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.

[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).

[jjaney]

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.

Hi I was after some advice..
This is my firsy baby I`ve been trying for many years.
I`m 42 with gestational diabeties so in the eyes of the hospital staff in a HIGH risk category.
I have my heart set on a natural birth, I`ve been doing hypno therapy and yoga to prepare for the birth .
Now I`ve been told my baby is 8.2 pounds and I`m 37 weeks so .... The doctors are extremely keen to induce me,
I`ve read some awful things about being induced and the high raate of women being induced then a few hours into the labour having a ceaser-due to the body not being ready to birth naturally.and the hormones given don`t prepare the body like the natural on set of birth.

any advice?
Merci and many thanks.

[HotI]

Hi I was after some advice..
This is my firsy baby I`ve been trying for many years.
I`m 42 with gestational diabeties so in the eyes of the hospital staff in a HIGH risk category.
I have my heart set on a natural birth, I`ve been doing hypno therapy and yoga to prepare for the birth .
Now I`ve been told my baby is 8.2 pounds and I`m 37 weeks so .... The doctors are extremely keen to induce me,
I`ve read some awful things about being induced and the high raate of women being induced then a few hours into the labour having a ceaser-due to the body not being ready to birth naturally.and the hormones given don`t prepare the body like the natural on set of birth.

any advice?
Merci and many thanks.

I'm so sorry you are having all this pressure, when you should be surrounded by love and support.
Induction for predicted baby weight has been shown to NOT lead to better results for mum or baby, just an increase in interventions and c sections.
Henci Goer has some great evidence based articles on the benefits and risks of various interventions during pregnancy.
Do you have support people who can be strong and help you to make your voice heard?
I would be asking the drs for information on the risks and benefits of any intervention they are offering, and the risks and benefits of waiting.

good luck

[AndiE]

Amber - thanks for the update. Glad to hear your birth started naturally (acupuncture is wonderful!), and it sounds like you've got an amazing little boy who is doing well in spite of the challenges he has experienced. Wishing you and your baby boy all the best.

Jjaney: Predicted birth weight is such a subjective thing. For some, their bub's birth weight is as predicted, but for many others, their bubs' birth weights are considerably more, or less than guestimated. Honestly, no one can accurately know the weight until your baby arrives. I had my third son at 39, he was two weeks overdue and I was induced (he was being stubborn, but he and my body were ready for birth and he arrived quickly with gel-only induction). He was 4.5kg and I birthed him without a drama.

I have heard there is a growing trend to induce "older mothers". I've heard of two cases here in Brissie recently where the women were induced before 40w purely because of their age. I can only speak from my perspective, but I birthed just the same at 39 that I did at 35 and 37 (and I had gestational diabetes while pregnant with my first son).

I also understand that some bubs whose mums have GD have a heavier birth weight. I'm sure that is sometimes the case, but sometimes it isn't. DS1 (I had GD) - weighed 2.9kg at 39w3d. DS2 (no GD) - 3.6kg at 39w6d. DS3 (no GD) - 4.5kg at 42 weeks (but presumably was heavier than the other two at 40w). No rhyme or reason to the birth weights of my children although I was probably more conscious of my diet when pregnant with DS1.

From what you've written, and assuming your GD is under control and there's no concerning medical issues with you and bub, I'd stick to your guns and not be induced. Honestly, there is a time and a place for intervention ... you just need to question if THIS is the time and place. Where babies are concerned, the medical profession is risk-adverse and afraid of potential litigation, to say the least. Your body, your baby, your choice. Your belief in yourself to birth your baby naturally will also go a long, long way towards you achieving the birth you want. So good on you for going down the path of hypnotherapy and yoga. A good support team who are in your corner and back your choices will also be worth it's weight in gold. This forum is also a fabulous source of support and insipration which can only help to empower you and fuel your confidence. Good luck and keep us posted.

[jjaney]

Amber - thanks for the update. Glad to hear your birth started naturally (acupuncture is wonderful!), and it sounds like you've got an amazing little boy who is doing well in spite of the challenges he has experienced. Wishing you and your baby boy all the best.

Jjaney: Predicted birth weight is such a subjective thing. For some, their bub's birth weight is as predicted, but for many others, their bubs' birth weights are considerably more, or less than guestimated. Honestly, no one can accurately know the weight until your baby arrives. I had my third son at 39, he was two weeks overdue and I was induced (he was being stubborn, but he and my body were ready for birth and he arrived quickly with gel-only induction). He was 4.5kg and I birthed him without a drama.

I have heard there is a growing trend to induce "older mothers". I've heard of two cases here in Brissie recently where the women were induced before 40w purely because of their age. I can only speak from my perspective, but I birthed just the same at 39 that I did at 35 and 37 (and I had gestational diabetes while pregnant with my first son).

I also understand that some bubs whose mums have GD have a heavier birth weight. I'm sure that is sometimes the case, but sometimes it isn't. DS1 (I had GD) - weighed 2.9kg at 39w3d. DS2 (no GD) - 3.6kg at 39w6d. DS3 (no GD) - 4.5kg at 42 weeks (but presumably was heavier than the other two at 40w). No rhyme or reason to the birth weights of my children although I was probably more conscious of my diet when pregnant with DS1.

From what you've written, and assuming your GD is under control and there's no concerning medical issues with you and bub, I'd stick to your guns and not be induced. Honestly, there is a time and a place for intervention ... you just need to question if THIS is the time and place. Where babies are concerned, the medical profession is risk-adverse and afraid of potential litigation, to say the least. Your body, your baby, your choice. Your belief in yourself to birth your baby naturally will also go a long, long way towards you achieving the birth you want. So good on you for going down the path of hypnotherapy and yoga. A good support team who are in your corner and back your choices will also be worth it's weight in gold. This forum is also a fabulous source of support and insipration which can only help to empower you and fuel your confidence. Good luck and keep us posted.

[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

[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.

[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]

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

[forshelby]

[Ladylove]

I too was scared of induction and went into natural labour at 40 + 4, giving birth early the morning after. Now I don't know if it was coincidental but I had been doing the following things in the days prior to labour -

Lots of walking (or waddling!)
Fit ball bouncing
Massage on the pressure points relating to labour- inner wrist and just near the ankles
Nipple stimulation. I was in fact stimulating my nipples when I felt my first gentle contraction!