the labor induction debate

NewMrs07

Seems to me like the doctors nowadays love to schedule inductions, even when you're not even officially past your due date! You can't believe the resistance I'm having at my ob/gyn office b/c I want labor to start naturally, even if it's after 41 weeks. I know with 99% certainty that my due date is around 8/24 but b/c I have long menstrual cycles, the 28-day wheel isn't accurate for me and the doctor's computer puts my EDD at 8/19. So when they think I'm 41 weeks and "late" I'll actually be 40 weeks, which is not late at all.

It's going to be a battle w/ the doctors if this baby isn't born around 40 weeks, which is very probable. I am very against being induced b/c so far (knock on wood) there are no medical reasons for it.

What do you all think? Yay or nay for inductions? WWYD in my case. I don't know if I should find a different ob/gyn at this point or just go with the flow. So frustrating. Maybe baby comes on time and this is a moot issue, but I'm just trying to figure out my options here.

MrsW.10.15.05

Hi.. I agree on a lot of docs wanting to schedule inductions.  I am an OB nurse and see it a lot, unfortunately.  Sometimes for pt request and a lot of time for MD convenience.  I went to 41 weeks with no problems.  Still didnt go into labor though. The one thing I will say is that once you go past 41 weeks the efficiency of your placenta starts to decrease.  Some docs (not as many these days) will let you go to 42 weeks but its pretty rare.   It is totally not unreasonable to tell your doc you want to wait!!  good luck!

KD288

Hmmm, I don't think I would find a new doc I think I would go with the flow.  BUt I am the type of person who if the dr recommends something then I will trust they know best.  This is not to say I won't question the reasoning like in your case, but honestly I would just ask for them to wait until week 41 and if nothing happens then I would go forward with the induction. The concerns I have read about with induction seem to really be associated with those induction at like 36 weeks.

But thats my 2 cents.

Let us know what you decide to do!

Kristina

carladillon

I'm with you - I really don't want non-medically essential interventions.  Have they given you a reason as to why they want to induce?  I mean, do they feel the baby is too big or under any stress?  Of course, it is always ultimately up to you.  I haven't had that discussion with my doc yet, but I guess my questions would be as to a medical reason why.  And are they able to support me decision?

Good luck - keep us posted as I am really curious about this as well.

stever

Though inductions are sometimes necessary, I don't get the prevailing attitude that they need to be scheduled as soon as you hit 40 weeks. I'd say you jut need to stand your ground. They can't make you induce... I think.

Laura Cochran

I really think it's a personal choice. I personally have concerns with going too much past my due date, placental degradation, meconium, freakishly huge baby. Ask your doctor what his/her reasons for wanting to induce? If the reasons aren't good enough for you , then you'll have to make some choices.

My baby is due on Dec 27 (based on my Ovulation) and I have no intention of having this baby in 2010- so an induction may be in my future, but I really hope she comes on her own, on time. 

gobigblue

my OBs office recs delivering before 41w.  i was 40w5d when induced w/ DD.  all went perfectly fine.  i do think you should talk to your OB and voice your concerns.  surely, they will work w/ you up to a point.  even if they "let" you go to 41w, that will still be 2 days past YOUR calculations.  good luck!  i do think finding another OB at this point might be too stressful.

Kandie35

I went into my 42nd week with my first two children and then went into labor on my own. That was 18.5 and almost 16 years ago though, so there wasn't even talk of induction because the pregnancies were healthy and normal. My fourteen year old was nearing the 43rd week and was beginning to lose weight so she was induced. My four year old they induced me early because of a medical condition. My last one they induced me a week early out of fear she would be large like her siblings (she ended up being my tiniest at 7 pounds). I say, be firm with your doctor. Let him/her know that you will not have an induction done unless it is medically necessary and that your insurance won't cover it unless there is a problem (nothing wrong with putting the fear of not being paid in there if you have to ;-) ). Being induced is a much more difficult way to labor than naturally going into labor, so avoid it if you can! I wish you the best. You make sure you do what your conscience dictates.

mominatrix

If they want to induce you at 40 weeks, say no.

Here's the American College of Obstetricians and Gynecologists (THE organization for OBGYN's) pamphlet on labor induction:

https://www.acog.org/publications/patient_education/bp154.cfm

ACOG says that these are valid reasons for induction:

 

Unless a problem occurs, labor induction is not done before 39 weeks of pregnancy. Reasons for inducing labor may include one or more of the following conditions:

• Your pregnancy is postterm (more than 42 weeks [emphasis mine]).
• You have high blood pressure caused by your pregnancy.
• You have health problems that could harm you or your baby.
• You have an infection in the uterus.
• You have placental abruption (the placenta has begun to separate from the inner wall of the uterus before the baby is born). You may have your baby by cesarean birth in this situation.
• You have premature rupture of membranes (your water has broken too early).

 

In other words, unless there's a medical reason to induce you, you shouldn't be induced for being "late" or even "term" until you reach 42 WEEKS.

 

The fact of the matter is that induction isn't as good as going into labor naturally... you stand a 50% higher chance of ending up with a c-section when you induce... 

The reality is that primaparas (first time moms) don't average out at 40 weeks... they average out at 41 - - 

Why not let the baby stay until they're ready?

There's no evidence of any negative ramifications before 42 weeks... what's the rush???

 

 

funchicken

I'm sort of torn on the issue.  Did they use an early ultrasound to estimate your due date?  I've heard those are pretty accurate. 

When I was trying to decide what to do before S was born, my midwife did tell me that there's a higher incidence of needing a c-section if you're induced at 42 weeks vs. 41 weeks, and for that reason I scheduled an induction at 41 weeks (I ended up going into labor naturally at 40wks 4 days).  One of my friends chose to hold off on the induction and had acupuncture to help her labor get started--I think she was about 10 days past her due date when she finally went into labor.

Now that I've been through it, I think I'd hold off in hopes of going into labor on my own.

I don't think I'd find a new OB at this point since you're so close, but get your doctor to explain the advantages and disadvantages.  You shouldn't be coerced into doing something you're not comfortable with.

livvielo

I don't have any answers, but I'm glad you brought up the question. I've been starting to think about it?my gut says I would rather not be induced. But I don't feel like I have all my information in order to have a solid opinion yet. It's good to hear all these perspectives, so thanks everyone!

dkays

My first DD was induced and I ended up having a c-section @ 42 weeks. My other two DDs were not induced even though they were 42 weeks and I was able to have VBAC both times. They were both bigger than my first. If you feel strongly about this you need to stand your ground. 

Peppernut

I would very much like to avoid induction.  They can determine placental degradation through ultrasound, so, to me, if the baby is doing fine and the placenta's still in good shape, I'd rather go into labor naturally.

My mother had 5 children, and every one of them came at least a week late.  The youngest was the only one that was induced, because she was a *month* past due.  Her mother also had late babies, and my sister had one at term and one induced at 41 weeks.  I don't want my doctor to push to induce at 40 weeks if my family history clearly indicates we tend to take a little longer.

akgram

I certainly wouldn't find a new OB at this point but that's just me.  Hopefully you'll go into labor on your own and I'm sure you've researched all of the risks for going overdue?  GL in what ever you decide.

Kat28655

I went into labor naturally with DD at 41 weeks. I am more likely to avoid unnecessary medical intervention if possible. My body know how to go into labor and it will do it when it's ready. As long as my child is OK, please don't bother me! That said, at 41 weeks I was so ready to not be pregnant anymore!

Jerseygirl16

Well, in your situation wanting to avoid an induction I think that you should definitely have input over your own delivery.  Since you know for sure when you conceived and assuming you are willing to go for close monitoring (to ensure the conditions in the womb are not deteriorating) then I think you should be allowed to wait it out a little. 

Personally though I'm all for induction.  I have been induced with every deliery so far and it was great.  With DD #1 they induced at 38w3d because she was estimated to be just under 9 pounds and if we waited until my EDD she would be estimated over 10 pounds and the hospital would have insisted on a c-section.  It was my choice but I went with the induction to hopefully avoid the c-section which I was able to do.  Delivery was fantastic considering I was in the hospital when my labor was started and was able to get the epidural before I ever felt any pain.  With #2 it was the same situation and I was induced at 38w5d.  

This time I am going to ask about an elective induction regardless of size.  If it's another large baby we can indue early and that is fine with me but even if it's not then I'd like to be induced in my 39th week.  We just moved 2 hours from family and don't know anyone here that we can have watch our 2 small children.  If I went into labor naturally and it went fast (as is likely with baby #3) there is a very good chance that I'd have the baby before anyone could get here to relieve DH and I'd be alone at delivery (and he would miss the birth of his last child).  I am seeing a midwife right now so I may need to be transferred to an OB and I need to talk to them about this.  

dsoltys

I guess I am the minority, but it scares me greatly to go past the EDD.  Here's why:

My neighbor was just shy of her due date and her OB asked her if she would like to be induced.  Wanting to go the more natural route, she and her husband decided to wait till she could go on her own.  She was not that much overdue when she did go into labor.  Their baby swallowed meconium and developed a severe infection which landed him in very critical condition.  His blood needed to be filtered.  He was in the NICU for 6 months. He is fine now, but still develops croup at the drop of the hat.

I don't think it was worth it for them to wait, do you?

I have always gone past my due date because I cannot go into labor on my own.  I am 38 years old and expecting my 4th child.  I am severly high-risk because of some nuchal fold issues that we had early on and because of a past fetal demise at 20 weeks.  My OB says we will induce a week early.  At this point, I think we will all be happy once this baby is born.