Induction question

tacosandtums · June 2014

Hi ladies,
Just found out (I'm only 21 weeks) that my hospital has mandatory induction at 41 weeks. I have a doula and a planned natural birth, but now I'm so terrified after reading all about the negative possibilities that can happen as a result of induction. I can't switch hospitals- I work at the one I'm delivering at and insurance covers everything at 100%- if I went somewhere else we couldn't afford it.

What can I do? My doula said we can talk more about this at our next meeting.... But wanted to hear from experience if there is anything I can do to prepare for things not going as planned. I'm so upset right now.

Wyn · June 2014

What will they do if you show up at 42 weeks? Turn you away?

margaritachikita · June 2014

First of all, 41 weeks is a long way off so try not to stress about it too early. Have you talked to your provider about this? Is there a specific reason why that policy is in place? Most reasonable providers should agree to do non-stress tests starting at 40 or 41 weeks, and as long as baby is doing well, there should be no for an induction. Also, the word mandatory is very misleading. Remember that this is your body and your baby - you are calling the shots, not your doctor or your hospital's policies. You always have a choice even if they make it seem like you don't. I would just start the conversation with your provider sooner than later. Ask the tough questions - "What evidence is there that inducing at 41 weeks will provide a better outcome for me and my baby?" "Why is induction at 41 weeks mandatory when current research shows that the average first time mom is pregnant for 41.5 weeks?" "Please tell me all the known risks of an induction (including a 50% chance of ending in cesarean), and explain how you see the benefits of inducing outweighing those risks" (do your research with your doula beforehand so you know if your doctor is being honest with you and your concerns or if he is just brushing you off or trying to scare you) HTH good luck!!

margaritachikita · June 2014

If doctors hear that women are educating themselves about current research and not just going along with what policy mandates, they will be more motivated to make changes for the better (aka evidence based decisions).

margaritachikita · June 2014

Also are there multiple providers who work at that hospital? You could try to find one who is the most natural friendly.

GPeterson24 · June 2014

I'm in Canada so I'm not sure how your insurance works but what would happen if you just didn't show up for the induction?

Also, you probably don't want to be fighting that late in the game so maybe bringing some research and guidelines to discuss with your doctor ahead of time as to why you'd prefer not to be induced?

https://www.acog.org/Resources_And_Publications/Obstetric_Care_Consensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery

tacosandtums · June 2014

Great info, thanks everyone. The doula is very experienced at the hospital I'm delivering at, so she was speaking from experience. My next OB visit is the 17, I will bring up my concerns with her then. Thank you for the suggestions about questions to ask.

Fwiw, I also just learned my hospital is 22% higher then national average for c sections.

Part of me wishes Id done more thorough research sooner, and part of me is glad I didn't since this is kind of where I have to deliver. It's not a good night over here.

sschwege · June 2014

Mandatory Induction, what in the world does that even mean?! Any and all medical procedures require your consent, end of story! Don't ever let anyone tell you something is mandatory! The hospital can not refuse you care either, so if you show up in labor after 41w they must still treat you, they can not turn you away.

I think what you are going to have to do is educate yourself and figure out what your comfort level is, how far are YOU willing to go? If your comfort level is different than theirs then you always have the option of declining. My office recommends induction at 41w6d if you want to go longer all you have to do is sign a form and then you are set to go (I would not have declined induction at that point, just using this as an example).

Aurora_Borealis · June 2014

Is the induction policy due to lack of a neo-natal ICU? The hospital where I delivered is normally very anti-intervention, but their insurance (as in the hospital's own liability insurance) requires them to have a 41w3d induction policy due to limited newborn care facilities. The OBs and midwives are not fans of this policy any more than the patients are. So, they won't turn you away if you arrive in active labor after 41w3d, nor will they make a stink if you cancel your scheduled induction (if you've had to schedule due to the policy). But if you show up in early labor at 41w4d they will not admit you and will refer you to their affiliate hospital across town.

Anyway, that probably doesn't help you all that much, but it could explain why such a policy exists. Hopefully your hospital also has a similar unofficial policy about missed inductions.

Luckily your doula is experienced with this hospital. Ask her if there are specific OBs she has found to be more natural-friendly than others. That will make a world of difference in the care you receive.

LineUponLine · June 2014

Do not consent to the induction. They cannot force medical intervention on you. Get your OB in agreement early.

tacosandtums · June 2014

@Aurora_Borealis the hospital has a level 3 NICU. I feel like my doula may have outdated information. I will be asking my OB about her policy during my appointment next week.

If that fails, I did learn of another OB in this hospital who accepts my insurance who does not have that policy, so I could always switch if needed.

Thanks for all the support on here!!!

Amandaskafidas · June 2014

The hospital I gave birth in had a "mandatory" induction at 42 weeks. I also got very upset upon learning this but after talking to my midwife and my sister (who is a doula) I learned that they cannot force you to do anything you aren't comfortable with. My midwife subtly suggested that I just don't make an issue about it ahead of time, and if the time comes and I actually reached the 42 week mark I could simply refuse to be induced. They cannot refuse to deliver your baby because of this. Hope this helps and good luck!

tacosandtums · June 2014

Thanks, @Amandaskafidas! That is helpful.

I did learn of an OB practice that does not have the "policy" and I will switch if I *have* to.

I have an appt. a week from today with my OB in which I plan to ask her what happens in the event I go past my due date. I'm really nervous about it!

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