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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I am sorry you are facing this pressure. I remember it very well since each of my babies went to at least 42 weeks gestation. It's so stressful!! Trust your body. It will tell you when it's time.
You are "almost" 40 weeks and your OB has been "pushing for an induction" since last week? That sounds as if he has been wanting you to induce prior to 39 weeks...a big no-no according to his professional organization, ACOG (American College of Obstetricians and Gynecologists). Now that you are beyond 39 weeks though, that argument loses steam, but I wanted to point out to you that he certainly is not behaving as if "he knows best", if he is not even following the guidelines of his own fraternal organization (who do quite enough meddling in the natural process as it is!). That still does not give his advice or attitude any credibility, however.

Statistically, you are safe staying pregnant until 42 weeks. His attitude that "he knows best" is disrespectful to you and every other woman he "cares" for. He doesn't know you best! Every woman's body reacts differently to the mediators that combine to start labor. You will undoubtedly hear "scare" stories from those who know mothers who had stillbirths prior to 42-plus weeks, but those would not necessarily have been avoidable had an induction taken place prior to then. At 40 1/2 weeks, if you have not begun labor, you can compromise by agreeing to twice weekly Non-Stress tests (fetal monitoring for a short period of time to assess the baby's responsiveness). In the meantime you can do fetal "kick" counts daily, an even less interventive, but very helpful form of fetal assessment. Just pick one of your baby's active times (you have probably noticed a pattern by now), empty your bladder, drink a glass of your favorite juice, rest on your left side, and count how many times you feel any movement from the baby (kicks, rolls, swishes, whatever) in a two hour period. 10 movements is a good, active count, especially in these last few days or weeks of pregnancy when room in the womb is becoming more crowded. Easy peasy, and very reassuring. If you only feel 8 or nine movements, do another count; but all is probably well. If you feel significantly less than that amount, an NST at the doctor's office is in order. Research has shown that, even in compromised babies, a mother who does regular fetal kick counts can determine if her baby's activity pattern has declined well in time to get medical intervention and get baby born. Still birth is rarely sudden, unless an undetected medical problem is at play...and modern obstetrics tests early and regularly for so many things...diabetes, congenital defects, pre-eclampsia, etc.), that this is rare.

Induction is not all it's cracked up to be, especially if your cervix is not "ripe"...that is, it is not yet soft, has not yet shortened significantly, and may still be posterior (pointed towards the back of your body rather than the front). An induction at this point is a long, drawn out process that can easily exceed 24-48 hours...all time that you are usually confined to a labor room, on continuous fetal monitoring, and not "allowed" to eat or drink...brutal!...and it should only happen if baby absolutely, for dire health reasons (yours or his/hers), be born quickly...and that does not seem to be the case with you.

You are not incompetent...do not fall for this paternalistic, manipulative behavior by your physician. Believe in yourself and your intelligence! In all likelihood, you labor will start when you and your baby are ready. Until then, try to remove as much stress as you can from your life, relax, and enjoy these last few precious days or short weeks. Rest when you can, eat light, frequent, healthy meals, and try to get some pampering in (massage, pedicure, your favorite movies on DVD, etc.) It's a shame that you have to deal with such an unsupportive physician at this time, but try to focus on the positive.

Although it is an extra expense, please consider employing a doula to accompany you to your labor. A doula can help advocate for you (although she cannot speak for you) during your labor, and let you know if you are being given information that is potentially suspect; and while you wait for your labor's arrival, get to your nearest bookstore and get a copy of Henci Goer's book "The Thinking Woman's Guide to a Better Birth", and read up on pregnancy dating, length, induction, etc. Don't get discouraged when you talk to other pregnant women and hear that they are so many centimeters dilated, or such-and-such percentage effaced, if neither has happened to you yet. First time moms (and a good portion of mothers in subsequent pregnancies) can take a while to get the softer, shorter cervix that will begin to dilate and move into full blown labor.

When your physician asks for a Biophysical Profile (and he probably will), an in-depth ultrasound to check on such things as the amount of fluid around the baby, the baby's "breathing" movements, the baby's gross motor movements, etc., should he tell you that you have "low fluid", ask him to tell you exactly how much fluid you have, and what the normal number is. Ask him to show you ACOG guidelines for the "normal" amount. If he knows you are holding him to the standards of his profession, perhaps he will not be so condescending...he may be peturbed, but he can't say you aren't being "safe" (it also helps to stay hydrated...so keep those fluids going in...at least a couple quarts a day!).

One final note. Don't take too much to the labor room...you'll just need to lug it from room to room when you get to the hospital. Most things you pack for your hospital stay you can stow in the trunk of the car until you give birth and have been settled into your postpartum room; but do take some "creature comforts" with you...a favorite quilt or pillow, a hand massager, something that says "home", or "comfort". A strong, active labor can stall out once you get to the hospital, because of the stress of moving from home to hospital, nerves, anticipation, etc. That piece of familiar comfort can help you feel more secure, help you get settled in sooner, and relax you back into active labor.

Hang In There!; And best wishes!

An Experienced Labor Nurse
It's only peer pressure if it's your peer. Your OB is using his professional stature to take advantage of your vulnerability as a first-time mom and is patronizing you--i.e. instead of providing information, mentioning his credentials/experience and pressuring you to let HIM make the decision. I'm sure your local moms can direct you to an OB or midwifery practice who will be willing to accept you at this date and who will not try to convince you to undergo medical procedures for convenience instead of medical reasons. You should be aware that induction, among other risks, doubles your risk of c-section:

Monica, have you given birth yet? Please fill us in if you are up to it.
Best wishes, Mandy
This is very common with OBs and even some CNMs, these days. The problem is that OBs and some (most are pro-natural) CNMs overbook themselves to be able to make $$$ and cover their malpractice insurance. What happens when you overbook? You run the risk of nighttime deliveries, office-hours imposition, etc. It is much easier for them to schedule as many as they can in advance. This way, no two moms labor at the same time and they still get their bank.

But birth shouldn't be like that. Birth is not scheduled...its spontaneous joy. This should be respected unless there are complications occuring...right now. Many docs will say that the incidence of fetal demise or maternal hemorrhage increase as the gestation passes 40 wks. And they would be right. It increases by something like 0.5% if you wait until 41 wks. Another 0.5% for another week. After that, you're looking at a more significant increase, but still in the single numbers for percentage. I can't remember where I read that, and I wish I had the direct source right now.

The bottom line is that it is your chice. I would start looking for a different practitioner who might be more respectful of your wishes. Then speak with your current practitioner about your wishes. Be up front. Be educated. You might request a membrane strip.

Also a doula would help you out in the hospital. She can offer additional insight to you about how to deal with the wishes of your care practitioner.
I was overdue with my first baby as well, and at exactly 40 weeks I agreed to a non-stress test to be sure baby was ok. I refused to be induced and went into labor naturally only 3 days later, after being told by the nurse doing the NST that the baby was much too high & she felt I wouldn't go into labor any time soon. Ask your doctor if there is a medical reason why he wants to induce labor. If not, sit back & relax and try to wait for nature to take it's course. Sometimes there are reasons but in your case it sounds like the doctor is just practicing protocol. I believe that the more relaxed you are, the more likely your body will be ready for labor. A little mind over matter. In the meantime, do something to busy your brain, like going to the movies or a concert & trust your intuition. Your instincts are your greatest asset from now on into motherhood :) Best wishes...
I'm coming in on this late and I'm sure the baby has been delivered by now, but I'm going to comment anyhow. I didn't see any mention of asking about your Bishop's Score and I think there should be. If you're not familiar with it it's a score(done sort of like the APGAR) to judge your how effectively your body will respond to induction. If you are still battling, first educate your self on it, and then ask your doctor what he would say your score is. I'd be interested to hear what he says when he recovers from t he shock of your question. :)
Hey, I've never heard of the Bishop's Score before, thanks for sharing! I think every woman should know about this!
Me too. :)
Try to find a doula or midwife who can attend the birth with you. You are going to need that support, someone who can advocate for you and help you in the midst of your labor when people are trying to pressure you. In hindsight, I really wish I had done that for my birth. I cancelled my first scheduled induction at 41 weeks. I wish I cancelled my second too, I gave in and went in to be induced at 10 days late, and ended up with pit, an IUPC, among other interventions which then confined me to the bed... long story short I ended up with a c-section for 'failure to progress' because my Dr. would not give me more time, even though the baby was fine and there were no other problems. In that situation, it is pretty impossible to continue to fight for vaginal birth, let alone any sort of positive labor experience. Try to get someone to be there with you to support you, and do what you can to not get induced.

Of course, as others have said, go do your non-stress tests and get the amniotic fluid checked to make sure. Don't give in to the induction unless there is really a medical reason for it.

I just realized I'm commenting really late here - you've probably already had the baby. Hope everything went well. Thanks everyone for your comments, this is a really helpful discussion.



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