Hello. I've been meaning to come back to this thread for days, but frankly I've been too exhausted. (Too exhausted to be excited actually...)
Peepee: I don't know anything about your condition and I'm not doubting the integrity of your consultant, but based on my own experience I would try and find out as much about the condition as you can. I only say this because of the amount of rubbish and conflicting opinions I've been given recently.
I saw a different consultant a couple of weeks ago - but only because there were no ultrasound appointments available in three hospitals and she was the only person who could do it. I initially thought she was nice enough, but the more I think about it, the more I realise how manipulative she was. She asked me if anyone had discussed the risks of a home birth with me, given my 'high risk' status - and said that people with antiphospholipid antibodies are usually induced between 38 and 40 weeks - and definitely by 40 weeks. She then said that I was at higher risk of pph (eh?? aren't I a clotter not a bleeder???) and the peanut of intrauterine death. We asked her what the statistics are on this, but she couldn't provide any - but then went on to say 'Of course, this IS your FOURTH pregnancy...' and 'It is a PLANNED pregnancy...' What the hell difference does that make? I'm not sure that someone who has never had a miscarriage, or has reached this point in an UNplanned pregnancy would sit around thinking 'Never mind, I'll just let it die, I can always make another...' if there were strong evidence to suggest induction at a certain point, due to placental insufficiency.
This consultant had the cheek to say that - whilst I couldn't use a birth centre (tell me something I don't know...) - I could have a 'low intervention' birth on the main ward and I didn't have to have an epidural. Thanks a lot. How they expect someone to labour effectively without painkillers when they've barred other methods of 'natural' pain relief (eg birthing pool), I really don't know. Not to mention the fact that epidurals are contraindicated when you've been on heparin due to the risk of bleeding into the spine.
Besides, as I keep ranting on in various places on MN - part of my thinking in trying to have as active a birth as possible, and trying to reduce my chances of a Caesarean, is that by keeping mobile, I reduce my risk of dvt.
Anyway - I was fairly upset by this whole conversation, but my gut feeling was that in the absence of firm information, I would decline induction before my due date - and base my decision thereafter on facts presented to me. We asked this consultant for facts relating to intrauterine death with my condition, but she couldn't find any to hand, said she would look on the internet (like I can't do that myself?) and give them to the midwife present, who would be at the ante-natal clinic at which I had my next appointment this week. Needless to say, they didn't materialise.
Despite this consultant going on about how it was my decision etc etc, she'd written across the scan report 'Recommend IOL by 40/40, discuss with Mr X'. Amusingly, when my consultant saw this, he went off on one about how he'd only sent me to her because she had a skill that he needed to use and if he'd wanted an opinion, he'd have asked for it (the implication being that it will be a very long time indeed before HE goes to HER for advice...) and if she's going to make comments like that, she should really have all the information and statistics at her fingertips.
He also completely slated the advice given to me by his registrar a few weeks previously about when I should finish the anticoagulants (now extended to the beginning of labour, recommencing afterwards for six weeks), saying that he doesn't hire these people, he has no control over them and that this particular registrar should know better.
He also confirmed that I could have a natural or managed third stage, if I wanted, and there are no implications thereto with the antiphospholipid thing because I AM a clotter, not a bleeder. Which also means that the consultant who did the scan was also talking rubbish.
He doesn't approve of the home birth plan - but then I never expected him to - but restricted his comments to a statement of fact and three lines in my notes. Bless him. His concern with regard to myself is that I apparently need to be monitored for clots. How they would intend to do this in hospital without comprising my movement and therefore making clotting more likely, isn't clear to me...
I do feel a certain pressure, that because this person has diagnosed a medical condition and I'm now 37 weeks pregnant because of that, that I should follow ALL of his advice, or else I'm being ungrateful... which is silly really - because it's still my body and I'm still entitled to make informed choices.
Anyway - that's my twopennorth for the day...