Thoughts on refusing induction
My hospital mw recommended induction at 39 weeks due to borderline high BP. I was devastated, but I also remember feeling so vulnerable at that point in my pregnancy. If you are dead set against induction, do you get a second opinion, change providers at the last minute, or just flat out refuse it? If you refuse, doesn't that set you up for a very stressful environment once you check into the hospital?
Personally, I was really worn down by "worst case scenario" thoughts and it seemed like being induced was a choice to err on the side of caution. It was also a way to preserve the good relationship I had with my midwives. Fortunately, my MW ended up consulting an OB at the hospital and they agreed to let me go another week (I went into labor on my own 5 days later). But I was literally in tears, packing for the hospital when she called it off.
Anyway, I just want to extend my sympathy to anyone who finds themselves in this situation. It seems like there are a lot of these stories out there.
Re: Thoughts on refusing induction
I'm not well versed in the conditions that prompt early induction (high BP, GD); but I am struggling to understand the logic of it. (I'm working on being open minded and not just hating on all things hospital.)
Is the concern for the mother's health.... that pregnancy is hurting the mother and 39 weeks is the compromise between healthy baby/healthy mother? Is the concern for baby... that a less-than-optimal mother isn't providing enough for the baby?
I've just read several posts about early induction, and I am scratching my head to understand how it helps the situation. My sympathies to those of you out there dealing with this.
I'm not really sure how I feel about it. I was lucky to go into labor 15 days early with my first - so it was never an issue. This time around, my OB told me he will induce at 40 weeks because studies have shown a higher number of still births after 40 weeks. So basically, you either deliver early or you are induced.
I think it's craziness, and it's one of the reasons I'm seriously considering a birthing center with a new set of providers.
WHAT? That is ridiculous! Based on what? I have NEVER heard of this before, and I have been reading pregnancy books like crazy.
I am so against induction due to going over the "expected delivery date." The date is exactly that: an expectation. An estimate. A medically educated guess. I have found more studies that show that induced babies are often not as prepared to deal with the real world because they're not "done cooking" as opposed to letting the baby stay in longer. That just shows how medically prejudiced your OB is, to want to interfere when not necessary.
Oh I need to find a good blog post I read regarding the "your baby will die" suggestions! I was actually induced at 40w for PIH even though I had read up on everything, but was still scared b/c I didn't know anybody else besides my midwives that were naturally minded at the time (obviously they were still hospital midwives though). That being said, after 3 nights of failed induction I asked to go home since my bp came down and so did my proteins. This is why I'm switching providers and getting a doula this time!
One nurse in the hospital even made the analogy of a perfectly formed apple on the tree in the middle of winter and how nature isn't always right. Ah, see the "your baby will die" suggestion again! Totally went over my DH's head, but not mine.
the average pregnancy lasts 41w1d... so how could they say that?? my MW said that they would induce at 42w, which seems to be the longest that most practitioners will allow. i understand that as the placenta ages it starts to break down, but 40w is a little too early if you ask me.
I would never accept an induction unless there was a verified medical emergency. This does not include going past due or speculations that the baby is getting too big b/c as a health care provider - I've never seen these speculations to be born out in reality. A colleague of mine who is a nurse at a local ER went 42 weeks and 5 days before beginning labor naturally and having a wonderful, natural home birth. She has a healthy, happy one year old daughter now. So there I would refuse any induction based on EDD.
That being said, there are a few conditions I would accept induction for, including pre-eclampsia because this can be a very serious or fatal complication. I would have to think long and hard if it was just borderline high blood pressure -- and consider the other factors to the individual situation. GD is also something I would consider the individual factors before making a decision, as this too is something that can be prone to speculation -- there is a lot of talk in the medical community that the standards for establishing GD are too low and therefore most women who are told they have this and induced early do not and there really isn't any cause for alarm. That's not to say it doesn't exist - but again, would give me thought before I agreed to induction.
My MW is of the same mindset ... allowing baby as long as he needs. So she will simply monitor me when going past due date, and as long as there is no fetal or maternal distress, she won't even broach the subject of induction.
I am a very big proponent of having a spontaneous natural birth with no interventions; however, I would never advocate bypassing the professional judgement of my midwife. I think it is always a good idea to research your options, engage in a discussion with your provider, even seek a second or third opinion, but at the end of the day, they are the professionals and I trust that they are doing their job.
My OB saved my DS1's life. My placenta was calcifying prematurely and causing IUGR. I just read a birth story yesterday about a similar condition in which the outcome did not turn out so well. The midwife didn't catch it and the baby died in utero at 39 weeks. I was induced at 38 weeks and was able to have a med free labor and DS1 was born perfectly healthy.
Oh and I will say that I have had both a spontaneous natural labor med free and an induced med free labor and it was not that different (as far as pain goes). I think people are just anticipating it being worse so they "hype it up" and it causes it to feel worse. Our minds are pretty powerful and it can work for us or against us.
9 angels in heaven-3 in my arms and 1 in the NICU
Mono/di twin girls: Josephine born to heaven and Evangeline born Earthside at 25w
I had to augment with pitocin after 24 hours of natural labor (I made it to 7cm on my own.) Despite my "good attitude," lots of preparation and a great support team, the contractions on pit were VERY different for me. The pain was absolutely blinding. I have to say I kind of resent your implication that it was all in my head!
That said, I'm glad you had a good experience and your sons were born healthy.
Sorry to offend. I am just basing it on my personal experience and FOR ME it was not that much different. My labors are very intense and very fast, so normal contractions came at me the same way pitocin induced contractions came at me.
9 angels in heaven-3 in my arms and 1 in the NICU
Mono/di twin girls: Josephine born to heaven and Evangeline born Earthside at 25w
when did your water break? Did they break it at they same time they administered the pit? Laboring after your water breaks IS very painful because there is nothing cushioning/protecting you anymore so you feel everything.
9 angels in heaven-3 in my arms and 1 in the NICU
Mono/di twin girls: Josephine born to heaven and Evangeline born Earthside at 25w
My water broke at home about 24 hours before I got the pitocin. It was very painful before the pit. After the pit, the pain was completely debilitating. I hope I'm not scaring anyone who plans a pain-med free induction. I do think it's doable in many cases, as your experience clearly demonstrates.
What pregnancy books have you been reading? I doubt it would be mentioned, unless you are reading medical journals.
Fact is, stillbirth rate goes up after 37 weeks. Nothing magically happens at 40 weeks, because as you said, it's just an estimation. You don't often see inductions at 37 or 38 weeks to prevent a stillbirth because the risks of going early compete with the risks of stillbirth. After 41 weeks there really aren't anymore risks to being early but there are certainly rising risks of stillbirth.
I think 41-41.5 weeks is a good compromise between inducing too early (right at 40 weeks) and waiting until it's too late, and as a result most OBs and MWs have that policy as well.