XP: Induction based on Dr leaving town?

krissymikey · June 2012

I am a FTM and 39 weeks and 2 days pregnant at the moment. At my dr appt today I was 4 cm and 75% effaced, and my doctor raised the possibility of an induction this Thursday (she says I would be very favorable for an induction and an "easy nudge"). I have no medical need to do so, and would ideally like to wait till 40 weeks before considering induction, but my doctor will apparently be out of town all next week and therefore unable to deliver me regardless of if I go into natural labor or were to want an induction next week.So my question is, should I take that into account or just be fine with whatever doctor I happen to get? I really like her and would like her to be there, but understand that may not be a good enough reason to induce on Thursday...

KatiPowers · June 2012

Personally, I wouldn't induce. Inductions without a medical reason seems like a risk not worth taking IMO. You can ask to meet with whatever docs will be on call in her absence so you at least recognize them when you go into labor. I'm also a FTM, so I've not been in your shoes, but that's what I would do. I don't really care which doctor is there, as long as Baby is healthy. Y'know?

WordsmithMom · June 2012

Your OB is an irresponsible jackass who's putting his wallet before your and your baby's health. Tell him to shove it. I'd rather deliver with an on call doc or his backup than this joker.

baloneydisc · June 2012

I wouldn't have an induction just to make sure my doctor would be there. I love my OB, but he was honestly only there for about 10 minutes. DD got stuck, so my OB was there to pull her out with forceps & stitch up my episiotomy & tears. The nurses did everything else.

hooslisa · June 2012

EspressoBean:
Your OB is an irresponsible jackass who's putting his wallet before your and your baby's health. Tell him to shove it. I'd rather deliver with an on call doc or his backup than this joker.

ditto

Yes

OUKatie · June 2012

My doctor will be OOT for the week leading up to and the week after my due date. We haven't even discussed induction, other than the normal "I won't let you go 2 weeks overdue" stuff. If I go into labor while she is OOT (likely) then one of the other doctors in the practice will deliver DD. I much prefer that than forcing DD out just so my ob can catch her. So, I would NOT induce solely so that your ob can deliver your LO.

PepperStick · June 2012

I would personally just wait and let LO come on their own. Like a PP said, your doctor will basically be there to catch the kid and stitch you up if need be. Or for an emergency, obviously. The nurses do everything else.

Mike_Patti · June 2012

I'm going to take a totally opposite view than the previous posters. I don't think that you are in any way obligated to say yes to the induction, but I think that if you wanted to go ahead with it it would not be a terrible thing. Your cervix is really favorable which makes the likelihood of successful induction better. I would not consider offering an induction to a 39+ week patient with a super favorable cervix ridiculous at all.

I don't think your doctor is being selfish, greedy or mean unless she is acting rude or trying to force you into the induction. I think it's courteous of her to give you the heads up about her being out of town. That lets you make an informed choice.

My OB does the same thing. He offers his patients the choice of induction vs the wait and see method in cases where induction is not medically indicated. If he's out of town then he tells his patients about that ahead of time in case that affects the decision.

I would not think you were making a bad decision if you chose to be induced. Nor do I think that you would be making a bad decision if you decided to just wait and see for now.

rp-chicago-mom · June 2012

I already know I probably won't have my specific OB when I have my baby because it's the luck of the draw as to which OB is on call at the hospital. I get the feeling that you mostly deal with nurses and the doctor just catches the baby or orders and performs a c/s. I would not feel the need to induce. Unless you're high risk, I would assume all the doctors at your hospital are more than capable to catch the baby or make the necessary decisions for your care.

krissymikey · June 2012

I feel the same way, which is why I am conflicted. My doctor in no way is trying to force me into induction....she simply raised it as an option due to everything seeming favorable. She said exactly what you did about not making a "bad" decision either way and is leaving it up to me. She didn't even tell me she was going out of town....I figured it out through the receptionist. I am leaning away from the induction though and am hoping baby comes on her own sooner than later

allardr · June 2012

I wouldn't induce. Heck mine won't be on vacation but regardless my hospital policy is just they call the doc on call so I only have a 50/50 chance of getting mine for delivery. It doesn't bother me though, I'd rather it be on my bodies time/baby time than the doc's schedule.

roxyttandme · June 2012

EspressoBean:
Your OB is an irresponsible jackass who's putting his wallet before your and your baby's health. Tell him to shove it. I'd rather deliver with an on call doc or his backup than this joker.

Word.

BakerMommy · June 2012

roxyttandme:
EspressoBean:
Your OB is an irresponsible jackass who's putting his wallet before your and your baby's health. Tell him to shove it. I'd rather deliver with an on call doc or his backup than this joker.
Word.

Agreed. I think it's irresponsible to offer, even if you're in no way obligated to accept. It's not necessary, and increases risk--why even bring it up?

FWIW, my induction with DD1 (which was medically indicated for PROM) took three days. I was in the hospital for five. So depending on when your OB leaves town, he might not even be there for the entire thing anyway.

mlf625 · June 2012

Confused Only on TB would everyone get their panties in a wad over a 39+ week induction with as much progress as you've got going on.

Do what you want, I don't think there's a wrong choice here, and based on your f/u post it sounds like your doctor feels the same way. I've delivered both of my babies by c/s but from what my vaginal birthing friends say, the OB has very little to do with the actual delivery - it's more about the nurses. So if you're not ready, I wouldn't induce just to have your doc there. But if you are? Go for it!

noah-bear · June 2012

Dr is only there for deliveryanyway, so i would say no. Inductions are awful. My dr is gone during my two "prime" weeks. Sucks, but really all they do is catch and release with the LO's

wh288205 · June 2012

I would have a fit if my doctor wanted to induce me because she would be out of town, but then again, I haven't really developed a close relationship with my doctor. I have had friends with multiple children say that when they were induced, it was much more painful than when they went into labor naturally.

erjarv · June 2012

Well I'm a FTM too, so I don't really have any experience to base my opinion on but honestly...I'd say tough luck, doc. If you want to wait until 40 weeks to consider induction, then wait till 40 weeks.

Personally, the only way I'm going to be induced before 40 weeks is if there is a very legitimate and serious medical reason to do so. However, it's entirely up to you, obviously. You're pretty darn close to 40 weeks, and I don't think anyone in their right mind would judge you for inducing at 39 weeks, regardless of the reason.

stever · June 2012

I wouldn't want to induce anyway, but especially to accomodate my OB. Like PP said, the OB is only there at the very end.

jasrun80 · June 2012

i would not have the induction,,, id even consider seeing another dr based on the fact that your doc is so willing to induce, even if it would be an easy nudge. im not flaming,,, i just think that dr's need to step down when it comes to early induction based on THEIR travels. somehow i hear this all too often & think the docs are crazy.... personally i am scared of induction & feel that if your body isnt ready, can result a worse situation than disappointment because you dont get the doc youve developed rapport with. ... that being said, im sure if you do decide to you will be in good hands & feel great this weekend !!!

mw_sorrel · June 2012

(Lurkin')

Do what you are comfortable with - I don't see anything wrong with inducing at 39+ weeks. If your doctor is comforable with it (mind you - the person with the medical degree) and you are as well go for it. If you were at 0 cm and 0% effaced I would feel differently.

If having your doctor is not a big deal and going into labor natually is a big deal, then don't.

I was induced at 39 weeks due to maternal hypertension and a huge ass baby (9 lbs.). I was 3 cm and 80% effaced. My induction was very easy, and only a very low dose of pitocin was needed to get things rolling.

Trust your doctor and go with what is important to you.

AprilAngie · June 2012

EspressoBean:
Your OB is an irresponsible jackass who's putting his wallet before your and your baby's health. Tell him to shove it. I'd rather deliver with an on call doc or his backup than this joker.

I agree with this too. Plus at 4 cm you could go soon or late. your almost half way there. I agree I wouldn't want to do it for convienence sake.

InfinityDreamer · June 2012

I wouldn't agree to an induction to cater to anyones schedule. One reason I have a midwife is because I am certain she'll be available to me and she doesn't take clients who are due within a month of any of her vacation plans. Taking on clients when there is a good chance you won't be available seems irresponsible.

meganroselee · June 2012

EspressoBean:
Your OB is an irresponsible jackass who's putting his wallet before your and your baby's health. Tell him to shove it. I'd rather deliver with an on call doc or his backup than this joker.

Nice. So is he supposed to never go on vacation? How is he putting his wallet first? He gave her a choice of induction 2d before full term with.a favorable cervix or delivering with another dr. Patients like you trip me out. A choice is just that. Also, not seeing pts that are due near your vacation time is near impossible.... Who can predict whether the patient you see at 12wk will end up with pree or go to 41wks? No one. That's why physicians join group practices. Is he not allowed to have a life bc he's a physician? OP-- I would decide how much you trust him vs. his partners. Literature on outcomes for induction for someone at 39+5 with a favorable cervix wouldn't show a significant inc risk in adverse outcomes.

aaturnwald · June 2012

I have heard of this before, and known people who do it.. I say do what makes you comfortable.. If you would rather have your dr then another and are ready. Then do it.. But if you want to wait and go natural then that's fine too..

meganroselee · June 2012

Making some assumptiond about her station and cervix consistentancy, her risk for C/S is less than 25% (not significantly inc as compared to spontaneous birth). This is evidence based medicine and not fear.mongering. it sounds like you're an L&D nurse so you know as well as I do that a 39+5 pt with goid dates and first tri us can be +/- 2 wks. It would be shocking if any hospital would discipline a Dr for inducing at that point but I guess NH is different than Tx. I am well aware that most physicians arrive in time to just catch, its the skills before and during delivery in the 10% of abnormal births that make the physician's presence necesary. And as a physician, I would rather have the midwife that I know with me even if she only catches" bc I know I can trust her skills in in the unlikely event things go poorly. Her partners, I don't trust as much. Once again this is a choice. The OP is going to have to make the decision right for her but I certainly wouldn't criticize an induction two days before her due date... Also, i have to disagree, ppl did imply that the ob is inconsiderate for taking vacay when he did as well as accusing him of being money grubbing both of which are unfair and non sensical characterizations.

meganroselee · June 2012

Agree with all of the above. I am home on bedrest for preeclampia and still opted to wait for induction until the midwife I trusted was on. I know things may not work out but I feel better knowing that its more likely she'll be there. Also, pls see above correction. I meant 25% not 2%, which with a favorable (bishops greater than 7) is on par with a sp.delivery.

meganroselee · June 2012

?? The risk for unsuccessful induction ie, cs is exactly what the bishops is used to predict.. https://www.ncbi.nlm.nih.gov/m/pubmed/15802392/ I can understand if you're not really into evidenced based medicine but the literature supports someone in the OP's case having exactly the same risk a spontaneous vaginal for csection. I still maintain that at 39+5 with a favorable cervix, giving a pt a *choice* is not unsound, medically. I guess we will have to agree to disagree.

meganroselee · June 2012

It is in fact used to predict a successful induction, ie a spontaneous vaginal delivery. You misread/interpreted the study. After controlling for bishops, meaning taking the bishops into account, there was no difference in outcome for ppl that went into spontaneous labor vs those who were induced. Meaning if op is induced with a bishop of 7 and someone presents for labor spontaneously with bishop of 7, their risk of cs is the same. Ie, she is not putting herself at inc risk of section.

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