Out of the blue, at my 39 week checkup, my doctor started talking induction. This has been an extremely easy pregnancy, my blood pressure and sugar, the baby's heartbeat, basically everything has been completely free of complications, and the doctors have done nothing but tell me how great everything is. I am, however, not dilated, in fact, I am not even really effaced. The problem is, I think the baby is just not 'done'. I don't want an induction, but , I am not completely opposed to them. I just don't see the medical need for one. My doctor has basically said that I will not 'be permitted' to go to week 42. They could have told me this much earlier in my pregnancy, and I could have looked for a new doctor, but they did not. I do not think this is legal for her to say. I really feel like I am being bullied, especially after the 'perfect' biophysical profile and nonstress test I had yesterday, and I just want to know if anyone else has had an experience like this, and if so, what they think my options are. I know they can't force me into labor and delivery, but they can drop me as a patient I think. I don't want to be bullied, but I also don't want to do anything to hurt my baby. I don't care if they send me in to get these tests every other day quite frankly, but if I'm not even completely effaced, I feel like they are just setting me up for an unneccessary c-section, which the doctor has already slyly tried suggesting we set up. Anyone, please help. I don't know what to do any more.
Re: I think my doctor is bullying me.
I'm not a doctor but I believe going past 42 weeks is dangerous for mother and baby. I'd say an induction if you haven't had the baby at that point is reasonable, if not necessary. Could be wrong...
Based on the standards of medical care, going past 42 weeks (even 41) can be considered very, very risky. The placenta will begin to deteriorate at some point and can put both the mother and child in danger. Inductions, in these cases, make medical sense. I think sometimes inductions on the whole are "demonized", when the truth is, sometimes they ARE necessary.
Stick to your guns, but be clear with your doctor about your wishes. Be open to options that make sense and be ready for anything. That's the best advice I can give you....
Good luck!
You won't find many doctors that will let you go past 42 weeks - it's pretty standard procedure to induce before that mark.
That being said, with DS#1 I wasn't effaced or dilated at all at my 39 week appointment - but within 36 hours of that appointment I was in labor.
If the dr is saying to start inducing now and not even waiting until 42 weeks what I would do, if I wasn't ready, was like PP said, not show up to the appointment and just go to an emergency room/hospital when I do have the baby.
The only concern would be starting at 42 weeks the amniotic fluid can start getting low and more complications could arrise (according to our prepared child birth instructor). She went 42 weeks and didn't want to be induced but started researching how it would not be good for the baby. But if you are 39 weeks or 40 and you aren't ready....I would wait. Once 42 weeks hits then I'd be thinking induction.
It's a GIRL!
this.
I don't think there are m/any doctors that will let you go past 42 weeks. 42 weeks is still quite far off for you though. I think it's good that the doctor has opened the door to have the discussion with you so that it isn't sprung upon you at 41 weeks if you're still pregnant. You can say "no, I don't want to be induced before X date" but know that you most likely won't go past 42 weeks anyway so it will be a moot point.
You can go from 0% effaced and barely dilated to fully dilated and effaced in a very short time, your body will do what it's supposed to.
This. Age and calcification of the placenta can lead to decreased ability to pass oxygen and nutrients to your baby - especially at the 42-week mark and beyond.
My doctor and I had the induction talk the other day and here was her position: She will induce between 40-41 weeks if I desire - but that I should know that lack of effacement and dilatation may mean increased risk of c-section with induction. Waiting to the 41-42 week time frame would lower the risk of c-section, but not eliminate it. So, my choice - but I had to acknowledge that the risk of c-section existed.
Personally, I see no reason not to schedule an induction - especially if you are particular about being delivered by a particular doctor in your group (schedule when they will be on call). If you go into labor before that, no problem. We've decided to schedule in the 41st week and hope I go into labor before that.
I am officially at 41 weeks today. The doctor initially just indicated that they "don't let us get to 42 weeks". She then stated the standard concerns about low fluid levels and placenta breaking down. I don't mind going in for checking on those things every other day, the sonographer yesterday said that I had great fluid levels and she could see no indication of any sort of placental issues. For the nonstress test, they gave me juice and crackers and the baby responded as expected, with increased movements not long after I had eaten. I really just want to be allowed to go to 42 weeks before throwing in the towel. The practice only schedules inductions on Tuesdays and on Friday nights/Saturday AM, and as my weekly due date is a Thursday, and they claim to be full induction wise that weekend, and again, they 'don't let us get to 42 weeks'. My big thing is that I was quite late (more than 2 weeks) and I think I turned out OK, and also, I have no idea what my conception date was. We are just going off of my LMP, so I feel like the baby might not actually be as far as they think he is. The sonographer didn't say that the baby was 'big', and even if she had, the doctor herself said that the ultrasound measures of size are almost always wrong.
The number of BH contractions or severity of RLP can vary greatly. The risks of going past due are the same for everyone.
I understand that you don't want to be induced and that the tests seem to show everything is fine. However, your obstetrician is a trained professional and knows the risks of post-term pregnancy. There are risks associated with induction, but by 41 weeks, the risks to the baby far outweigh the risks of being induced.
You'll be 41 weeks and 5 days on Tuesday. Get induced then.
Your doctor is being responsible in discussing options and what may end up happening with you because you are considered full term and have not progressed. If they said he wouldn't let you go past 42 weeks, that's WISE and SMART for your safety and for the baby's safety due to all of the reasons mentioned above.
And the person who said it wouldn't be wise to start "considering" induction at 42 weeks - they're right. When scheduling a non-emergency induction, you are scheduled based on what the hospital has available. So, submitting your request at 42 weeks could mean L&D can call you in two days, schedule you for two days after that... and when you arrive, if the beds are full of active laborers, you're sent home. Its just way too risky, whether you feel great or not.
I would just keep your options open at this point because the end result is a healthy baby and a safe, complication-free delivery. If your doctor, the expert, thinks an induction around 41-42 weeks is wise, I would seriously consider heading their advice. And yes, the risk of a c-section increases a bit with an induction... but the risk of a c-section increases a lot the larger the baby gets and the longer you wait, the bigger the baby grows and FAST in the end.
I was induced with both of my kids and I already have an induction scheduled for this one if I don't go into labor on my own. I do not progress - with both of mine and so far with this one, I have always been like you - 0cm dilated, 0% effaced when I walked into the hospital. I delivered vaginally with no complications.
I do not think your doctor is bullying you - he is being responsible in making you aware of the reality of your no-progress situation. His JOB is to deliver YOUR baby safely and healthy and place him/her into your arms. You chose an OB to do just that... let him.
no dr. or midwife will let you go past 42 weeks! I would be concerned if they wanted to do it sooner but usually at 41 1/2 weeks they'll do it! they're probably just concerned about your lack of progress.
good luck!
Ahhh, the ol' OB bait and switch. I had this same experience with my first pregnancy and it caught me off guard as well. There really is no need, IMO, to talk induction so early unless there's a medical need to be induced. Like PP suggested, you don't have to show up to your induction appointment, and what's more, you don't really have to consent to one to begin with. While yes, there is some concern about the placenta and amniotic fluid once you get to a certain point, due dates are also not expiration dates. They are an estimation based on your last period (usually), and they usually assume you ovulated on day 14 of your cycle.
I was induced at 41w3d with my last pregnancy because I was "very overdue." I ended up with a c/s because my body wasn't ready yet. My son came out with plenty of vernix on him, so he really wasn't all that overdue as they thought.
You shouldn't do anything you aren't comfortable with, no matter what standard practice is. It's common for first time moms to go past 41 weeks. I say keep going in for the NSTs and don't schedule an induction until you actually feel comfortable doing it. Your instincts count for a lot in this.
Hang in there!
There is a 30+% C-section rate in this country. Yes, she should question her OB's advice. It's often situations like these where mothers end up having C-sections that could have been avoided.
Its also situations like these when a patient is okay with going as overdue as they want that causes serious complications. C sections are not fatal car accidents - sometimes you just don't know what the alternative could have caused, and the doctors' job is to keep everyone safe first and foremost. A friend of mine refused any type of medical intervention with her first delivery - she was 18 days overdue questioning her OB's advice and ended up laboring for 38 hours - baby was too big (at 10 lbs, 15 oz and 22.5 " long) and she couldn't get her out. She had an emergency c-section and her large "healthy" baby was in the NICU for 3 weeks because of the complications endured during the mother's anti-OB stint. The same OB suggested she wait at least 18 months before getting pregnant again because of the trauma her body endured. 9 months later, she was pregnant and insisted on a home VBAC, again questioning her OB's advice. Both she AND her second baby were taken by helicopter to the hospital because her uterus ruptured. Had she just gone with an induction around 41 weeks with her first, her body would probably have been in great shape - but now, she cannot have children again and she and her baby almost died from questioning their OB's advice. Its really not smart to question an OB's advice when you are overdue. This poster is currently at 41 weeks pregnant. Its not a "bait and switch" like you said in your previous post. Its serious if she goes past 42 weeks. The OB is not suggesting an elective induction at 37 weeks because the patient is a little uncomfortable. That's very different.
I'm sorry about your friend. Glad she and her babies are okay.
I get where you're coming from, but I also stand by what I said originally. If things are looking good, then why look for pathology when there isn't any? And yes, I still maintain that she should question her OB, especially if he started pushing her towards induction at 39 weeks, before she had even reached her "due date." (I called that move the "bait and switch" because it's a classic example - I wasn't referring to her being 41 weeks now.)
Honestly, some women have longer pregnancies than others. Some women's bodies just take longer to go into labor. I know that bad things can happen if you go too far overdue, but I also think that if she's feeling bullied by her OB, then she should pay attention to that feeling. Having been there myself, I know how it feels. It's her body and her baby, and she should have some say in what happens. It doesn't mean that I'm suggesting she should put her baby in mortal danger. I don't think there's any mortal danger going on in this situation. I think she's doing the smart thing by saying, "Hey, this doesn't sound right to me."
i'm going to go against the grain of the comments i've read and say that you have EVERY right to not be induced if you don't want to and there are no indications. this is a BIG patients' rights issue and doctors are put under a lot of pressure from their hospitals and insurance companies to induce whenever anything looks a little abnormal. do NOT let them force you into any procedures you're not completely comfortable with. obstetrics is particularly bad about forgetting that the woman is a patient, not just an incubator, and there are horror stories about women being forced into inductions and c-sections against their will. hopefully, you won't experience this, but the fact that your doctor is telling you will not be ALLOWED to deliver when your body is ready, is a big red flag.
if there is a natural birthing center near you, i'd suggest calling and just speaking to them. they tend to have a lot of experience with this kind of thing and can give you advice about what to say and what your rights are.
this is YOUR body and YOUR baby. don't let anyone try to scare you or bully you into doing something that doesn't feel right for both of you.
try to remember, just because it's common, or standard, doesn't make it right.
They did a c-section on my mother about 12 years ago (I'm the 3rd oldest of 13), because the baby was "done" but when my sister was born she was tiny and they said she was actually weeks EARLY! I suggest looking into natural ways to induce labor, though use caution when searching the internet. Perhaps you could contact a birthing center or midwife near you for advice. Take long walks if possible. Your last resort would be to wait until you are in active labor and then go in. You should be under no obligation to take every test, or even to go to every appointment, especially if they are harassing you. My doctor told me that no one stays pregnant forever (though it sure does seem like it! and the only danger in going "late" (IF your dates are COMPLETELY correct) is the placenta starting to fail, which is very rare. I wish you luck!
Mom of 4 on earth and 6 lost ones
I think your doctor is being responsible and trying to plant the seed, so that if it is necessary (inducement or csection for whatever reason) you are not surprised at the last minute. The doctor is preping you for things that might happen, so that they are not thrown at you later, this is smart. I understand it is upsetting, its a very emotional time for you right now. But inducements and csections are not the end of the world.
try some natural labor starters yourself, like the caster oil etc. try to relax, walk, try not to worry.
and the ultrasounds are a better indication of your due date than your LMP - my lmp "due date" is two weeks later than my actual due date, which I can confirm since my ultrasounds have been at 5 weeks, 7 weeks, 9 weeks - so im pretty sure they are right, and any LMP date is not.
Post this on the "Natural Birth" board and you'll like your responses better! I'm totally of the belief that many doctors are induction and c-section-happy. In many other developed countries they "let" you go past 42 weeks, and both maternal and infant mortality rates are lower than in the US. In fact in many other counties, your due date is set to 41 weeks, not 40.
Can you think of any reasons why your due date could be wrong to buy you some extra time? Was it based on your U/S or your cycle?
I totally agree with you.
Before agreeing to an induction, ask your doctor what your bishop score is. If it is 8 or above, a chemical induction will most likely be successful. If it's below, chemical induction won't work and you are headed for a c-section.
There are lots of natural ways to induce labor, but they will only work if you and your baby are ready. If you google this subject you will find a ton of info.
The bottom line is that if everything is ok with you and your baby, there is no harm in waiting. While it is true that most everyone agrees that going beyond 42 weeks is risky, it is still considered normal to have a 42 week long pregnancy. This is a fact and it is well documented.
If you don't like the way your doctor is treating you, it's never too late to switch. My midwife told me of a woman who switched to homebirth at 37 weeks after her doctor told her that 'women weren't designed to have babies'. Your doctor is essentially 'hired' by you~you can fire them anytime you want, you are not their property.
Keep us posted on how it goes!
I'm sorry you are feeling bullied. At this point it would be hard for you to find another doctor but as the other posters have said, it's common practice that doctors will induce by 42 weeks. I doubt you would find anyone willing to deliver naturally (assuming you can) after that. My doctor told me the same thing. First babies are on average 7-8 days "late," and as long as your tests show that you and the baby are healthy, I don't see why you shouldn't wait a little longer. You could make an induction appointment for the 42 week time just in case so that in the event the hospital is busy, at least you can get in.
I wanted a natural birth and didn't want to get induced when I had my son because it can lead to a seemingly endless amount of interventions. Pitocin causes harder contractions than naturally occur, so once you are induced, you will probably need an epidural or some other narcotic, which can cause you to have an inability to push and make for longer labor. This can lead to c-sections, which though common are major surgery. Pitocin can also cause the baby to stop breathing because they can't handle the strong contractions. That said, I would have been induced if I was 2 weeks "overdue."
Their are pros and cons both ways but you have to consider what is best and safest for you and your baby. Just don't wait too long and have a plan if you do get induced. It's hard to think clearly when you are in labor. Have an advocate, like your husband, who knows what you want and can go to bat for you when you're having that beautiful baby. Birth is big business and many doctors will advise c-sections for their own convenience. I don't know if your doctor has this attitude but I would make sure that she has a good reason.
I think this issue is pretty cut and dried but as a side note, in general, it's always wise to question your doctor. They don't know everything but it's also wise to take their advice into consideration too. They do know what they are talking about but sometimes new advancements are made that they don't all know about.