. (baby has grown as it should since I had the bleeds).
He seems to have the opinion that there is a 'potential' risk, but as far as I can see, if there's been no more blood and baby is developing fine with no evidence to suspect a problem, then why induce?

You can say you would rather not be induced, but will agree to having your baby monitored- this will mean you going to the hospital every other day or so until you go into labour where they will put you on a fetal monitor to check baby. He really should be explaining his recommendation better .

Stand by what you want!

Why not push for a 2nd opinion from an ob, plus one from a consultant mw?

I was induced at 39 weeks for similar issues, it ended in a c.s, that was also partyl due to being totalyl immobile for my entire labour.

i would consider asking for more monitoring, scanning etc, if all seems well ,it seems overly cautious, but i suppose th e presumption is that the bleeding is placental and the placenta does start declining at the end of pregnancy

however , based on what you have said , it sounds like all is well

Asking a genuine question here; why si monitoring a good option as honeyapple says? It only gives a snapshot of how the baby is during that 40 or whatever minutes. Is there actually an evidence base for it showing to decrease maternal/fetal outsome? That's the question that I would be asking.

There were concerns about my placental function with dd2; I was offered in-depth ultrasound studies which obviously I accepted.

my placenta was low lying initially, and another consultant (who i saw at the time I was in hospital) said the bleeds were probaby due to the fact that the placenta had moved up.

Everything just seems to be based on an overly-cautious, 'what if' way of thinking.

I always thought the longer the baby stayed in the womb, the better...(even tho I know 38 weeks would be considered full term)

The asking for monitoring is in order to call their bluff, essentially. It means you're effectively saying, "Ok, if you've got a good medical reason for this then it'll show up in the scan. If not, then I can let the baby arrive in his/her own good time." There are a lot of studies which show that the drugs used in induction can have dodgy side-effects and that caesarians very often are the end-result since more intervention tends to beget more intervention.

It sounds stressful, prob the best thing you can do is get as much medical advice as possible to make an informed decision. Good luck!

There is very little evidence to support induction (ie it often ends with more intervention) unless it is absolutely medically neccessary- so by asking for fetal monitoring (as alliew says) you are showing that you are a competent adult who is aware of the problems associated with induction and that you do not want to go down that route without good reason. Pregnancy and birth are a physiological thing that works a lot better when left alone. Doctors unfortunately like to 'do' things. They like to 'fix' things- and birth is not something that benefits from this attitude (unless as I say there is good medical need).

Good idea to get a second opinion, good luck .

Thanks for all the replies!!

I actually saw my own midwife this morning and she made it very clear that she doesn't agree with the consultant's view.

I'm due to see the consultant again next Tues, and now that I have had time to think, and after all the advice I have been given, I will be much more informed and feel much more able to question his opinion.

I like the idea of asking for more monitoring, and will definitely ask for that if he continues to push for this induction.

it doesn't really sound like you need an induction but just so you know I have had 2 inducions at 38 weeks my cervix was not ready and both ended with normal biths with a few stitches so everything was fine. they are talking about possibly allowing me to go naturally this time and its a new experience for me

I had medical reasons for both my inductions though I would definitley question the need for one in your case