I am almost 40 weeks with my first child and no complications and my OBGYN has been pushing for an induction since last week. He seems to be very agitated with the fact that I want to wait and makes me feel incompetent. He says that there are risks involved and that he has been doing this for years and that he knows best. He is freaking me out about leaving the baby in there longer than necessary and even getting somewhat upset that I am not taking his advice. I dont know what to do I am so inexperienced especially since this is my first baby.

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Your OB has been pushing since last week, before 40 weeks? Stand your ground! You do not have to consent to any medical care you don't want.
In the meantime, there are natural ways to help labor come on its own - walking, sex, castor oil - but I'll let the experts here comment on that.
The average first-time mother gestates for 41 weeks, 1 day.

Stick to your guns! You're doing the right thing!! Inducing is unnecessary because your body knows when it's ready to do what it needs to do. Why induce & end up worrying extra about whether your baby is ready enough and might have to spend more time in the hospital?

If he schedules an induction for you, you are under no obligation to go. Call & cancel or just don't show. The induction police will not be knocking on your door! :O)

Good luck!
When I went over do I had NST's(non stress tests) done to check for baby's heart rate and reactiveness. I also had my amniotic fluid checked. I would do these things to reassure yourself and give you some leverage with the doctor. If they don't check out ok, then maybe induction may be something you would want to consider. I would always try more natural ways first, though.
I would say to your Dr. "have you ever labored with induced contractions?" Going through labor that is induced is *a lot* more painful than natural contractions....not that natural contractions don't hurt.....its just.....different. I would not agree to be induced unless there was a very strong medical reason for it. Also, since it appears your Dr. doesn't respect your opinion much, do you have people who will be with you and can advocate for you while you are in labor? If your Dr. is giving scare tactics BEFORE labor starts, its pretty likely he'll do the same time when you are IN labor and that's an awful time to be scared into something that may not be necessary.
This is a good solid study from 2009. When they're discussing post-term gestation they're talking about 42 weeks, or 41 completed weeks of pregnancy.


Indications for induction of labour: a best-evidence review

E Mozurkewich, J Chilimigras, E Koepke, K Keeton, VJ King, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA Correspondence: Dr E Mozurkewich, F4835, PO Box 0264, Mott Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0264, USA.

Email mozurk@umich.edu

Accepted 2 November 2008. Published Online 4 February 2009.

Background: Rates of labour induction are increasing.

Objectives: To review the evidence supporting indications for induction.

Search strategy: We listed indications for labour induction and then reviewed the evidence. We searched MEDLINE and the Cochrane Library between 1980 and April 2008 using several terms and combinations, including induction of labour, premature rupture of membranes, post-term pregnancy, preterm prelabour rupture of membranes (PROM), multiple gestation, suspected macrosomia, diabetes, gestational diabetes mellitus, cardiac disease, fetal anomalies, systemic lupus erythematosis, oligohydramnios, alloimmunization, rhesus disease, intrahepatic cholestasis of pregnancy (IHCP), and intrauterine growth restriction (IUGR). We performed a review of the literature supporting each indication.

Selection criteria: We identified 1387 abstracts and reviewed 418 full text articles. We preferentially included high-quality systematic reviews or large randomised trials. Where no such studies existed, we included the best evidence available from smaller randomised trials and observational studies.

Main results: We included 34 full text articles. For each indication, we assigned levels of evidence and grades of recommendation based upon the GRADE system. Recommendations for induction of labour for post-term gestation, PROM at term, and premature rupture of membranes near term with pulmonary maturity are supported by the evidence. Induction for IUGR before term reduces intrauterine fetal death, but increases caesarean deliveries and neonatal deaths.

Evidence is insufficient to support induction for women with insulin-requiring diabetes, twin gestation, fetal macrosomia, oligohydramnios, cholestasis of pregnancy, maternal cardiac disease and fetal gastroschisis.

Authors’ conclusions: Research is needed to determine risks and benefits of induction for many commonly advocated clinical indications.

Here is an article that details the use of pitocin for labor induction and augmentation. Some doctors use Cytotec or prostglandins for the same indication. You definitely want to look up info on these drugs before you consent to have them used on you. If you feel that your doctor's behavior is unacceptable, consider hiring a doula or a midwife, or changing doctors if you can. If you are worried about being pressured now, think about what it might be like when you are actually in labor. Your birth team should also be aware of how you feel about interventions (IV, restriction of food and water, vaginal examinations, breaking your waters, epidural, freedom of movement during labor, choosing to be upright during the birth, a labor time limit, episiotomy). Some women like to have a birth plan prepared. You have the right to decline any intervention that you don't want, but if you do decide to decline, make sure that your refusal has been recorded in your chart.


Here's an article about the pushing stage of labor.


I hope this helps some.
I completely know what you're going through! With both my children my doctors were pressuring me to induce. Fortunately, for my first she came the day before I was scheduled to go in, and I did a lot more research before my second so I stood up more for myself. I know for me I have pretty irregular periods which tend to have longer than the average time between them, so the typical way of calculating a due date ends up being earlier, which makes it seem like I'm more overdue than I am. I don't know if that's a factor with you, but it made me feel better about waiting.

With my 2nd, my dr was pushing for induction at 36 weeks because she thought I was too small and my placenta would not be able to keep my baby alive. So I was pretty freaked out, but I did stand my ground. Finally, at what they measured over 40 weeks I let them schedule an induction, but when the day came, I just didn't feel right about it, so I called and cancelled (I found the nurses at the hospital were more sympathetic than the dr). I did go in every week to get checked on, and they would measure the amniotic fluid with an ultrasound, which was always just fine. Another week or so went by and they tried again to induce me, but they weren't able to fit me in--much to my relief. And then the next day I went into labor on my own, and my son was born perfectly healthy and 8 pounds (not a bit too small!!).

Also, both of my natural labors went by pretty quickly. I was only in the hospital for my son for about an hour before he was born. I know a few friends who were induced and their labors were 30+ hours and very painful, and one friend had complications because of the drugs.

So I would really encourage you to trust your body. For peace of mind, it was nice to have them check my fluid levels, but if they wouldn't have scared me in the first place I wouldn't have been worrying! A due date calculation is just a guess; that's why full-term is anywhere between 38 and 42 weeks. And an induction is easier for a doctor--he can plan it and control it (and get more money from the use of drugs!), but it's not the best choice for the mother (typically). Stay strong and before you know it, that beautiful baby will make an appearance at just the right time!
That's just it Jenn...it's your estimated due date!! Monica....whatever you do don't let them induce you...it's sucks!! With my one and only child, my water broke but I didn't get a single contraction so they had to give me pitocin and it was the worst thing ever! I swear I instantly went from 0 to 4 in like 5 minutes! Tell your doctor to suck it and get a new one for your next child! It's your body and there is no reason to start you when you haven't even reached your EDD. He needs to slow his roll! I hope that helps...sorry most of it was just ranting cause it makes me so mad when they try to pull this crap! Good Luck....and keep us posted!!
"Tell your Dr to Suck it!" Ha! i love it ;)
Sorry to hear your doc is being such a jerk! Just remember- you are the customer and *you* have hired *him*. You have the final say- this is your baby!! Stick to your guns and know that you have lots of support from other moms- you are doing the right thing! Lots of babies arrive past 40 weeks of an estimated due date. And if there are no signs of distress for you or the baby there is no reason for you to start interventions, as they will most likely lead to further interventions. Let the baby cook and come out when he/she is ready! Best of luck to you. Stay strong! Oh- and hire a doula to advocate and put any scare tactics into perspective cause if your dr is trying to freak you out now, no doubt it will be worse when you are in labour. Doulas are wonderful for helping you keep calm and make educated decisions during labour!
Don't be intimidated into doing something that doesn't feel right. If your doctor tries to unnaturally put you into labor before your body is ready the chances of you having a c-section or other interventions goes up. As long as you and the baby are not in distress there is no reason to rush it. 40 weeks is just an estimate. No one really knows when a baby is supposed to come except your baby. My first two were early. I was 35 when I was pregnant with my third and my doctor set up an induction the day I reached my due date. I stood my ground and said I wanted to wait. My daughter came 9 days later. She was a healthy 8 pounds and 10 ounces. I am now 38 and pregnant with baby #4. Whatever you decide to do just make sure it is your decision or you may have regrets later. I wish you a happy birth experience no matter you decide.

I'm answering this as a mom and a certified childbirth educator. It is completely NORMAL for full-term, healthy babies to be born anywhere between 37-42 weeks. There is something called the feto-placental clock which determines the timing of the baby's birth based on when baby is ready to be born and when mom is ready to give birth and nurture and nourish her baby. If you haven't gone into labor yet, it's most likely because the baby isn't ready or your body isn't yet prepared. Do not let this man make you feel incompetent. Inductions (even with a valid medical reason) carry risks, including increased risk of requiring more interventions including cesarean birth due to a failed induction (if you aren't ready, it may not work and may be a long and painful process).

I would ask him to give you specifics on what risks he thinks you are facing by letting your baby come when he/she is ready. True "post-mature" babies are very rare. Due dates are not accurate. It should really be a "due month" and there is no reason to get all freaked out about a specific date if you and your baby are healthy.

Best wishes,
This discussion has been so helpful. I wish I had had this support for my first child. I was induced, which led to pitocin to increase contractions (ouch!), which led to an epidural, which led to vacuum (narrowly escaped a c-section). And what was the Dr's reasoning for inducing me? Possibility of the baby's stool infecting his lungs and higher birth weight making more painful delivery. When I look back, the risks of waiting are minimal compared to the interventions that made my birthing experience so awful. I should have trusted my baby and my body, and they weren't ready.

Thanks for all of your advice, ladies. I'm definitely sticking to my guns and NOT inducing for my next one. :)



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