XP: Induction dilemma...not sure what to do.

erinlovesdavid · May 2011

I posted this on the June board, but thought I'd see what you ladies think as well.

I'm so torn on what to do.

LO is measuring +/- 3 weeks ahead, and DH and I were both 9 lb newborns. My doctor has agreed to induce me on my EDD if I don't go on my own before then. The main reason is because I don't want to deal with the possible complications of delivering an extremely large baby (c-section, tearing, episiotomy, intervention snowball effect, etc). Another reason is because our health insurance re-sets on July 1st (EDD is 6/22), so if LO and I are still in the hospital, I will likely end up having to pay another $2000 out of pocket for each of us. Obviously money is not the main reason we would induce, but it does factor in.

The reason I'm torn is because I have heard that induction can significantly increase the chances of needing to have a c-section, but avoiding c-section is the reason I would want to be induced to begin with! On the other hand, if I wait to go naturally my odds of a c-section are increased because of how big LO is, and I would wind up paying more $.

I am going to discuss this with my doctor at my appointment on Friday, but I'd like to get some other thoughts on this before I go in. Obviously none of you can predict what the future holds, but what do you think you would do in this situation?

vflipo · May 2011

Ask your doctor about your bishop score as you get closer. I was a good candidate for induction at my 40w appt. I would go for it, personally. I wasn't into the idea until I hit 40w, was still working, and had been pregnant for 12 out of 15 months.

BritanyV · May 2011

What I was told with my son was that if you aren't at least dilated 1cm before you go for an induction that you are higher risk of a c-section. However, if you are dilated more than 1cm it doesn't guarantee that you will be successful either.

I was induced because my bp was creeping up and starting to get some protein in my urine. I was probably just barely 1 cm and I had no issues with the induction and everything went well .

I think if I were you, I would just see what my cervix was doing the week or so before your EDD and make the decision then.

ColleenS629 · May 2011

I would go with the induction probably. It seems that you have a chance of c/s either way... either because of the induction or because of the baby being too big. I'm sure your doctor will probably be able to give you better advice though.

ksulli · May 2011

ColleenS629:
I would go with the induction probably. It seems that you have a chance of c/s either way... either because of the induction or because of the baby being too big. I'm sure your doctor will probably be able to give you better advice though.

This. The good news about big babies is they tend to be good eaters & sleepers- good luck!

olivia_eve · May 2011

My bias is always to avoid induction if at all possible. The measurements can be off, so I wouldn't necessarily go by just that- I've heard so many stories of people being told they were going to have a large baby only to have the baby come out perfectly average sized. And while a 9 pound baby is on the larger side, I wouldn't say it's so large as to guarantee a c-section or complications.

Personally, I would wait and make the decision when you are closer and know how favorable you are for induction. And remember things can change quickly- at 40 weeks, I would not have been a good candidate for induction- DD was up high, I wasn't dilated at all and was only 50% effaced. I went into labor 4 days later, so I went from no progress to progress pretty quickly.

tiffanysbride · May 2011

You have to wait until you get closer to your due date. If you are progressing normally I don't see why you would have a problem. I have several friends that were induced and only 1 ended up with a c/s b/c of another complication.

I was induced with DS, my water broke w/o contractions for hours. Once I got the drug DS was out in about 2 hrs, 3-10 cm it was kinda nuts. I know that isn't typical but wanted to throw out a good story. FWIW I will probably be induced again b/c of the previous cord issue and b/c they know how I typically respond (oh and I had high BP with DS the last few wks). I would really talk with your OB b/c they'd know better then we will what your medical odds are.

erinlovesdavid · May 2011

tiffanysbride:
You have to wait until you get closer to your due date. If you are progressing normally I don't see why you would have a problem. I have several friends that were induced and only 1 ended up with a c/s b/c of another complication.
I was induced with DS, my water broke w/o contractions for hours. Once I got the drug DS was out in about 2 hrs, 3-10 cm it was kinda nuts. I know that isn't typical but wanted to throw out a good story. FWIW I will probably be induced again b/c of the previous cord issue and b/c they know how I typically respond (oh and I had high BP with DS the last few wks). I would really talk with your OB b/c they'd know better then we will what your medical odds are.

thanks for the replies, ladies! It's especially helpful to hear from the BTDT moms.

I will definitely be chatting with my doctor about all of this at my appointment on Friday, and I know that he will have a better insight into my specific medical situation. I just want to be prepared with ideas and questions, which you ladies are definitely helping me consider! Smile

tiffanysbride · May 2011

I would ask how long they let you go during an induction before a c/s. That would probably be helpful in your decision. I think my OB is 24-36 hours depending on the progress, water breaking, fetal distress, etc.

rock-elle · May 2011

Hmm I say I'd have to go the induction route for many reasons...

nbbride06 · May 2011

My bias is against induction whenever possible. I seem to be the oddball on this one though. My mom had 4 big babies (8 and 9 pounders) and delivered all vaginally with quick labors (she was late with all of us and was never induced). She's not a big person either (5'4" and petite). Different people, different bodies. If it were me, I'd probably let myself go a week past my due date which would still put you before your insurance cutoff.

MrsGo4Hockeychick · May 2011

I'm another fairly anti-induction person.

It's so hard to tell how big baby will be on u/s. During the 3rd tri, they can be off by 2+ pounds (more on an older machine!). Fundal height is hard too, because sometimes positioning can affect it, but so can the amount of amniotic fluid.

But I totally understand the insurance thing. My friend had a little girl 4 years ago, she was born the end of July, but was about 6 weeks early. Their insurance reset August 1st, so they had to meet their out of pocket max twice. It's kind of ridiculous that it works that way! If it's one hospital stay, it should be one deductible/copay/OOP max.

Rossi17 · May 2011

I was induced on my EDD with my daughter (100% effaced, 1 cm dilated) because I really wanted my doctor to be the one delivering her. She was 9 lbs 4 oz (no pain meds, no c-section). The pitocin was at the highest dose (for some reason, at first it really wasn't doing anything to get my contractions going), and they told me that if I didn't dilate to at least 4 cm after 6 hours, I would be sent home. Luckily, at 6 hours, I was 4.5 cm dilated- Dr. broke my water and my daughter was born 5 hours later. I did have a tear, but no episiotomy.

Everyone's story is different, but having a larger baby does not automatically mean c-section or other complications- it just depends on your situation.

itsmevkb · May 2011

I would see how you are progressing the closer you get to your due date. Doing an induction when you aren't even beginning to dilate is a lot different from doing one when you are dilated. If your body is showing signs of readying itself for labor at the time your due date hits then I would think go ahead and induce and if not then I would hold tight as I wouldn't want a failed induction.

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