Say no to induction or just try to bring on birth naturally?

[Amber4]

Help please... I could really use some advice as my head is in a bit of an anxious muddle:

I'm 40w3d today and have a home birth planned. It's really important to me to try and avoid intervention this time around, most especially if it's unwarranted. For that reason I chose a MW this pregancy and not an OB, and I've done my research and preparation well, I think, about natural birth.

Weekly checks with GP and midwife show that baby and mama are well, my BP is low, baby is already engaged and has strong foetal heart sounds. Apart from swollen feet and feeling like my belly is going to burst, I feel good. At my midwife appointment this week, she spoke about what my options are if I haven't birthed by 42 weeks... Basically medical induction which means hospital, or monitoring via regular CTG and/or the biophysical ultrasound at 42 weeks to get the ok to wait it out until 43 weeks. My understanding is that these checks still move me more into the medical system (on the MWs recommendation I booked into the local public hospital a while back so that they had my records "just in case").

I really believe that, with no medical reason to induce (as in, a valid reason specific to my body and my baby, not a general statistic) that it's best not to intervene with mother nature. What happens if I refuse an induction or monitoring at 42 weeks? The MW made vague mention of a woman she had heard of being reported for negligence in similar circumstances. I'm already stressing about birth being much later, as DH has 4 days left of his leave and can't take more time off beyond this weekend. Now im stressing much more about the prospect of induction. I honestly didn't think that with a homebirth planned, I would have to consider induction unless there was a medical case for it. Probably that was naive of me.

Sorry for the long post... I could really use some mama wisdom here. Im trying not to get too worried as ive got 10 more days before it becomes an issue, but i also want to ensure I'm as informed as I can be so I can have a plan in my head about how to handle it if necessary. Or should I turn off my energy from worrying about this and put it into trying to speed up labour naturally? (in which case, please hit me with suggestions!) Thanks so much x

[AliBaby]

I refused induction at 10 days over. I was scared of being induced that it would lead to further interventions and possible c section. The doctors pushed my induction date to 42 weeks and I said we could re-access then If baby wasn't here as all monitoring was fine. You have no idea, well actually I am sure you do, How hard it was as I just wanted the baby out. I walked everyday, inserted EPO capsules and 2 days later I went into labour naturally. Dd came early the next morning, so on the 13th day past dates. It was a natural labour and birth.

Stick to your guns if you don't want to be induced. Have some info to back you up is d a support person to go with you to your appointments who will speak up for you if needed.

[Traveller]

Have you asked your midwife if she is still happy to care for you at home past 42 weeks without extra monitoring? The monitoring itself is not intervention and often it can be the basis for reassuring you and your caregiver that everything is ok.

As for agreeing to induction or not, your post sums it up for me and if you make an informed decision to refuse then it's unlikely that you will face much opposition, especially if your midwife has your back.

However important to remember is that a lot can change in almost two weeks, heck a lot can change in a few hours, and most women give birth by 42 weeks so most likely you will not have to make this decision.

[Amber4]

Thanks Traveller.. no, I didn't think to ask her what it means for her care if I refuse monitoring or induction. As usual, these things all occur to me after the discussion

My impression from the way my MW spoke is that she is pro the monitoring.. for instance, she still said I can negotiate with an OB at the hospital and she knows of one who is apparently open minded and quite reasonable, but she still referred to best practice being induced or monitored. I came across a belly belly sticky about the biophysical ultrasound being flawed... so I guess my concern is that if I consent to monitoring, it could be used as a justification to push me towards induction, iykwim?

Still, you're right, I am very, very hopeful that this won't become an issue and that this little one gets moving in time!

[AliBaby]

I chose to say yes to the monitoring once overdue because I thought it was best to know that all was ok with baby. The only time that could have led to an induction was if something appeared wrong with the baby, which of course I would want them to do whatever possible. All was fine though and I got my natural delivery and labour.

Stay positive

[Amber4]

Thanks Alibaby yours is an encouraging story. I'm basically scared of intervention after a really hard time with DD in hospital a few years ago. It was a difficult start for both of us really and the minute the MW mentioned induction, it brought back a lot of bad thoughts. I'll try to stay positive and confident though. Thanks.

[onthefly]

I've been in similar situation
First, I think it's really, really important that you talk with your midwife about all this. Most likely, she is just paving the way, just in case it comes to it. You need to know where you stand though - what are her terms of care? at what point (if any) will she no longer care for you? What would be your options then?
What sort of relationship do you feel you have with your midwife? Would you trust her if she recommended a particular intervention? Perhaps talking to her more frankly would help to alleviate your fears - is she aware of your strong feelings on the subject? It's something she should be able to help you work through, as your carer.

It's just so important that you feel comfortable and confident in your carer. So I hope that you can talk with her and feel better about everything.

With my midwives, because I had been induced at 42 weeks first time round and was very unhappy with the experience, we talked about this ahead of time as it was a source of anxiety for me. We decided we would wait till at least 41 weeks before doing anything. I would consent to a stretch & sweep at close to 42 weeks, if nothing had happened, and monitoring at the hospital from 42 weeks. This was a condition of continuing under her care with the homebirth program, however. I went in at 42+2, having had an S&s the previous day and already starting to lose my plug. The tests all came back fine. Theh OB tried to get me to book in for an inducgtion. I refused. My baby was born the following evening. We ended up transferring and had some issues with the birth and afterwards, but in the end we were happy with our care as our midwives were known to us and i felt safe and respected (even though things didn't exactly go to plan).

[Pholi]

I was very keen to go into labour naturally, and started to do all sorts of things to bring labour on - long walks, with lots of stairs and hills, squats and lunges at home, hands and knees , on my knees over the ball, burning clary sage oil, having acupuncture. I can't say if any of it made the difference, but it was such a relief when I went into labour naturally at 40+4. I would redirect your energy into doing these kind of things, because stressing over something like this can't ever be good!

[luna moth]

7 weeks ago my baby girl was born at 40 + 13, planned hospital birth. I was pretty keen to avoid induction, in spite of a previous positive experience. My midwife mentioned it at 41+2, as an alternative option to 42 week ultrasound. I went with the ultrasound, although ultimately it was cancelled because baby popped out a day earlier. My midwife and her team were totally cool with it, only talking about induction when they wanted to make sure I knew it was an option. I felt really confident in not choosing induction, and I think that helped. I just wasn't going to be "booked in" -and if they'd tried, I sure as hell wouldn't have turned up.

And doing all the natural stuff is fun, so roll with that.

[AndiE]

I won't bore you with the details but I ended up with an extremely successful induction with DS3 - I had a hospital birth but my birthing preference is to do it drug-free, intervention-free (except for DS3!) etc. I should've been a home-birther, trust me! I did everything I could to avoid induction but at 42w, DS3 just wasn't interesting in kickstarting his birth. Anyway, I can't help you much re: the home birth aspects and impact of intervention, but just wanted to say that all I required was gel and DS3 was born not long afterwards with wonderful midwives supporting my birth choices. I know you had a bad experience with your DD, but "if" you do end up requiring an induction then take some comfort that it doesn't have to go cactus. I negotiated minimal monitoring and the brilliant midwife I had even took off the monitoring a few minutes before she was supposed to as bub (and I) was doing so well. Basically, all but the first 20-odd mins of my induction was monitor-free. Big hugs, hopefully bub will come of his/her own accord soon xx

[Amber4]

Thanks so much to you all for your thoughts and support. I had a big cry this morning feeling helpless about it all, then picked myself back up and went off to acupuncture smelling like clary sage this afternoon I'm catching up with my doula who is extremely supportive, so I think it will also help to chat to her.

MadB, I suspect you're right in that my MW was probably wanting to flag things as possibilities to bear in mind, although I completely agree with you, I need to talk with her about what her conditions are, if any, of continuing my care.

Thanks again I'll let you know when/if the little man makes an appearance before I have to cross this bridge. Xx

[e_p]

Hey Amber, just thought I'd let you know my baby was homeborn at 42 weeks on the dot. Some women just gestate their babies for longer

I was anxiously waiting for labour to start when I was post-dates and scrutinizing every possible sign of labour. I had a visit from my midwife who reassured me that my baby was healthy and would come when it was ready. With the knowledge that she supported us, I went and had a relaxing massage, let go of all my expectations and just enjoyed my last moments of being pregnant...it was a huge emotional shift to go from waiting/watching to noticing/enjoying and I think that's what allowed my labour to start.

Maybe a really frank chat with your midwife about what her limits are and you working out what you're comfortable with will make things more clear for you?

I hope your babe arrives soon and you have a beautiful birth x

[onthefly]

All the best Amber! Talking it through and releasing your anxiety - any way that works for you - can only help your state of mind and increase the likelihood that you'll have the birth you want.

[Amber4]

Thanks Andi, it is really helpful to hear another positive story. The MW said that it's not possible to continue down the home birth track with any kind of induction (even gel).. she apparently can't get a prescription for it. So basically intervention = no more home birth. My sister went to 43w with her second child (planned public hospital birth) before she consented to induction with the gel. She lives in country NSW and the staff she dealt with were happy to support that. It seems like there are different rules in different areas... my MW admitted that hospital bureaucracies play a big role in this and apparently my local area health service isn't renowned for their open-mindedness in this regard.

That all said, I appreciate the reminder that it won't necessarily go pear shaped if it had to happen. It's one of the reasons I wanted to hire a doula this time from the get-go, so that even if I ended up in hospital, I had someone with me that I trusted and could ask to advocate on my behalf. My past experience with a very unsympathetic MW and a dictatorial OB isn't necessarily going to be repeated. Logically I know that but it's hard to shake the memories and emotions attached to that experience. Thanks again. x

[toomanyshoes]

Home birth was never an option for me but I was hell bent on avoiding another induction for my second after being induced early with my first.

I tried everything but it just wouldn't happen, although I was lucky enough to have a great OB the second time around and even though I was induced that was the only intervention I needed.

Really hope it doesn't get to that for you and you have the home birth you want.

[Amber4]

I was anxiously waiting for labour to start when I was post-dates and scrutinizing every possible sign of labour. I had a visit from my midwife who reassured me that my baby was healthy and would come when it was ready. With the knowledge that she supported us, I went and had a relaxing massage, let go of all my expectations and just enjoyed my last moments of being pregnant...it was a huge emotional shift to go from waiting/watching to noticing/enjoying and I think that's what allowed my labour to start.

e_p, that describes me to a T at the moment! It doesn't help that well-meaning family are hanging out for news and call every day asking if he's here yet (note to self, next pregnancy I am adding 3 weeks to the EDD that I tell people!). I do manage to find moments of peace where I can be totally OK with where this is at, and actually if I take the anxiety and stress out of the equation, I really do believe in my gut that bub is fine, we are great, and he will arrive at the precise moment he is meant to and not a minute before. To be honest, I think that's why the conversation with the MW threw me so much yesterday... up until this point, my belief in my body and mother nature doing her thing have been so strong that it really didn't occur to me that a conversation about induction would ever happen. Live and learn, huh? It took me right back to all the fears attached to my past experience. It occurred to me today that I don't need to invest a lot of energy into getting my MW onside with me... it's perfectly OK for her to have her position, and limitations if she has them, just as it's perfectly OK for me to not consent to induction if there's no good reason to have one. I do need to chat to her and work out what her bottom lines are.

I agree wholeheartedly though that letting go of expectations and finding joy in the last days of pregnancy is a state of mind that's well worth aiming for. Thanks for your post. x

[Amber4]

Home birth was never an option for me but I was hell bent on avoiding another induction for my second after being induced early with my first.

I tried everything but it just wouldn't happen, although I was lucky enough to have a great OB the second time around and even though I was induced that was the only intervention I needed.

Really hope it doesn't get to that for you and you have the home birth you want.

Thanks TooManyShoes... it's funny the acupuncturist asked me today why labour hadn't occurred yet and I was like 'well, wouldn't I be the most popular woman in the world if I could identify the missing piece of the puzzle?' I feel for you having tried everything under the sun to bring it on with your second and not getting anywhere. Good to know you didn't need any further intervention.

[Cassius2]

From what I can gather your MW is asking if you would be comfortable to have monitoring done at the local post 42 weeks? Is this the part that bothers you? or are you worried about the hospital placing pressure on you while you are there?

Is your MW willing to go with you for the monitoring (i would highly recommend her to be there with you)?

I really hope that you can find a path that you feel comfortable with, this added stress cannot be fun . 42 weeks is still quite a bit away, plenty of time to keep baking for your wee bub, and if all shows well with baby at 42 weeks (which i am sure all will be!), then you still can go home and have your baby! by 43 weeks the majority of babies have chosen to come, you are still well on track to having your bubba at home