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3rd Trimester
alk1234
member
OB is being pushy!
alk1234
member
My last appointment with my OB, I was 34 weeks pregnant. I'm 35 weeks now. He asked me if I was having contractions, and I told him no. He said "I guess the baby is just content to stay in there still."
Then he started talking to me about induction. He started telling me that when I get to 39 weeks, we should schedule an induction for the 40th week or *maybe* the 41st.
Is this normal? I don't get why he was talking to me about induction when I hadn't even reached the 37th week yet. And I thought that they let you go until the 42nd week. My pregnancy is normal. There have been no complications, and I see no reason why he wants the baby to be induced in the 40th week.
I've been thinking about it, and I've come to the possible conclusion that he doesn't want to induce in the 41st week because that would be Christmas time. Am I being cynical? Is there a reason to induce in the 40th week?
Is it strange that I have no contractions in my 35th week?
This discussion has been closed.
Re: OB is being pushy!
Thanks.
This is my first time pregnant, and I've gotten so many conflicting stories about induction from different people that I just don't know what to think. Some people make induction sound like it's the most evil thing in the world, and if there's a way to avoid it, you should. So the doctor talking about induction at 40 weeks just kind of scared me.
It seems unsual that he is already taking induction when you aren't even close to 40 wks. That said, if he isn't trying to induce you before 41 weeks, I don't think that is a big deal. Overall, I have been told that having a holiday baby means often means that medical professionals will try to "schedule" you so that you don't interfere with their holidays. You just have to stay viligant and make sure no one is making you do something you are uncomfortable. Delivering babies during holidays just comes with the territory. They have to deal with it.
Side note, inducing when you are not ready can set you up to have a c-section. Don't let anyone push you into it if it is not needed or unlikely to be succesful. They give you a thing called a Bishop score which can predict the likelihood your induction with have good results. Research that more before you let anyone induce you. Good luck.
I agree! He's being pro-active. I also wanted to say that going 2 weeks over your due date is not necessarily safe. I had to be induced with DS, and everything went fine.
My MW wont induce until 42 weeks. Unless there is a problem. Don't let your OB push you into doing something you don't want to do. Personally - even if it was the holidays I would not want to be induced. The bottom line is that it's your body and your baby. You have a right to say no. If you are having a healthy pregnancy than going to 42 weeks before induction should be fine. Just don't be pushed into doing anything you don't want to do.
And I agree with you - it seems odd that he would be commenting on contractions and inductions so soon. It seems like he is trying to "schedule" you around his holiday schedule
I understand that the placenta could break down and the amniotic fluid could become too low if you wait too long. Of course I wouldn't want to risk that. Are there tests to see whether your baby is still thriving in there- to see if the placenta is doing its job and the baby is ok? If they can perform these tests and everything is fine, is there a reason for induction?
At 34 weeks unless you have amniotic fluid or other issues, there would be absolutely no reason to be talking induction with you.
Like I said, look up more info about Bishop scores. Essentially they look at a couple different factors: cervical dilation, effacement, consistency, position, and fetal station. By evaluating those factors, the doctor can predict how likely an inducement would be successful. If there wasn't a medical reason and if your score wasn't predicting inducement would be succesful I wouldn't do it. Of course, this is a personal decision only you can make.
Yes there are several tests that your provider will probably order once you hit 40 weeks (NST-non stress test, BPP-biophysical profile, ultrasound to check fluid levels and placenta, etc). If these results are still within normal ranges, then induction may not be medically necessary until between 41 and 42 weeks.
Oh, and I agree with RoseTor's reply 100%. HTH and GL.
~Sweet Girl *8/18/08* c-section ~ Sweet Boy *12/2/10* VBAC ~ Sweet Boy *8/14/12* VBAC~
VBAC Birth Story 2VBAC Birth Story
I'm probably more on the induction is evil side. Here would be my advice -
Do you care about having an increased likelihood for c/s? If yes, see if you can schedule NST (monitor baby's heart rate and movements) and u/s (check fluid levels) for sometime past your due date ex. 40 weeks 2 days. In the time being research the bishop's score, and when you get to that appt ask for your bishop's score.
Then you can make an informed decision about what it is best for you and your growing family. You'll have information about your well being and baby's well being and can choose then, if induction is right for you.
I'd try to avoid induction with a low bishop's score and a HEALTHY HAPPY baby, especially if you want more than 2 kids. Multiple c/s are a lot of surgeries to go through and can have complications further down the road. If you do have a c/s from failure to progress, unfortunately the road to VBAC is an uphill battle.
Hope everything goes well for you and none of what we're righting to you matters cause you have a healthy baby at 39 weeks -
it shouldnt be the doctor's plan, it should be the patient's - there is no reason for the doctor to 'plan" anything unless its for the health and wellbeing of mom and baby.
I would actually be concerned if you were having cxns at 34/35 weeks, and my caregiver would be as well (i know because it happened to me).
Mine mentioned induction at my 39 week appt, stating that if i made it to my 40wk appt (which is today) we could schedule my induction for that Fri night (which would put me at 40w6d by the following day) - however all i said was "i dont want to do that" and she said no problem, we could wait another week. At that time everything was fine with me and baby, BP normal etc. I am sure once i hit 41 weeks she will want to do NST, BPP, etc and i would welcome it at that time. but there's no reason to rush into induction ahead of that (especially since i have a low bishop score). the average first time pregnancy goes to 41w3d, and in fact, in Europe they are looking to change pregnancy completion to 41 weeks, instead of 40.
i agree it sounds like he may have realized that your EDD falls near xmas, and that may be the motivation.
Just most importantly know that you have rights, and just b/c your Dr says "we're going to schedule your induction for X date" doesn't mean you have to agree to it- sometimes saying something as simple as "i'd rather wait another week", or "X amount of days", or simply "i dont want to do that" is enough to get them to change course. a lot of Drs are just used to patients who b want scheduled births, so they assume everyone does. Bottom line, as long as mom and baby are healthy, the longer you wait to be induced, the higher the likelihood that it will be successful (because your body/cervix is more "favorable")
It's pretty simple, really. There are only a certain amount of labor and delivery rooms in a hospital. At certain times, especially Christmas, there are a surge of inductions. If you need to get in, your name is on the schedule. If you don't hold a space, you're SOL when you need to deliver, and you may have to go to another hospital and your doctor might not be able to deliver you. And don't give me that "they can't turn you away" crap, because they can. All a hospital legally has to do in the ER is stabilize you and transfer you if needed. If they are full... they are full. Sorry, no room, keep going to the next facility.
Also, your placenta begins to degrade at 40 weeks, and by 42 weeks, it's can fail. They CAN leave you till then, but every day you're pregnant past 40 weeks if potential for problems.
You women get a little too gung ho anti-induction. An induction really isn't that big of a deal. I've had one induction and one spontaneous. The way women talk about inductions, I was waiting for them to come in with the leather straps and tazers and force that baby out.
If it is something as sinister (by you guys' perception) as him wanting to make his life convenient, consider that doctors have lives too. They might be traveling for the holidays and they would prefer to know their patients are all taken care of before they leave town.
Yeah, you have rights. You can cross your arms, stomp your feet and refuse to be induced, but if he goes out of town, oh well for you. You can deliver with his covering physician. Maybe it's someone you've never met or when you do meet him you feel he's a horrible person, but you're stuck then.
Think about it.
For the record, I hope they DO induce me... and I'm hoping it's at 38 weeks. Just like my last one. He was 8-2, and ready to come out.
I plan on asking the perinatologist about it today and discussing it with my OB next week. I'm all for planning ahead...
I think it is pushy. As to doctors being "nice" to want to schedule, why? My OB has Jets tickets on the day of my 41s week, which is apparently his hard & fast cut-off date, so I can see where that's going.
Birth is a perfectly natural process. Why make someone feel as if they are not going to progress? You should enjoy your pregnancy with the expectation that things will develop as they should - you've made it this far!
As for inductions - they are medical procedures with both benefits AND risks. Some people have it easy & for others (like me) when your body is not ready, you can have some major health consequences.
So, it's good that she's thinking.
Best wishes to you all for a speedy and efficient delivery and a healthy newborn!
It's false logic to assume that because something went well for you, it will go well for someone else.
Each person is an individual with different medical circumstances that need to be considered, in terms of how well an induction will work.
I hope no one ever has to go through what I went through. I wish I had asked more questions and been more assertive.
Sigh. You guys really amuse me with this:
Childbirth ALWAYS has risks. And can also have major health consequences.
I would prefer a controlled induction with my epidural anyday over driving around with a bag packed in my car afraid to leave the house or go anywhere because you don't have your hospital bag. Hoping your child care doesn't fall through at the last minute if you go in labor at 3 a.m. and have no place to leave your other kid(s).
You know when it's happening, you know everything in advance. The hospital isn't short staffed either because yes... I have worked on Labor and Delivery and seen the place turn into a madhouse because they got 10 surprise births and the nurses can't keep up.
Plus, like I said... what if you wait and your doc isn't available? Screw that. Give me my induction.
I disagree with PP that at 40 weeks the placenta automatically starts to degrade in every woman. After 42 weeks, yes--that chance is high. But at 40-41 weeks, it varies by woman.
I think that induction is awesome in certain situations (my BFF who was risking liver failure), but I think that if you want a low-intervention birth it is right to question and postpone as long as baby and mama are both doing fine. And no matter what kind of birth you are hoping for, being an informed patient and asking questions before agreeing to something is both your right and responsibility.
I think the key is to ask questions.
-Why should I schedule an induction now instead of waiting?
-What are the risks of not scheduling an induction now?
-What things will we do at 40+ weeks (or whatever # of weeks he has in mind) to see if I truly need an induction?
-Can I cancel the induction if things are going well?
-What are my options for induction? (for example, cervadil vs. low-levels of pitocin vs. full dose of pitocin)
-What are the risks of those steps? (hard contractions, etc.)
More Green For Less Green
Not cynical - totally realistic. Many doctors don't want to be at the hospital any more than you do on Christmas. It's definitely odd that at 34 weeks he's already talking about contractions.
To skip the for-or-against induction debate, just some additional food for thought: some HOSPITALS will not allow patients delivering there to go beyond 41w, due to the much higher risks associated with possible placental breakdown & what those risks do to their malpractice insurance rates - the hospital where I'm delivering is one such hospital... and as a result, my OB office will induce, no matter what, if LO hasn't arrived by 40w5d. If a patient wants to go longer, they have to switch OBs *and* hospitals - the closest one that will allow a patient to approach 42w is about 45 minutes away.
None of these policies are discussed ahead of time with patients, at least not in the OB office. I found out about the hospital's policy in my childbirth class @ the hospital, and my OB's policy when I asked specifically about it @ 26ish weeks. (It's a moot point for me, as I'll be induced ~2w early for medical issues anyway, but it was good information to have).
It's possible that your OB is trying to schedule around his holiday plans, but it's also possible that he's working within the constraints of a hospital policy. Before you get bent out of shape that he's trying to "pressure" you, you should really find out which it is, and then discuss with him how you'd like your birth experience to play out. There may be a compromise (if it's schedule-related) or there may not be (if it's policy-related), but you won't know until you sit down with the doctor and discuss this with him. GL!
Controlled? <sigh right back at ya>
One of the side effects of pit is retained placenta. If you haven't had a manual removal without painkillers you really haven't had the full experience. Let's just say my back arched off the table about 3 feet. I also had the baby turned inside me, internal monitors screwed into her head, an episiotomy, had to be given oxygen during labor and hemorrhaged. I was initially filing a malpractice lawsuit, since I did not consent to the manual removal, nor was it explained to me, and I was perfectly lucid prior to that, however, in consulting several attorneys, it seems that without long term damage (aside from me having PTSS), it is very hard to win that case in my state.
I'm glad you enjoyed YOUR induction. Bet you wouldn't be so smug if you'd been through what I've been through.
It is not strange to have no contractions at 35 weeks. Contractions would indicate PTL.
I have 3 children. Due to moving, I have had three different providers see me through my pregnancies. I have never had a doctor talk about induction at 34 weeks. Your doctor sounds like he treats every pregnancy the same and automatically schedules an induction at your 39 week appointment. You can ask for the induction to pushed out as far as possible. You will provided with US and NST to check the health of the baby and the plancenta. Try not worry. Scheduling an induction does not mean you will have one.
THIS!
I think sometimes OBs give too much info and then can come off looking pushy. And depending on the type of patient you are, can make you feel uncomfortable either way.
My OB is very type-A and likes to lay things on the table early on. It can either come off as pushy or as if she is trying to keep her patients hyper-informed very early on. And if you are the type of person who "goes with the flow" and doesn't want info before it becomes necessary then it can be uncomfortable.
I was induced last week. My OB started talking induction at about 35 weeks because of how big I was measuring. By 37 weeks she had me in for a growth scan and at 38 weeks she had me on a waiting list for a 39 (40th week) week induction. I had advanced dilation (I was 5cm dilated and 80% effaced by 38 weeks pregnant), lived far from the hospital, and had a big baby. I delivered by induction at 39w4d and DS was born 3 hours after she broke my water weighing in at a whopping 9 pounds 11 ounces. My OB was CORRECT to induce me. Had I gone another week I would have likely needed a c-section for his size alone. And considering I needed zero pitocin and only 3 hours to deliver my baby I was obviously ready.
As for the holidays... I think that it is important to keep patients informed. YES, it comes with the territory to delivery babies on holidays. But it is also common to share call on the holidays. So as long as you are comfortable with the idea of being delivered by a different OB then I think you are set. If you absolutely cannot handle the thought of a different OB then I think induction is an appropriate conversation with a holiday due date (and I'm not saying I neessarily think that is a good reason... but just something to think about).
Hopefully this will all be moot and you will go into labor on your own.