Peer pressured into induction
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.
Replies to This Discussion
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Permalink Reply by Shanta Brownridge on -
I've never gone over 39 weeks so I don't know the pressure that is put on women to go into labor on a time schedule. Saying that, I was told by my midwife during my last pregnancy that we would wait till 42 weeks (which I believe is the normal recommendation from all health agencies) and then I had the choice of artificial induction OR I could go for an ultra sound every three days to check for fetal distress or changes in amniotic fluid. The latter would have been my choice - due dates are far from an exact science!
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Permalink Reply by Sara on -
Shanta-
For all my kids I've been late. For my first 3 I was told that he'd induce me at 42 weeks, but when I became pg with #4, I was told that "they" no longer recommend going over 41 weeks. I'm assuming the "they" is the ACOG.
With #4 I was induced at 41 weeks, but sent home without baby because of no progression after having the pit turned up as high as they allowed. I was angry and frustrated because he didn't listen to me when I told him the u/s dates were 11 days later than my LMP dates. He wanted to try again 3 days later, but I told him he'd have to wait at least a week (by which time I was 42wks 2days according to LMP dates) He wasn't happy, but when I told him I wasn't showing up before then, he kinda backed off. During that week I did EVERYTHING that I possibly could to get things going naturally and although I had a couple nights of regular contractions, they quit around 4 AM both times. When I went in for the second induction, I was on pit for 12 hours before they broke my water. I was at 4cm by then and 20 minutes later, by baby girl was born. I think that all the cervical ripening I tried really helped, but knowing what I know now, thanks to this site and others with huge amounts of info that is not distributed freely, I will not be showing up for any inductions if I go past my "due date" this time. As was said before, it's only an estimated date, and because of my history of irregular cycles and going late, if everything looks good, baby is going to be staying put. :)
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Permalink Reply by Desire'e on -
Is there a reason he is so worried!?!? Its one thing if they've asked you to do an ultrasound etc and they are worried about your baby's growth or the baby's heart variability/activity (which is called a NST or Non-reactive stress test or NRST if they don't like what they see on the strips).
Basically he has a God complex and he's used to everyone just saying "OK" ... and you dear aren't being a "lemming" you are doing the right thing questioning "why?" And he doesn't like this....You know what ..soooo what he doesn't like this. Last time I checked This is YOUR pregnancy and he is talking about YOU and YOUR baby. A doctor is there to diagnose, treat when need, give advise, & perform when necessary, & to watch over you and answer questions and interact, BUT you are the Ultimate because it is ultimately YOU that controls it ALL. If you say no; then its no...that is your right as a patient to see or be given every option to make a decision or INFORMED CHOICE He doesn't like the fact that he isn't in total control because doctor patient relationship should be a give and take.
Ok getting off the soap box.. If you have a history of a large baby and they want to induce early for fear of not being able to pass through the pelvic bones which we call CPD or Cephalo-pelvic Dissproportion which basically means baby is too big to pass through due to size or your pelvic bones just don't want to budge to let the baby on through. I have seen this with all size babies. 6#, 8#, 9# And alot of times if you delivered vaginally the first time they try and induce early to allow you to vaginally deliver again decreasing risks of this.
The other reason they induce at 40weeks cause the aging of the placenta begins to deteriorate after 40 weeks plus there is no reason for a baby to stay in after 40 weeks because they are fully developed etc. What do I mean about aging of the placenta? Well after 40 weeks the placenta starts to form calcifications on it and begins to stop functioning as well but research shows there is no reason to intervene/induce unless necessary like a bad NST reading; decrease in growth; etc... until 43 or 44 weeks if a benign course of pregnacy has occured.
The majority of women that get induced at the hospital ...They can start you with either Pitocin which is the usual drug of choice by doctors still its a Oxytocin like synthetic drug that causes you to contract and force you into labor essentially. The other newer drug is Cytotec which is a Gastrointestinal drug for GI upset or Gastric ulcers you can get from taking NSAIDS (non-steroidal anti-inflammatory drugs) and its "OFF LABEL use" is to induce, BUT it is not endorsed by the FDA and they do not; YES you heard me say it DO NOT recommend use of this drug for inducing labor, but its cheap about 25 cents or so a pill as oppossed to the pitocin that is a few hundred dollars per 1000ml bag.
Now in the past with the cytotec has caused women to get a ruptured uterus but they say that was with high dose.....Suppossedly they use lower dose pills now and don't have the same risk.. In the two years I've worked around the L&D dept I haveNOT witnessed a rupture so maybe they are right. But the risk is still there not just with Cytotec but with Pitocin also.... With cytotec they either have you swallow it or they insert it vaginally next to the cervix. BUT once you've swallowed it or its in the vaginal canal its in there an they can't go in and get it back.
With Pitocin if your baby shows signs of getting stressed they can turn it down or off. My cousin was getting induced for her 5th child and she ruptured on Pitocin. They don't admit it was probably the Pitocin but who wants to admit to that...... This is the worse case scenario but she had to have an emergency hysterectomy; lost 7 1/2 pints of blood (in lamiens terms she basically had every bit of her blood replaced and was an inch away from dieing) She is a miracle walking. Most women aren't that lucky with ruptures. This isn't to scare you cause I've witnessed plenty of labors that were textbook deliveries no problem but its a possibility.
Another synthetic they use in combo with the above is Cervadil a synthetic prostaglandin which is found in Male semen (the white stuff in male ejaculate). This helps to soften the Cervix or to ripen it to get labor moving along. Cause you can dilate but unless your cervix softens the baby isn't coming out vaginally. I almost forgot....another thing they do in combo with Pitocin etc is they may break your bag of waters to help speed along the labor and help with the contractions (if your membrane ruptures the contractions tend to be more intense it allows for baby's head to come down to push on the cervix to help soften and open it up) BUT you run the risk for AN INFECTION. The usual procedure is if you haven't progressed to a certain point by 24hrs they bring you up for a section because of the high risk for an infection to you and the baby.
I mean unless they say that your cervix (the part of the uterus that opens up that the baby comes through once 10 cms) is "favorable" and you plan on having an epidural and you don't mind being hooked up to a monitor 24/7. You could go in and deliver within 12 hours or so. But that's not always the case.
With inducing before time you could run the risk of laboring for 12 to 32 hours and end up a C/section anyway. Or you could go in and the baby doesn't tolerate the induction medicines at all and they want to call a stat/emergency C/section. So here's some advice research your options. You could go in and they can start your induction and if you haven't allowed them to break your bag of waters than you can Change your mind and believe or not go home and come back another day to try it again. One of our nurses' did that and they ended up coming in two days later they retried and sure enough 8 hours later had her baby vaginally. Just know there ARE OPTIONS. The other thing look up natural inductions....You can have sex with your husband (prostaglandins), walking sometimes does the trick (brings the baby's head down), Drink Red-leaf raspberry tea.
I'm a wife, mother of two, an RN. I delivered my first naturally (NO pain meds) vaginally after 11 1/2 hours of labor w/IV antiboitics due to having Group B strep in a hospital (had horrible delivery experience) My water broke at 315am got to the hospital about 4am they checked me at 5am I was 5 cms & fully effaced (my cervix was 100% soft & as thin as paper) My son was OP positioned (occiput posteriorly positioned) looking face up which means longer harder (back) labor and delivery....they almost ruptured by bladder ended up with an episiotomy I didn't need (due to the full bladdar he had problems coming out) All they had to do was what we call IN/out cath me to drain some of the bladdar. He was 8#1oz 14 1/2" chest (big) was totally fine
My second was delivered with a Midwife at a birthingcenter. I had an anterior partial placenta previa (which means my placenta implanted really low in the uterus near my cervix and it was located on the front of my belly where they would have to cut if I would have needed a C/section...so I was high risk for bleeding was put on moderate bedrest (no lifting, pulling, pushing, no walking long distances) with him which resolved meaning it moved up the cervix enough to be off of it to where I could deliver at the birthing center instead of being observed at a hospital. My labor started @ approximately 945pm called the midwife at 1030p to give a heads up left for the center 11p go there 1120p and he was delivered @ 1:57am. He didn't cry at first it was a totally different experience it was a quiet calm atmosphere but since he was still attached to the cord it was ok cause still receiving oxygen as we were drying him off he cried turned pick then let the cord stop pulsing which since my placenta was low didn't take long at all she clamped the cord my hubby cut it. But both my pregnancies were 40 wks exactly. I used sex, red leaf raspberry tea, (2nd pregnancy) primrose oil capsules, & walking to natrually induce for both. I also attended a bradley method class for my second and preferred it to taking Lamaze (which I went to for my first). With my second pregnancy it was in the 39th week I used the the above because of the risk involved. And because I drank the red-leaf raspberry tea it decreased my chance of bleeding (the indians used it to aid the uterus in strenthening it for faster quicker labors) Sometimes you can do all of these things go to 44 weeks; they induce and you could still end up in a c/section. That's the funny thing about pregnancy You just never know how it will turn out.?!.... We just know if you've had previous pregnancies that were uncomplicated then your risk is lower but....
JUST reasearch and inform yourself!!!!!! and see what's best for you!!! cause its better to be informed and educated than not knowing at all so you can make the best decisions for you, your baby, & your family!!!! Good LUCK!!!! and Congratulations!!!
Oh and say no to blue and black cohosh when thinking of inducing it has some major side effects not worth experimenting with.
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Permalink Reply by Mandy Hand on -
That is very sad.
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Permalink Reply by Rachel on -
I went 42 weeks overdue, but I had my fluid checked and and NST's done more than weekly. I am all for waiting, but you should make sure you are monitoring baby to be sure everything is ok. Low fluid can definitely be a problem. But that's why I'm grateful for the technology we do have. It just needs to be used wisely. Quite honestly, problems happen throughout the whole duration of labor and birth. That's a part of life. That doesn't mean that we should dismiss them, but our bodies really are remarkable in their ability to time things much better than we give them credit for. The bottom line is, babies can do fine going post dates, but if baby is looking bad, I wouldn't hesitate to get induced.
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Permalink Reply by Britte Nihart on -
I am a student midwife and have some years of OB Nurse experience. In MY experience, most docs want to induce early so that they can control the timing of it. They don't want you delivering in the middle of their office hours and messing up their schedule or (Heaven Forbid!) in the middle of the night and costing them precious sleep! They are becoming quite accustomed to controlling their schedule with inductions and cesareans and they don't like it if that gets messed with by uncooperative patients who don't play along.
It is important to have regular non stress tests to ensure that the baby is still healthy after 40 weeks. But, it is very normal to deliver at 40, 41, or 42 weeks. Generally your body and your baby know when the time is right!
As for the poster that mentioned her friend who had a fetal demise at 41 weeks... That is horribly sad and tragic, but the writer was right- it could just as easily have happened at 20 weeks or 30 weeks or 38 weeks. These things can not be prevented or predicted. We can't induce everyone at 36 weeks because someone had this happen at 37 weeks. Far more babies would be harmed by the inductions!
To the original poster, if I were you, I might seek a second opinion from someone in the same group if necessary, but from a midwife if possible. Follow your gut. If you and your baby are healthy, you are right to allow nature to take it's course.
Best wishes!
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Permalink Reply by Jenny B on
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I just went through the same thing you did. My OB was also pressuring for induction after 40 weeks. I'm pretty good with pressure though. I knew I could trust my body (but I also knew not to be unreasonably stubborn if something came up). My strategy was to smile and nod but stand my ground. I didn't argue. I didn't challenge the doctor. I simply said "I understand", "I see your point", "I get what you are saying" to all of my doctor's warnings and then continued to push for 42 weeks. Whenever she suggested I come in on a certain date to get re-checked, I would say "That doesn't work for me. How about this date instead?" If you argue, the doctor will get defensive and argue back. If you just smile and nod but stand your ground, the doctor may get flustered but s/he can't say much if you don't respond.
I worked with my doc and we set up NonStress Tests often so that we all could have peace of mind. As it turned out, I had to go for a last minute ultrasound after my last NonStress Test and I did wind up having low amniotic fluid which did lead to an induction at 41 weeks. That's just my case though. Don't let NonStress Tests scare you. If you do have them done, make sure to eat well beforehand so that your baby's awake when you get the test done. Now, if you do wind up getting an induction--for medical reasons--rest assured that you did all you could for the safety of your baby. Have no regrets. And remember, everyone's birth is DIFFERENT. Even the induction births! My induction had no complications. I had pitocin started on a low dose and gradually raised. I opted for no epidural and it was still manageable. I had my baby as naturally as I could given the circumstances (ie the pitocin) after 5.5 hours of active labor. I used HypnoBabies which helped me stay calm which is the most important thing you can do for yourself to help reduce the "pain" of childbirth. There are other positive induction stories here:
http://www.pregnancybirthandbabies.com/induction_birth_stories.htm
Now I'm not advocating induction at all. I was and am totally against it, as in most cases it is not necessary. But, I just want you to know that you should never go into birth feeling stressed or guilty.
Bless you and Have a wonderful birth!
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Permalink Reply by Gena Kirby on -
It's so cute how OB's FREAK when their patients don't roll over for them!
Do what your gut says, your baby's biggest advocate is you!
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Permalink Reply by Karen Melton on
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Dear Monica, I want to support your instinct as a pregnant mom to resist this pressure from your doctor. It has, unfortunately, become normal for medical doctors to induce babies. Once you are induced you are put on their clock and usually given 12 hours to get your baby out. Often this will end in a c-section with many other interventions in between. Just from the point of view of your baby: when we are ready to get born we send out a chemical signal to our mom and this starts the contractions. Having the experience of initiating our own birth, from the inside-out is very important. It is a core imprint for being able to feel your own impulse and make your own beginnings from that place - really crucial. It is important to us as little ones to feel our impulse, and move through the whole sequence uninterrupted, from beginning, through the middle and to the end (birth) and the integration phase (immediately after birth). This gives us a complete physiological, emotional/psychological imprint for the way we move through life generally, and on a daily basis. Hospital births tend to interfere with this important aspect of birth routinely, and they have no understanding of the psychological, emotional and spiritual implications of the practices they carry out every day. Doctors generally tend to want to be in control of the birthing, and to have it all happen on their schedule, they don't know how to get on baby time. Unless your baby is enormous and there is genuine concern for you about whether you will be able to birth vaginally for that reason, you might consider some more natural inducements. In hospital they often use Pitocin which creates an unnatural rhythm in the birthing contractions, often with no rest points in between. Pitocin itself adds another layer of imprinting into the babies experience of getting born. Hope it goes well for you! warmly Karen Melton, Preventing & Healing Prenatal, Birth & Bonding Trauma
www.HealYourEarlyImprints.com
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Permalink Reply by Michelle Huhn on -
Dear Pressured~
Although it may be too late to switch Drs now, you may want to consider doing that. And for sure in the future!!
Trust your gut, trust your instincts. Really, this is your FIRST true test as a Mom. Why? Because as you raise your children, you will have influences from everyone. Only you can make the decision. This is your first time to stand up to peer pressure. Consider it your training ground for future battles!
YOU CAN DO IT!
Blessings and I hope all turns out well!
M
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Permalink Reply by Sarah Atondo on -
I work in L&D, so I know exactly what you are going through.
Let me just tell you that docs consider you post dates at 40 weeks. We induce people on their due date all of the time for post dates. This is not accurate at all because you're due date is never really accurate. It is just a close guess. It could be off by 2 weeks either way, so until they consider you 42 weeks, I wouldn't even consider inducing, unless medically indicated.
What happens is, they induce you at 38-40 weeks, when in reality you may be only 36-38 weeks, which makes you clearly NOT ready to give birth, and you end up with massive complications, like an emergency c-section because you baby is not tolerating labor, and you could end up with a baby in the NICU for many reasons. If your baby was ready you would be in labor already.
With both of my children I had them 1 and 2 days before my due date, so DO NOT DO NOT, let them do this to you. You are too early and let me tell you a hard truth...they don't care! They would much rather induce you and plan the delivery to their schedule, then get a call at 2 am to come in and deliver you. This is our medical system now.
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Permalink Reply by Kimberly V. Wallace on
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Good info, Sarah! So important for moms to know; Doesn't it make you crazy that some Doc's just don't seem to know the difference between post "Dates" and post "Term"? Big difference! and sad, but true, that so many Docs are still trying to make labor fit office hours. Makes me nuts!
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