Frustrated with my OBGYN and induction policy... tips?

lovemyzeppelinWed117837

Well, I wish I did more research in the beginning and went with a midwife and birthing center.  We have an OBGYN and are delivering at a hospital.  I told my doctor and she was like "ok great! but be open to the epidural"... I was too thrilled with that response.  she also told me that they induce if you are even ONE day past 40 weeks.  That blew me away.  One day?  A week, ok fine, but one day?  Does this seem unreasonable to anyone else?  We are in the 3rd trimester and I feel like it is too late to switch doctors.  DH and I really want to go natural so we will labor at home as long as possible and be stern with the doctors and nurses. What do you think? thanks!

WearingRed

It's never too late to switch. I have a friend who switched at 40 weeks because she was told she had to have a csection without trial of labor for a baby who would be too big. She said no. The doctor said then you need to find someone else. She found a midwife willing to take her on. Delivered 3 days later without a problem healthy 9 pound baby boy. At least look around to see what your options are.

mjr12

WearingRed:

It's never too late to switch. I have a friend who switched at 40 weeks because she was told she had to have a csection without trial of labor for a baby who would be too big. She said no. The doctor said then you need to find someone else. She found a midwife willing to take her on. Delivered 3 days later without a problem healthy 9 pound baby boy. At least look around to see what your options are.

I agree.  I would start looking for a care provider.  Also the ACOG states that post dates is PAST 42 weeks.  https://birthwithoutfearblog.com/2011/08/22/what-acog-has-to-say-about-due-dates/ 

Check your state laws.  Also remember that just because you are induced DOES NOT mean that you will have your baby then.  It only increases the chances of an unnecessary c-section, IMO.

What would they do if you said no?  It's YOUR body. 

tokenhoser

I'd switch. If you're not in labour, it's not too late. There is no scientific backing to routine induction at 40 weeks.

There's also no squad to come deliver you to the hospital - if you choose to stay with them, you don't have to show up for an induction.

oliversmommy32912

tokenhoser:

I'd switch. If you're not in labour, it's not too late. There is no scientific backing to routine induction at 40 weeks.

There's also no squad to come deliver you to the hospital - if you choose to stay with them, you don't have to show up for an induction.

 

And sometimes it's not even too late if you go into labor. My mom is an L&D nurse and she said a woman came in in early labor once and the doc said he was going to rupture her membranes and she said no. He said if she wouldn't let him do it she would have to find a new doctor. She got up and left. She didn't come back so obviously she either had the baby on her own or she found someone else lol. 

I agree with PP's. It's not too late to think about someone else if you're serious about a birth with no interventions. All of these red flags that are coming up now will most likely become an issue when you're actually in labor. Laboring women are easy to manipulate. If you're hitting transition and your doctor offers you meds you might just take them. If you get induced at 40.1 and end up with a c-section you will have wished you had at least looked at other doctors. JMO.

wannabigfam

I find this interesting:  https://www.acog.org/~/media/Districts/District I/20120120_ElectiveIOLGuideline.pdf?dmc=1&ts=20120920T2258569383

 

Basically I find it interesting that the definition of elective induction states that there is no medical benefit for mother or child, and that one of the indications for elective induction is post-maturity (less than 41 weeks).  Print that off, show it to the OB and ask why they would recommend something that the ACOG states wouldn't provide medical benefit.

 And then search for a new provider.  If you can't switch at this point, I'd just not show up for the induction.  They can't make you do anything you don't want to do.  Worst case scenario, you go into labor whenever you go into labor and just show up at the hospital - they aren't going to turn you down.

shutupanddance07

There are lots of natural ways to get things going that you could try if you are afraid to switch doctors. That said, depending on where you live and how far along you are, you might be able to find a midwife and a birthing center that CAN take you on. You should do whatever you're comfortable with, and don't let your doctor bully you into treatment you don't want. If you don't want an induction, they can't MAKE you have one. Don't do anything you aren't comfortable with without an argument. Your doctor needs to make a case for an induction that early. 

sbevmc09

tokenhoser:

I'd switch. If you're not in labour, it's not too late. There is no scientific backing to routine induction at 40 weeks.

There's also no squad to come deliver you to the hospital - if you choose to stay with them, you don't have to show up for an induction.

I'd switch today.  It's never too late, even when you're in labor.  If you're not happy with your care provider you can always take the on call doctor over them (but considering you're not yet in labor I'd definitely just find a new provider ).  Yes, you can always refuse induction, but if this is their policy it's a HUGE red flag to me.  I wouldn't be able to trust them during labor/delivery.  

nosoup4u

1. It's never too late to switch, even if you are in your 3rd trimester

2. You don't have to show up for an induction (though you run the risk of having a pissed-off doctor, which could make for more stressed-out labor)

This is a good post about standing up for your rights in labor: https://rixarixa.blogspot.com/2010/12/dont-ask-just-do.html

I would seriously call around and see what other providers can take you right now. Good luck!

Hyaline

Yes, one day is completely unreasonable.  I tend to think that any date-based rather than situation-based policy for induction is unreasonable, but one day is truly off the map. 

And if you can't switch--if no one in your area will take you this late or insurance is a problem or whatever--remember that they CANNOT do anything without your consent.  They can't induce you, they can't push Pitocin, they can't schedule a c-section--not unless you give the ok.  If you're sticking with this OB, I would do what PPs have suggested and bring the ACOG recommendations to your next visit and ask WTH he's doing insisting on induction based on a "policy" that doesn't even follow current guidelines.  And while you're at it, push the envelope on any other "policies" you may not be happy with--IVs, continuous fetal monitoring, eating during labor.  Making him aware that *you* are educated and aware might be a tipping point--if he's used to maleable patients, he'll realize you aren't one.

ridesbuttons

Not knowing how far away you are, I would revisit this 'one day policy' with your OB at your next visit.  I find it hard to believe that this is policy and not a miscommunication between you and the OB.

mrsodonnell12

sbevmc09:

tokenhoser:

I'd switch. If you're not in labour, it's not too late. There is no scientific backing to routine induction at 40 weeks.

There's also no squad to come deliver you to the hospital - if you choose to stay with them, you don't have to show up for an induction.

I'd switch today.  It's never too late, even when you're in labor.  If you're not happy with your care provider you can always take the on call doctor over them (but considering you're not yet in labor I'd definitely just find a new provider ).  Yes, you can always refuse induction, but if this is their policy it's a HUGE red flag to me.  I wouldn't be able to trust them during labor/delivery.  

All of this. If that is the policy that sends several red flags up for me. Get out now!!

BBhopes15

I'm with you. I've been going back and forth about whether to switch or not. Do know your right and he/she can't make you do anything! You have the right to say NO. And if they don't like it you can get dropped from their care but there are places out there that will take you. Like some of PP said, you can even find a new doctor during delivery. Its my understanding that I can tell my doctor you are fired even during delivery and either the nurses will have to deliver the baby or I'm stuck with the on call. Or you can walk out and leave. Good luck!

tralalablah

agreed.  switch now while you can still get to know another provider.

i was reading henci goer's book yesterday which said that studies support that first time moms typically go eight days longer than the forty weeks, so i don't understand how an induction could even be considered until fairly well after that. i believe she quotes the studies in the appendices and you could show your OB if you just can't make the switch.

vsackett1

Well first of all, she can't do ANYTHING without your consent, and I would compromise a plan with her to make everyone happy, for example twice weekly NST and AFI scan's to monitor you and the baby. That way if your fluid level is fine and the baby is fine, she would have no reasonable answer as to why to induce you. Two weeks past EDD is totally common and normal (I was!) and again, as long as the baby is fine and you are fine, there is no reason to induce. If she is unwavering in this, then yes I would switch because it is just a red flag as to what she will be like at the actual birth. And for the record, you can request a new doctor in the middle of labor if you wanted to.

Celyn

If you can switch, that'd be the best situation.  If you can't, try to find out what your CP will do about your refusal.  I'd love to say that they can't do anything without your consent, but there are several known cases where that has not been true.  Know what the laws are in your state.

LindseyJW

it's not too late to switch and your doctor is telling you that she does not support your birth plan or have any respect for your baby or your body. mandatory inductions at 40 weeks are not evidence based and are increasing substantially your risk for unnecessary surgery. 

 

of course you can refuse the induction, but you will likely be met with resistance and have a difficult and contentious relationship with your OB.

if you choose to stay here, i would hire the best doula you can find and stay at home until you are ready to birth (which, as a birth professional, i don't normally suggest, but in this situation, it might be less risk to do that than to to subject yourself to the arbitrary rules set in place by your OB and the fact that she's already told you she'd prefer you to have an epidural). 

LaurelBee

Run, not walk far away from that Dr!! Simply saying no is not going to be enough! Your Dr will come back with Xyz reasons and will most likely tell you it's for the benefit of the baby. If you continue to argue, he'll start with the worst case scenario stories to scare you. 

And even if you are able to fight and win the induction debate, how do you think he's going to treat you during labor?!  Find someone who supports the mother and child, not their own conveniences! GL mama

mrsodonnell12

tralalablah:

agreed.  switch now while you can still get to know another provider.

i was reading henci goer's book yesterday which said that studies support that first time moms typically go eight days longer than the forty weeks, so i don't understand how an induction could even be considered until fairly well after that. i believe she quotes the studies in the appendices and you could show your OB if you just can't make the switch.

Thread hack.... what does the book say for the average STM and when she will give birth on average?

KathyLDRN

You have every right to refuse an induction. You have every right to refuse anything. You can refuse an IV, even monitoring. (Not that I recommend that), but I don't think people realize that they can refuse everything. You just have to sign a refusal of medical treatment. It's just a way that the hospital can prove that they told you they think you should have xxxyyzz, and you understand the risks, but choose to refuse it.

Unfortunately we live in a litigious society and OB is the highest area of litigation. You aren't just dealing with an old guy that only has a few good years left, you are dealing with someone that has 80 or so years of life left when you are talking about a baby.

seethesmiles

I switched providers at 38+ weeks with DS. One of the best decisions I ever made. Obviously, I'm recommending you find a new provider ASAP. Good luck!

cwm11985

You're not due until December...you have MORE than enough time to find a new doctor.  I think you'd be hard pressed to find another doctor that has a similar policy.  Make it a point this weekend to find the numbers of a few new ones and set an appointment.

rixaf

Based on your doctor's response to unmedicated birth and on her routine induction policy, I would not continue with that practice. It's really, really hard to get the birth that you want if your care provider isn't supportive. It can be done, but more often you'll end up with something you don't want. You'll also have to fight for what you want during labor. Many women find it impossible to do once they're in the process. And even if you can stand up successfully for what you want, that's NOT what you should have to be doing!

I second all the advice to start looking for another care provider and birth location. You still have time.

 In the meantime, I'd test that waters a bit more. At your next doctor's appointment, tell her that you will decline a routine induction and will wait until at or close to 42 weeks (or whatever) before considering one. See what her response is. Don't ask her permission; just gently but firmly tell her these are your strong preferences. See how she reacts. You could also ask her to provide evidence for her recommendation. 

But frankly, staying with this particular doctor doesn't seem like it will do either of you much good! One good way to start finding a supportive provider with less time than usual is to connect with local doulas. Tell them what you want and which doctors/hospitals/midwives/birth centers they'd recommend in your situation. They've seen a lot of providers in action and can usually give you "behind the scenes" information. 

FYI, here are the Canadian guidelines for  managing pregnancy between 41-42 weeks. And some commentary on induction for a Canadian parenting magazine. I don't know if you're in the US or Canada, but surely women's bodies work the same way regardless of which side of the border they live on!