Natural Birth

I'm so sneaky...

Recently I posted about how my ob/mw practice starts talking about induction at 41 weeks (even though they told me that they let patients go to 42 weeks). After reading all of your posts and thinking about whether or not I would decline the NST or the induction and all of the possibilities, I think I came up with a good compromise. I had my 38 week appointment today. I actually have all of my appointments on my week change day. So I told the receptionist that I needed to change an appointment time. She asked for which day. I told her March 29 (my 41 week appt) and she said, "Which day you want to come in?" and I said, "Ideally, Friday" (41 weeks, 3 days) and she said, "I have a 3:30 with Megan" (who happens to be my favorite MW!). Totally perfect! They can't start talking about induction at my 41 week appointment if I don't have one! Ha! Let's see if I get away with this...

Re: I'm so sneaky...

  • I thought you were certain that you were going early?  Seriously, why the FVCK are you so obsessed with planning every. single. aspect. of your pregnancy?  You're not even AT your due date and you're planning to sneak around your MW's induction policy?  Jesus, what else do you DO with your time?!
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  • That's hilarious :) Good luck getting what you want, don't let anyone tell you that you can't have it.  Don't listen to the negative comments.

    Stellar - take a page out of Bambi's book - If you can't say anything nice, don't say anything at all.

    Seriously, why do people feel the need to post such negative comments, especially when what people really need is positive encouragement around them. Good luck bigmare :) 

  • image navygirl90:

    That's hilarious :) Good luck getting what you want, don't let anyone tell you that you can't have it.  Don't listen to the negative comments.

    Stellar - take a page out of Bambi's book - If you can't say anything nice, don't say anything at all.

    Seriously, why do people feel the need to post such negative comments, especially when what people really need is positive encouragement around them. Good luck bigmare :) 

    Obviously I have already blocked Stellar because the only post I can see is yours. Thanks for the encouragement! 

  • Stellar- ok, whoa, hostile much?  that seems a little rough. 

    ETA:  sorry bigmare, after i saw that you had blocked stellar i came back to edit my post and take her comment out. 

     


    Ryan Keith born 2.19.12 weighing 8lb 15oz. At six weeks 12lb 4oz.

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  • image Texas77again:

    Stellar- ok, whoa, hostile much?  that seems a little rough. 

    ETA:  sorry bigmare, after i saw that you had blocked stellar i came back to edit my post and take her comment out. 

     

    Aw, that's so considerate of you. :) Usually the natural birth board is free from snark... 

  • image Stellar3713:
    I thought you were certain that you were going early?  Seriously, why the FVCK are you so obsessed with planning every. single. aspect. of your pregnancy?  You're not even AT your due date and you're planning to sneak around your MW's induction policy?  Jesus, what else do you DO with your time?!

    Seems to me Stellar has a point.   If you didn't like their policies, you shouldn't have established with them to begin with.  There is a reason they only induce at certain times.




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  • image EmjayTheHunted:

    image Stellar3713:
    I thought you were certain that you were going early?  Seriously, why the FVCK are you so obsessed with planning every. single. aspect. of your pregnancy?  You're not even AT your due date and you're planning to sneak around your MW's induction policy?  Jesus, what else do you DO with your time?!

    Seems to me Stellar has a point.   If you didn't like their policies, you shouldn't have established with them to begin with.  There is a reason they only induce at certain times.

    did you both read what she wrote, she said they start TALKING about it at 41 weeks they don't induce until 42 weeks. So their POLICY is not until 42 weeks and she established with them for that reason

    now I don't see why you need to switch the appointment just for that, I wouldn't personally just stand my ground and ask for NST's and if they were ok we would proceed as normal.

     

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  • "Talking" induction is not necessarily something to worry about if you are confident about the practitioner you chose. At my 40 week appointment with my MW, she mentioned we'd start "talking induction" at 41 weeks too. This didn't mean we'd have one, it meant we'd put in a plan of action for what would happen if we progressed past 42 weeks. It meant we'd have an NST then and schedule another as we got closer to 42 weeks. It meant we'd start talking about options like acupuncture, visiting a chiropractor, castor oil, AROM, etc. 42 weeks is the point where I would have risked out of my homebirth, so that's why we had to have the plan in place. I would think this is a talk you'd want to have with your practitioner? Anyway, I didn't make it to my 41 week appointment, I had my baby that day. :)

  • It is up to you whether or not you want to be induced. Them having a policy means nothing if their patient refuses :P  

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  • 41w3d appointment = 41w appointment. Are you that damn dense? Oh wait, you are.

    Here's a magic word if they want to induce you before you feel it is time- "No". Works wonders. They can't strap you down and make you take meds to induce labor against your will.

     

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    "People seem to couple an inordinate amount of stupidity with extreme laziness." ~ A wise interwebz friend.

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  • image kdodge423:

    41w3d appointment = 41w appointment. Are you that damn dense? Oh wait, you are.

    Here's a magic word if they want to induce you before you feel it is time- "No". Works wonders. They can't strap you down and make you take meds to induce labor against your will.

     

    Dude, I need to find a new doctor. I thought strapping you down and performing medical procedures without consent was standard practice. :-P 

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  • I'm a little confused too. How is a 41 week, 3 day appointment not your 41 weeks appointment? I daresay that if you still haven't given birth by then, your MW will talk inductions. And I agree w/ the PPers, what is wrong with talking about inductions? It's not like they said they'd induce at 40 weeks or even 41 weeks.

    Are you thinking they'll let you go past 42 weeks? Is that something you'd want? If so, I find it better to be upfront with my medical provider rather than trying to sneak around them.

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  • You're 38 weeks...  why are you even worrying about this now?
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  • image drpayne:
    You're 38 weeks...  why are you even worrying about this now?

    Because she's SNEAKY!  And damn proud of it!

    ::headdesk::

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  • image whenyouseesparks:
    "Talking" induction is not necessarily something to worry about if you are confident about the practitioner you chose. At my 40 week appointment with my MW, she mentioned we'd start "talking induction" at 41 weeks too. This didn't mean we'd have one, it meant we'd put in a plan of action for what would happen if we progressed past 42 weeks. It meant we'd have an NST then and schedule another as we got closer to 42 weeks. It meant we'd start talking about options like acupuncture, visiting a chiropractor, castor oil, AROM, etc. 42 weeks is the point where I would have risked out of my homebirth, so that's why we had to have the plan in place. I would think this is a talk you'd want to have with your practitioner? Anyway, I didn't make it to my 41 week appointment, I had my baby that day. :)

    Hopefully it will be just a plan of action like with your mw. There are 7 obs and 7 mws with this practice and I feel like every one of them proceeds differently. When I first joined this practice, I asked the mw that I interviewed with all of these questions, but I'm finding that the answers depend on the ob/mw which is kind of frustrating. I've been trying to see most of them because you don't know how will be on call when you deliver. Luckily I liked all of this particular mw's answers and she is the one I was able to schedule the 41 week appointment with.

    I read about things that your mws have suggested (like acupunture, chiropractor, raspberry tea leaves, evening primrose oil, etc) and these just aren't things that my mws have suggested to me. I have been seeing a chiropractor since the beginning of January. I mentioned this to one of the mws and she kinda wrinkled up her nose at the idea. I told another one how my chiropractor told me to stop taking fish oil at 36 weeks because it's a blood thinner and she had never heard that and also wondered why I was taking additional fish oil. 

    I hope that, like you, baby comes on his own before this is even an issue. I guess one of the ways that I'm preparing myself for the birth is really think everything through.  That's just how my mind works. I feel like it's a big exam that you study for and study for and you just can't wait until it's over so that you can stop studying for it. 

  • image margeincharge2:

    I'm a little confused too. How is a 41 week, 3 day appointment not your 41 weeks appointment? I daresay that if you still haven't given birth by then, your MW will talk inductions. And I agree w/ the PPers, what is wrong with talking about inductions? It's not like they said they'd induce at 40 weeks or even 41 weeks.

    Are you thinking they'll let you go past 42 weeks? Is that something you'd want? If so, I find it better to be upfront with my medical provider rather than trying to sneak around them.

    Well it sounded like if I have a 41 week appointment on my 41 week, 0 day, that they'll do a NST and if I pass, then I'll come back in on 41 weeks, 3 days to do another NST. If I pass that, they "may let me go to 42 weeks".  So I changed my appointment day to 41 weeks, 3 days as my 41 week appointment to delay talking about inductions as early. (Maybe this only makes sense to me...) When I joined this practice, I asked them when they induced and they said 42 weeks. But they never mentioned that they would start discussing it even before the average first time mom's delivery date of 41 weeks 3 days. When I brought this up with one of the mws, she said that she doesn't like the policy either but their hands are tied. I guess that's what I have the biggest problem with. And the idea that they will talk about it with me early as 41 weeks makes me very anxious since it's completely out of my control when my labor starts.

    I would consent to an induction at 42 weeks, especially since my EDD is accurate (I charted and had an u/s at 6 weeks that was only one day off what my charts said).  

    I guess I just want a hands off approach and they are being way more hands on than I originally thought they would be. I just feel like birth is a natural thing and it doesn't need to be so managed. We considered home birth, but decided to go with a hospital birth. I read all of these wonderful stories about home births on this board and I'm wondering if we made the right choice. But since we already made our choice, I'm just trying to work through my options. 

  • image thebigmare:

    Well it sounded like if I have a 41 week appointment on my 41 week, 0 day, that they'll do a NST and if I pass, then I'll come back in on 41 weeks, 3 days to do another NST. If I pass that, they "may let me go to 42 weeks".  So I changed my appointment day to 41 weeks, 3 days as my 41 week appointment to delay talking about inductions as early. (Maybe this only makes sense to me...) When I joined this practice, I asked them when they induced and they said 42 weeks. But they never mentioned that they would start discussing it even before the average first time mom's delivery date of 41 weeks 3 days. When I brought this up with one of the mws, she said that she doesn't like the policy either but their hands are tied. I guess that's what I have the biggest problem with. And the idea that they will talk about it with me early as 41 weeks makes me very anxious since it's completely out of my control when my labor starts.

    I would consent to an induction at 42 weeks, especially since my EDD is accurate (I charted and had an u/s at 6 weeks that was only one day off what my charts said).  

    I guess I just want a hands off approach and they are being way more hands on than I originally thought they would be. I just feel like birth is a natural thing and it doesn't need to be so managed. We considered home birth, but decided to go with a hospital birth. I read all of these wonderful stories about home births on this board and I'm wondering if we made the right choice. But since we already made our choice, I'm just trying to work through my options. 

    I guess I don't see the difference... it sounds like you're going to go in at 41+3 for your first NST. Had you kept the original schedule, one of two things would have happened: 1) You would have gone in at 41+0, and passed the NST. Then you would have come back at 41+3 for another NST, so you'd be on the same schedule that you are now from that point forward. Or 2) You would have gone in at 41+0, failed the NST, and been induced immediately. In which case, yes, your new schedule will delay that induction, since you won't find out till 41+3 that something is wrong... but then it may be too late.

    And I guess I don't see why it's OK to talk induction at 41+3 but not at 41+0? Maybe I'm biased because my induction was scheduled at my 41 week appointment, i.e. at 41+0. But it wasn't that I was induced at that point, we just, literally, "talked induction." I wasn't induced until 42 weeks, which was as late as I (and, apparently, you) wanted to go. It's not like delaying the induction talk for 3 more days would have also delayed the induction for 3 more days...

    I understand that you want a hands off approach, but if the biggest pregnancy-related problem that you have over the next few weeks is the fact that your provider wanted to "talk induction" at 41+0, consider yourself blessed.

    Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)

  • Oh I get the preparation and information gathering, that was me too. It's a certain personality type I think... all of the research I did beforehand allowed me to relax and just go with the flow during labor.

    I also get you wanting things as hands off as possible. What I don't get is why you wouldn't want an NST at 41 weeks. Not flaming you at all, just curious. In my mind, it's not invasive and it is an assurance that your baby and placenta are doing well so that you can AVOID induction. And if you failed the NST, that would mean there was a potential issue and a reason for considering induction (rather than an induction for convenience or after some arbitrary time beyond "due date"). My MW was super hands off... I never had my pee tested except for my GD screen, I never had an internal exam, and she still felt an NST at 41 weeks was a valuable tool.

    **Edited wording for clarity as suggested below.  Also, I forgot to mention, if there were concerns with the NST, my MW would have sent me in for a biophysical profile.


  • image whenyouseesparks:

    Oh I get the preparation and information gathering, that was me too. It's a certain personality type I think... all of the research I did beforehand allowed me to relax and just go with the flow during labor.

    I also get you wanting things as hands off as possible. What I don't get is why you wouldn't want an NST at 41 weeks. Not flaming you at all, just curious. In my mind, it's not invasive and it is an assurance that your baby and placenta are doing well so that you can AVOID induction. And if you failed the NST, that would mean there was an issue and a reason for the induction (rather than an induction for convenience or after some arbitrary time beyond "due date"). My MW was super hands off... I never had my pee tested except for my GD screen, I never had an internal exam, and she still felt an NST at 41 weeks was a valuable tool.

    I just want to clarify that this is not how NSTs work.  NSTs are a screening test, not a diagnostic test.  The results of a NST are either "reassuring" or "non-reassuring."  If you have a non-reassuring test, it does not necessarily mean there is a problem or that an induction is needed.  It means that more evaluation needs to be done to determine if there is a problem or not.  It's similar to the 1 hour glucose test.  "Failing" the 1 hour doesn't mean you have GD.  It means further testing is needed to determine whether you have GD or not.

    Here's ACOG's patient information on NSTs:

    http://www.acog.org/publications/patient_education/bp098.cfm 

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  • Oh geez......just because they talk about induction at your 41 week appt. does not mean they start the induction then.  Good grief.....
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  • image iris427:
    image whenyouseesparks:

    Oh I get the preparation and information gathering, that was me too. It's a certain personality type I think... all of the research I did beforehand allowed me to relax and just go with the flow during labor.

    I also get you wanting things as hands off as possible. What I don't get is why you wouldn't want an NST at 41 weeks. Not flaming you at all, just curious. In my mind, it's not invasive and it is an assurance that your baby and placenta are doing well so that you can AVOID induction. And if you failed the NST, that would mean there was an issue and a reason for the induction (rather than an induction for convenience or after some arbitrary time beyond "due date"). My MW was super hands off... I never had my pee tested except for my GD screen, I never had an internal exam, and she still felt an NST at 41 weeks was a valuable tool.

    I just want to clarify that this is not how NSTs work.  NSTs are a screening test, not a diagnostic test.  The results of a NST are either "reassuring" or "non-reassuring."  If you have a non-reassuring test, it does not necessarily mean there is a problem or that an induction is needed.  It means that more evaluation needs to be done to determine if there is a problem or not.  It's similar to the 1 hour glucose test.  "Failing" the 1 hour doesn't mean you have GD.  It means further testing is needed to determine whether you have GD or not.

    Here's ACOG's patient information on NSTs:

    http://www.acog.org/publications/patient_education/bp098.cfm 

    As always, Iris, thanks for the link.

    Is research part of your profession by any chance? 

  • image whenyouseesparks:

    Oh I get the preparation and information gathering, that was me too. It's a certain personality type I think... all of the research I did beforehand allowed me to relax and just go with the flow during labor.

    I also get you wanting things as hands off as possible. What I don't get is why you wouldn't want an NST at 41 weeks. Not flaming you at all, just curious. In my mind, it's not invasive and it is an assurance that your baby and placenta are doing well so that you can AVOID induction. And if you failed the NST, that would mean there was a potential issue and a reason for considering induction (rather than an induction for convenience or after some arbitrary time beyond "due date"). My MW was super hands off... I never had my pee tested except for my GD screen, I never had an internal exam, and she still felt an NST at 41 weeks was a valuable tool.

    **Edited wording for clarity as suggested below.  Also, I forgot to mention, if there were concerns with the NST, my MW would have sent me in for a biophysical profile.

    Not trying to beat a dead horse here...

    But to answer your question. I have an issue with having a NST done at 41+0, when the average first time mom delivers at 41+3. I mentioned this to the mw that I saw last and she agreed with me that it is a little ridiculous to act like you are overdue and need monitoring, when in fact, you're not overdue. But she said it's the practice's policy even though she understood where I was coming from. Also, one of the obs and I were talking about external fetal monitoring (EFM) recently. It was actually invented at the hospital that I'm delivering at. He said unfortunately, EFM has not been able to reduce fetal deaths (which is why it was invented) and all it has done is increase the c/s rate (And for the fact checkers, I don't have a source to cite except for my doctor). It is my understanding that a NST is considered an EFM. (BTW, he gave me some advice about EFM during labor. He said that if the ob on-call doesn't like the results of the EFM and starts talking about interventions, that I should ask for internal fetal monitoring before giving consent. He said even though it's more invasive, it's more accurate.) 

    Of course, when push comes to shove, if having a NST results in fewer inventions in the long run, I'd certainly consent to it.

  • image thebigmare:
    image iris427:
    image whenyouseesparks:

    Oh I get the preparation and information gathering, that was me too. It's a certain personality type I think... all of the research I did beforehand allowed me to relax and just go with the flow during labor.

    I also get you wanting things as hands off as possible. What I don't get is why you wouldn't want an NST at 41 weeks. Not flaming you at all, just curious. In my mind, it's not invasive and it is an assurance that your baby and placenta are doing well so that you can AVOID induction. And if you failed the NST, that would mean there was an issue and a reason for the induction (rather than an induction for convenience or after some arbitrary time beyond "due date"). My MW was super hands off... I never had my pee tested except for my GD screen, I never had an internal exam, and she still felt an NST at 41 weeks was a valuable tool.

    I just want to clarify that this is not how NSTs work.  NSTs are a screening test, not a diagnostic test.  The results of a NST are either "reassuring" or "non-reassuring."  If you have a non-reassuring test, it does not necessarily mean there is a problem or that an induction is needed.  It means that more evaluation needs to be done to determine if there is a problem or not.  It's similar to the 1 hour glucose test.  "Failing" the 1 hour doesn't mean you have GD.  It means further testing is needed to determine whether you have GD or not.

    Here's ACOG's patient information on NSTs:

    http://www.acog.org/publications/patient_education/bp098.cfm 

    As always, Iris, thanks for the link.

    Is research part of your profession by any chance? 

    My current profession is stay at home mom, so no.  I just get bored. Smile 

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  • Oh you're not beating a dead horse, I was just curious about your reasoning. Like I said, it wasn't something I had to do so I never gave it much thought.

     


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