Induction at (not before) 39 weeks for non-medical reason?

jpsquared

I'm going to talk to my doctor about this next week, but wanted to get other soon-to-be mommies' thoughts. I should preface this by saying I DO NOT want to be induced.  

That said, it is very likely that my state will drop my current health insurance plan on September 28.  I'm due on October 3.  This affects 200,000+ workers in my state; not just me.  There is a lawsuit pending between the state and one of the health insurance providers.  Long story.  I have called the Department of Health and Human Services, my HR rep, my doctor, my current health insurance plan, the plan I will likely get defaulted to, and some friends I have who work for the state.  The plan I will be defaulted to will provide much less coverage than my current plan.  I will end up paying around $10,000 more out of pocket. 

So, I do not want to be induced, but man, I could buy a lot more for my baby if I could just give birth five days earlier.   I know induction before 39 weeks is not advised without a medical reason, and I would not even consider that.  I'm looking for some information regarding the risks of being induced for a non-medical reason at 39 weeks.  I'm at 29 weeks right now, and I realize a lot could change once the due date gets closer; I'm just trying to be prepared.

XSailoretteX

That is an awful situation! I'm sorry.

How certain are you of your date of conception? Did you have an early (4-8 week) ultrasound? Were you charting at the time of conception?

Sorry to be so personal, but the certainty of the date of conception is pretty important.

HappyAardvark

Yikes, that is a REALLY tough one. Hopefully LO will help make the decision for you and come naturally on his own before 9/28!

This story was just in the news the other day - maybe you'll find it helpful for making your decision:

https://www.npr.org/2011/07/18/138473097/doctors-to-pregnant-women-wait-at-least-39-weeks

kellydw

If I were you and the doctor would do it and there is no harm to you or the baby, I would do it.

jpsquared

XSailoretteX:

That is an awful situation! I'm sorry.

How certain are you of your date of conception? Did you have an early (4-8 week) ultrasound? Were you charting at the time of conception?

Sorry to be so person, but the certainty of the date of conception is pretty important.

I'm not that sure.  I was not charting and did not have an early ultrasound.

My current carrier only covers the anatomy scan, which I've already had, but if it will help me get a more accurate date, I will definitely pay for another u/s out of pocket.  Hey, $250 is better than $10,000!

craitie

My friend had her c-section at 39 weeks for breech presentation.  I had another friend who's doc wanted to induce at 39 weeks because her baby was measuring to be 8 lbs and she was quite a small lady and they thought he might grow too big by 40 weeks.  So I'm sure they induce at 39 weeks all the time for various reasons and if it isn't unsafe for your baby they might be willing to do it for you.

BetsyDavis

Your risk for needing a c-section go up when induced early. Also induction do not mean for sure labor. If your body is not it is not ready. My induction took 2 days and they only pushed it because I was I had pre-e otherwise they probably would of stopped and waited longer. Being induced is no walk in park and if I had a choice I'd choose going natural every time. I'm about to be induced again if I do not go on my own by Friday due to pre-e again. Also many doctor's still will not do inductions even at 39 weeks unless you are a good candidate as in you are already dilated (usually they like you past 2 preferably 3) and effaced before hand. 

jpsquared

Does anyone know more about the dangers of pitocin and other induction drugs?  How would that play into your decision if you were me?

alicat108

Someone just posted an article on here from NPR about timing of induction and it looked like induction at 39-40 weeks was safe.  I would discuss the situation with your doctor and see what he/she says.  You would need to be a good candidate as well for induction. 

jpsquared

BetsyDavis:

Your risk for needing a c-section go up when induced early. Also induction do not mean for sure labor. If your body is not it is not ready. My induction took 2 days and they only pushed it because I was I had pre-e otherwise they probably would of stopped and waited longer. Being induced is no walk in park and if I had a choice I'd choose going natural every time. I'm about to be induced again if I do not go on my own by Friday due to pre-e again. Also many doctor's still will not do inductions even at 39 weeks unless you are a good candidate as in you are already dilated (usually they like you past 2 preferably 3) and effaced before hand. 

Thank you!  This is what I was looking for!

ludicrous

Another u/s at this point will not help to better date your pregnancy as it can be off by as much as 2-3 weeks.  And u/s at less than 12 weeks is very useful for dating purposes though.  This is a decision you and your doctor have to make.   I would be more leary about induction at 39 weeks with no early dating u/s but $10,000 is no joke.  If your doctor found heart tones via doppler at 10 weeks or something else that might provide a more solid idea of dates they may be agreeable to it.

KahlansMom

I too don't care what anyone else says, 10K is a LOT of money, I would talk to your doctor and explain the situation and hopefully he'll agree to a c-section at 39 weeks.  It might not be exactly what you were hoping for delivery, but to start out of the gate 10K in debt is ROUGH.  What a terrible situation, I really hope everything works out for the best.  Good luck!  Keep us posted!

BetsyDavis

jpsquared:

BetsyDavis:

Your risk for needing a c-section go up when induced early. Also induction do not mean for sure labor. If your body is not it is not ready. My induction took 2 days and they only pushed it because I was I had pre-e otherwise they probably would of stopped and waited longer. Being induced is no walk in park and if I had a choice I'd choose going natural every time. I'm about to be induced again if I do not go on my own by Friday due to pre-e again. Also many doctor's still will not do inductions even at 39 weeks unless you are a good candidate as in you are already dilated (usually they like you past 2 preferably 3) and effaced before hand. 

Thank you!  This is what I was looking for!

 

I saw you other question regarding drugs used. The affects they have can vary from person. Pitocin can make labor more painful and make you very nauseous. Most are considered safe and effective. Cytotec is not FDA approved for inducing but some doctors do like to use it since it is known for throwing woman into labor. If they do induce you I would ask that they try cervidil first if they mention cytotec at all.  

KOscar

I'd certainly talk to your doc.  I can't imagine paying 10K out of pocket.  That's totally insane.  My doc wanted to induce at 39 weeks exactly (medical reasons) but I wanted to wait.  We decided on 39 1/2 weeks.  I did have a dating ultrasound though at 7 weeks.  I spoke with several docs in the practice and they were all very comfortable with a 39 week induction.  I guess I'd just leave it to talk to your doc about what would be best for you.

unm00red

The problem is a third trimester ultrasound will not give you a good estimate of your conception date.  You really need one very early on for that.  (Like 5-6 weeks post-conception.)  It sounds like you could be off a week or two in terms of your conception date and that's significant when it comes to inductions.

You're in a really difficult situation and I feel for you.  Here is why I am, personally, so against voluntary induction...  First, it significantly increases your odds of having to have further interventions.  You may end up having to request pain medicine you wouldn't have otherwise due to the severity of contractions.  It also significantly raises your odds of ending up with a c-section which can cause additional complications to both LO and yourself. 

In addition, there have also been a couple of recent studies that inductions at 38 weeks literally double the rate of infant mortality at birth.  Now, the actual percentage is still really, really low.  (I want to say something like 0.5% vs. 1.0%  I'd have to look up the studies again.)  But if I was that one mom who ended up losing a LO due to complications from a voluntary induction, I don't know if I could ever live with myself.

I wish you all the best in making your decision.

pettycrocker

Even if you lose your ins. Cobra should pick you up. I would check into follow-up coverage before checking into being induced early. 

If you're body is not ready for labor, there is a possibility induction would fail- resulting in you having useless contractions for 48-72hrs and being sent home, or a c-section.  

jpsquared

Mrs Castillo:

Even if you lose your ins. Cobra should pick you up. I would check into follow-up coverage before checking into being induced early. 

That's the thing--I'm not losing insurance.  The $10,000 out of pocket is how much I will pay with the new insurance carrier.  And I know, that is about how much I could expect to pay if I didn't have any insurance and negotiated with the hospital (assuming there were no complications).  Insane.

caffinated_tulip

Mrs Castillo:

Even if you lose your ins. Cobra should pick you up. I would check into follow-up coverage before checking into being induced early. 

If you're body is not ready for labor, there is a possibility induction would fail- resulting in you having useless contractions for 48-72hrs and being sent home, or a c-section.  

Cobra is super expensive too though.

emmyloustu

Wait, you aren't talking about having to pay $10,000 for L&D are you? Am I understanding correctly that the new plan will have a $10,000 out of pocket deductible? If that is the case, that is your deductible for the entire upcoming calendar year and your L&D charges, while still expensive, would likely not cost $10k and you would be able to go on a payment plan for it.

We have a high deductible plan and while I don't love it, it hasn't been terrible. We had to pay 100% off all charges up to $2800, then from $2800 - $6,000 we paid and 80/20 split. Now that we are at our out of pocket max of $6k, everything is covered at 100%. 

With all that said, if your body is favorable at 39w, I would probably go for the induction and not have to worry about the deductible. 

elliesinclair

How unsure are you on the dates?  When did you get your BFP?  If you could have ovulated a week or more late, I would be worried about an induction at 39 weeks, just in case the baby was really only 37 or 38 weeks. 

Ritzy19

Normally I would not be a fan of people trying to get their Doctors to induce them for non-medical reasons like scheduling conflicts, Holiday conflicts, etc. However, in this case I would totally be considering the same thing.  That's a serious amount of money and the situation really sucks for you.  Hopefully your Dr. will be supportive of it.

itsmevkb

First, you may go into labor all on your own so let's hope for that.

Second, I would see how you're progressing closer to the 39 week mark.  If you're dilating then that would make it more likely that an induction would work.  Another poster cited a study showing an increase in infant mortality but I just read a study showing that even inducing at 38 weeks shows zero increase in fetal deaths.  Clearly if that were a big issue no doctor would induce early for anything other than very serious medical issues.

Fisherman'sWife

jpsquared:

XSailoretteX:

That is an awful situation! I'm sorry.

How certain are you of your date of conception? Did you have an early (4-8 week) ultrasound? Were you charting at the time of conception?

Sorry to be so person, but the certainty of the date of conception is pretty important.

I'm not that sure.  I was not charting and did not have an early ultrasound.

My current carrier only covers the anatomy scan, which I've already had, but if it will help me get a more accurate date, I will definitely pay for another u/s out of pocket.  Hey, $250 is better than $10,000!

I would think about getting another scan around 39 weeks and seeing how things are looking.  I am measuring big and am considering induction between 39-40 weeks.  

CalinsBride

In your situation, if the baby is fully developed, I would absolutely induce. $10,000 is a LOT of money.

alliapistor

How comfortable are you with a c-section?  I think you chances of ending up with a c-section due to a "stalled" labor are higher with an induction.  If that isn't a big deal to you and the baby otherwise looks healthy and ready to go, I would consider inducing.

I would try to confirm with the insurance company and your doctor again before I did anything.  A lot of doctors bill 1 time for all of maternity care.  That's one bill for care throughout the pregnancy and the delivery.  You've already paid for the care up to that point, so you should only be charged for the delivery.  Make sure you're getting the right data for your calculations before you make a decision.

 

forensicmama

I'm against unnecessary induction. HOWEVER, I think it is reasonable to ask to be induced at a week before your due date to avoid this whole mess. Hospitals don't like unpaid debts, either, so I can see them listening to your request. I would talk it over with your doctor now. Good luck!

memali26

Ugh, what a sucky situation for you Something else to consider - some insurance plans won't cover induction without a medical reason. If your current plan doesn't, your doctor would have to make up a reason to induce, which could constitute insurance fraud. I'm sure it happens quite frequently, but I honestly wouldn't want to be involved in that.

CurbsideProphet

Have you researched how much more an induction, potential c-section, etc will cost under your current plan? Are you okay with a c-section? Have you researched how much of your care will fall under your old insurance and how much the ave birth costs at your delivery location?

Depending on your coverage, you could still come out ahead with a low intervention vaginal birth on the new insurance.

Given everything you have said, I don't think I would induce.

wolverine8

Nope. I would not do that. I work at a hospital and with a normal vag delivery with an epi and a 2 night stay its not more than $8000 BEFORE ins. You need to find out what 10000 includes AND just because your doc says the babe is ready does not really mean he/she is. Wait. Banner Health facilities are banning elective inductions and c/secs.

MrsGo4Hockeychick

the only other problem to consider is how it would work if you were still in the hospital during the change. You would most likely be paying BOTH insurances at that time...and that might cost you more than just waiting it out and using the new insurance if needed. 

Kitty Holland

Mrs Castillo:

Even if you lose your ins. Cobra should pick you up. I would check into follow-up coverage before checking into being induced early. 

If you're body is not ready for labor, there is a possibility induction would fail- resulting in you having useless contractions for 48-72hrs and being sent home, or a c-section.  

I would definitely look into your COBRA rights once your insurance is dropped because that might be a way better option than getting induced early. 

LuluMommy3

GET INDUCED!!!!!!!!!!! 10K is way to much money!!!!!!!! Plus your baby is fully developed so I wouldn't worry! I've been induced with both of my pregnancies and this one soon! Good luck!

Jelliebean1982

Without a doubt I would induce.  $10,000 is a lot of money.  You need to think what's best for the whole family. 

kcisthebombdotcom

kdodge423:

Fisherman'sWife:

I would think about getting another scan around 39 weeks and seeing how things are looking.  I am measuring big and am considering induction between 39-40 weeks.  

Baby measuring large is not a reason to induce early. By the end I was measuring almost a month ahead. Early induction was never an option for that reason alone. Nor should it be. And an u/s now is worthless. Any dating u/s's must be done prior to 20 weeks as growth is at a standard rate until then (which is why anatomy scans are done at that point). After 20 weeks is where you start to see pronounced differences between small and large babies.

IMO, my child's health is priceless. I would rather have a healthy child and bill to pay than one with a lifetime of problems because I was trying to save money (which will also has a higher chance of costing you more money for a NICU stay and long term medical bills). I can understand with this reason the desire to go early, but is it really worth the risk in the long run? If it is something that you are going to look into OP, please insist that your doctor run tests to check the baby's lung maturity prior to induction (which they are supposed to do with early inductions if they follow ACOG guidelines anyway).

 

 

Statistically, the chances that a baby will need NICU time for not being ready at 39 weeks is less than 1%.

This is why many will induce/perform repeat c-sections @ 39 weeks.

I think anyone who would stay pregnant for a few more days and spend $10k is mentally insane. Babies are expensive enough as it is. It doesnt benefit the baby to have poor parents. Hospital payment plans only go so far.

NurseLaLa

99% of the time, I'd say NO WAY! But given your circumstances... The better option for your family is to try to have this baby early. 

Ask your doctor to schedule you in for a 39 week induction... At 38 weeks, ask your doc to check you... If you're dilated at all, ask for a S&S (it likely won't send you into labor just then.) Wait a few days, ask for another S&S, then if nothing happens off to your 39 week induction (ask for cirvodil first to ripen the cervix, then allow 12 or more hours to pass before allowing a pitocin drip).  If you aren't dilated at all, ask if he could do a foley dilation and follow that with a S&S. 

Matt Dvorak

Mrs Castillo:

Even if you lose your ins. Cobra should pick you up. I would check into follow-up coverage before checking into being induced early. 

If you're body is not ready for labor, there is a possibility induction would fail- resulting in you having useless contractions for 48-72hrs and being sent home, or a c-section.  

my dr. starts inductions 10 days past the due date b/c she doesn't like people to go past 14 days (the 42 week mark). Reason she does this, b/c not all inductions work right away and it might take a few days before the baby is actually born. So what if you got induced and then still had to pay money out of pocket? That would suck.

10K is a lot, but I think I'd just pay it to allow my baby to come on his own (I realize that not all are in the financial situation to do so, but that's how I feel). 

megd06

jpsquared:

BetsyDavis:

Your risk for needing a c-section go up when induced early. Also induction do not mean for sure labor. If your body is not it is not ready. My induction took 2 days and they only pushed it because I was I had pre-e otherwise they probably would of stopped and waited longer. Being induced is no walk in park and if I had a choice I'd choose going natural every time. I'm about to be induced again if I do not go on my own by Friday due to pre-e again. Also many doctor's still will not do inductions even at 39 weeks unless you are a good candidate as in you are already dilated (usually they like you past 2 preferably 3) and effaced before hand. 

Thank you!  This is what I was looking for!

something else to consider--if there were complications for the baby from being too early (on the off-chance that your dates were off by a week or 2) and had to stay in NICU--it might go past what your health insurance would cover--then you'd be out way more than that 10k. I'd definitely have a growth u/s  before inducing, just to make sure everything looks okay.