refusing induction?

[smileyfaces]

Any positive stories of ladies who have refused an induction and gone past 42 weeks?

I'm only 28 weeks but am sure I will go overdue and be offered induction again for a third time. Both my previous inductions weren't necessarily bad or anything I just would like to think that this time I will be able to give my body a chance to do its own thing.

Still got ages to go until then but would like to hear any stories of ladies who refused an induction when they were approaching 42 weeks.

Thanks in advance

 

[gemmagibs]

i dont think its wise to refuse they dont like you to go past 42 week for me i would be to worried about the increased risk of still birth! XXxx

 

[jtr2803]

I am afraid I can't help in that I have done it, but I will be refusing if I get there myself. I am a member of the home birth UK group and there are quite a few ladies who have gone past 42 weeks, a couple have even gone past 43 weeks and been absolutely fine.

I think people are too trusting, your midwife might say oh the still birth risk goes up after 42 weeks but did you know that the actual relative risk increase is around 0.3%?! There is no significant increase until week 43, and even then it's still well under 1% (all stats available on evidence based birth) as per the Weiss study from 2014. Just to show, I've copied the paragraph:

The stillbirth rates in this study were:
37.0-37.6 days = 2.77 per 1,000
38.0-38.6 days = 1.09 per 1,000
39.0-39.6 days = 0.90 per 1,000
40.0-40.6 days = 0.72 per 1,000
41.0-41.6 days = 0.44 per 1,000
42.0-42.6 days = 0.70 per 1,000>42.6 days = 8.85 per 1,000

There is no evidence that the Placenta ages excessively, as per the article by Harold Fox for the British Medical Journal.

Induction on the other hand inherently increases the risk of C-Section as also evidence in the Evidence Based Birth article.

Unfortunately, there aren't many of us who 'question' the status quo, as you can probably tell, I am one of them! I come across stories and situations time and time again of ladies being cajoled in to unnecessary procedures because no one has actually given them enough information to make an informed choice.

 

[awnmyown]

I also plan on refusing induction until I go over 42weeks. Ftm here as well, so I can't say I've done it, and I know already it'll come with pushback, but I'll fight it if I need to. The country's recommendations say daily monitoring after 41 weeks, so I think if that's showing clean, I wouldn't stress it. Plus, due dates are based on lmp, and I know for myself, I ovulated 5 days late the month we conceived. Which means the Aug 24 they gave me is actually 40w2d. Due dates are so not guaranteed accurate that I don't think we can trust an arbitrary number over our own bodies.

 

[tulip2002]

I was going to refuse any type of induction with my last baby as i was wanting a vbac my agreed plan with the hospital was allowed to be left alone till 42weeks. But agreed to sweeps at 40 and 41 weeks. If i was to go past 42 weeks i would go to the hospital for daily monitoring which i was happy with or course you do have to agree there comes a time when something would need to be done but luckily i went into labour at 41+2 so none of that happened and i continued to refuse any interventions and ler my labour progress on its own. I think personally i would have gone to 43 weeks then probably decided they induce me. Im pregnant again nearly 15 weeks and will be planning the same

 

[LoveCakes]

My friend refused until she went into spontaneous labour at 18 days over but they moved her dates by 2 weeks at her scan and she knew it was impossible so was confident that she was actually only a few days over. She went for monitoring every 2 days at the end

 

[smileyfaces]

Thank you all for the responses. I'm happy to hear that I'm not the only one looking at refusing. I'd like to think I'm getting a bit ahead of myself since I'm only 29 weeks but I just know I'm gonna be going overdue. I will probably give myself till just short of 43 weeks before I agree to it.

 

[Amygdala]

I refused with both my previous births. Baby one was 8 days "late" so although I had some fighting to do over not wanting to book an induction (which they ask you to do at 40 weeks here and book it for 40+12), I didn't actually make it to the point where they get worried. Baby two was 12 days "late". As I refused an induction date, they insisted I see a consultant at 40+11, who called me "ridiculous" for not not agreeing to induction and didn't offer any additional monitoring. I'm glad I stood my ground. I went into labour that night and ended up just barely escaping a section because baby had their very short cord around their neck, stalling labour. I was on the operating table when I went through transition and baby was born within 25 minutes of me being told I wasn't in active labour. There's no doubt in my mind that an even quicker, stronger labour as you get with induction would have ended in a section, or worse.

Saying all that, this time around with baby three, I'm considering agreeing to induction. We're now 35 minutes from the hospital with no traffic and given my lightening labour last time, I see the advantage of knowing when it's going to happen. Anecdotally, inducing a third labour also seems a lot less likely to lead to other interventions than inducing a first labour, although I haven't look at any actual research on this. I've not really started thinking about this properly yet, just initial thoughts really.

 

[Jessicahide]

You have lots of people offering you their own experience and how it worked out for them and that is fantastic, but can i just add last year when i was in neo with my son, i got talking to a nurse who had been left after failed induction to go until 43 weeks and she nearly lost her baby, she expressed to me that they leave far too many women to go past 40 weeks and it increased risks so much and she was witness to it... I am induced at 37 weeks, always and wouldn't dream of refusing... Sorry to go aginst the flow, but they induce for good reason, its not a hobby for them.

 

[smileyfaces]

Going past 40 weeks isn't a risk? 40 weeks is just a guide. In a lot of European countries your due date is actually considered as being 41 weeks. Close to 50% of babies are born after their due date, its really not unusual at all.

I assume you are induced at 37 weeks for medical reasons? That is a different situation entirely. I wouldn't refuse an induction if it was medically necessary either. I will be refusing induction this time round though if it is purely for being "overdue".

 

[Jessicahide]

Going past 40 weeks isn't a risk? 40 weeks is just a guide. In a lot of European countries your due date is actually considered as being 41 weeks. Close to 50% of babies are born after their due date, its really not unusual at all.

I assume you are induced at 37 weeks for medical reasons? That is a different situation entirely. I wouldn't refuse an induction if it was medically necessary either. I will be refusing induction this time round though if it is purely for being "overdue".

I am induced for medical reasons, and no her words were in her opinion after what she has seen leaving women past 40 weeks is dangerous, sorry if that is not what you want to hear, but it was a neonatal nurses opinion.

Stats might say different, but she is working hands on there and knows what she sees.

 

[smileyfaces]

If leaving women till 40 weeks was in any way dangerous then everyone would be pushed for an induction before their due date to ensure they were delivered for 40 weeks. Absolute rubbish, sorry.

 

[Jessicahide]

If leaving women till 40 weeks was in any way dangerous then everyone would be pushed for an induction before their due date to ensure they were delivered for 40 weeks. Absolute rubbish, sorry.

That's fine, i was quoting what someone who deals with this situation everyday told me.........

 

[jtr2803]

This is one of those things where someone who experienced a problem will obviously advise everyone to not do what they did.

A very big HOWEVER to me here though is that she had a failed induction?! You can't just interfere like that and then go hands off without some serious medical oversight on a continuous basis. There is not a single medical facility I know who will start an induction and then just point blank stop it because it doesn't progress. At that point they come out by c section and I'm very much wondering what they did to try and induce, there is every possibility that the intervention led to further issues - infection etc.

With any statistics, someone has to be the 1 in 1,000 that does go wrong, but that's still 999 that don't. I'm pretty happy with those odds so I'll be declining induction until close to 43 weeks.

Induction rate in the UK is 25% at the moment and 70% of those are for 'post date', wow, that's a crazy number of babies outstaying their welcome.... When there are that many not proceeding naturally, I can't help but wonder if that's just another variation of normal?

 

[Jessicahide]

This is one of those things where someone who experienced a problem will obviously advise everyone to not do what they did.

A very big HOWEVER to me here though is that she had a failed induction?! You can't just interfere like that and then go hands off without some serious medical oversight on a continuous basis. There is not a single medical facility I know who will start an induction and then just point blank stop it because it doesn't progress. At that point they come out by c section and I'm very much wondering what they did to try and induce, there is every possibility that the intervention led to further issues - infection etc.

With any statistics, someone has to be the 1 in 1,000 that does go wrong, but that's still 999 that don't. I'm pretty happy with those odds so I'll be declining induction until close to 43 weeks.

Induction rate in the UK is 25% at the moment and 70% of those are for 'post date', wow, that's a crazy number of babies outstaying their welcome.... When there are that many not proceeding naturally, I can't help but wonder if that's just another variation of normal?

If you are referring to the nurse i spoke with, she ended up with a c- section after he baby became distressed... The problem i have with the stats are they are showing still births, not when things go wrong. The nurse i spoke to deals on a daily basis with babies that she feels have been left too long who swallow meconium, become lodged and suffer lack of oxygen, suffer fractured skulls, broken arms ( from forceps) and have become distressed during birth. Loss of life before birth is not something she has to deal with working in neonatal.... In the past two years i have personal friends who have suffered losing their children, one after birth, he was born at 42 weeks and they didnt realise he was transverse, and another at 41 weeks who was stillborn, they said it was just "one of those things"

The reason they induce after a baby "overstays" is because its dangerous for mum and baby, the reason they don't induce when everyone turns 40 weeks is because most women will go into labour naturally ( and much cheaper may i add) before 41 weeks, that really doesn't change what the lady spoke to me about and her very serious concerns for the "laxidasicle" attitude she thought hospitals had....

 

[jtr2803]

This is one of those things where someone who experienced a problem will obviously advise everyone to not do what they did.

A very big HOWEVER to me here though is that she had a failed induction?! You can't just interfere like that and then go hands off without some serious medical oversight on a continuous basis. There is not a single medical facility I know who will start an induction and then just point blank stop it because it doesn't progress. At that point they come out by c section and I'm very much wondering what they did to try and induce, there is every possibility that the intervention led to further issues - infection etc.

With any statistics, someone has to be the 1 in 1,000 that does go wrong, but that's still 999 that don't. I'm pretty happy with those odds so I'll be declining induction until close to 43 weeks.

Induction rate in the UK is 25% at the moment and 70% of those are for 'post date', wow, that's a crazy number of babies outstaying their welcome.... When there are that many not proceeding naturally, I can't help but wonder if that's just another variation of normal?

If you are referring to the nurse i spoke with, she ended up with a c- section after he baby became distressed... The problem i have with the stats are they are showing still births, not when things go wrong. The nurse i spoke to deals on a daily basis with babies that she feels have been left too long who swallow meconium, become lodged and suffer lack of oxygen, suffer fractured skulls, broken arms ( from forceps) and have become distressed during birth. Loss of life before birth is not something she has to deal with working in neonatal.... In the past two years i have personal friends who have suffered losing their children, one after birth, he was born at 42 weeks and they didnt realise he was transverse, and another at 41 weeks who was stillborn, they said it was just "one of those things"

The reason they induce after a baby "overstays" is because its dangerous for mum and baby, the reason they don't induce when everyone turns 40 weeks is because most women will go into labour naturally ( and much cheaper may i add) before 41 weeks, that really doesn't change what the lady spoke to me about and her very serious concerns for the "laxidasicle" attitude she thought hospitals had....

I completely take your point on the fact that the statistics only look at still birth rates rather than other problems. In my experience, and from looking through other birth boards most hospitals are actually coercing ladies in to induction well before 42 weeks, so far, the people I know who are refusing induction have had to really fight their case. I am not sure where you live country/area wise?

Anyone who goes over their individual areas induction guidelines should be offered a least bi-weekly CTGs and also a weekly scan to confirm amniotic pool depth. Whilst things can go wrong at any time, these should help to assess a number of possible issues. I am very sorry for your friends who have experienced losses, it doesn't really matter at what gestation they happen, it's obviously devastating.

Babies in bad positions can happen at any time, my brother became transverse during labour at just over 40 weeks and had to be an EMCS. I on the other hand was breech at 37 weeks and no one realised and I was a natural delivery. I'm just saying that these things happen inside pregnancies that clearly do fit the 'norm' as it were. I don't think we could ever insinuate that those problems stem just from post date labours.

There is also a lot of evidence that many of the procedures and practices in operation today are not truly helpful. Babies can often become distressed during induction, I am sure there is evidence especially surrounding epidurals and the lead on to instrumental deliveries but I don't have anything to hand to link to. I just think our bodies are amazing, most of the time they know what they need to do and we are losing in touch with that as time goes on and birth becomes more medicalised and dare I say, regulated.

 

[Jessicahide]

This is one of those things where someone who experienced a problem will obviously advise everyone to not do what they did.

A very big HOWEVER to me here though is that she had a failed induction?! You can't just interfere like that and then go hands off without some serious medical oversight on a continuous basis. There is not a single medical facility I know who will start an induction and then just point blank stop it because it doesn't progress. At that point they come out by c section and I'm very much wondering what they did to try and induce, there is every possibility that the intervention led to further issues - infection etc.

With any statistics, someone has to be the 1 in 1,000 that does go wrong, but that's still 999 that don't. I'm pretty happy with those odds so I'll be declining induction until close to 43 weeks.

Induction rate in the UK is 25% at the moment and 70% of those are for 'post date', wow, that's a crazy number of babies outstaying their welcome.... When there are that many not proceeding naturally, I can't help but wonder if that's just another variation of normal?

If you are referring to the nurse i spoke with, she ended up with a c- section after he baby became distressed... The problem i have with the stats are they are showing still births, not when things go wrong. The nurse i spoke to deals on a daily basis with babies that she feels have been left too long who swallow meconium, become lodged and suffer lack of oxygen, suffer fractured skulls, broken arms ( from forceps) and have become distressed during birth. Loss of life before birth is not something she has to deal with working in neonatal.... In the past two years i have personal friends who have suffered losing their children, one after birth, he was born at 42 weeks and they didnt realise he was transverse, and another at 41 weeks who was stillborn, they said it was just "one of those things"

The reason they induce after a baby "overstays" is because its dangerous for mum and baby, the reason they don't induce when everyone turns 40 weeks is because most women will go into labour naturally ( and much cheaper may i add) before 41 weeks, that really doesn't change what the lady spoke to me about and her very serious concerns for the "laxidasicle" attitude she thought hospitals had....

I completely take your point on the fact that the statistics only look at still birth rates rather than other problems. In my experience, and from looking through other birth boards most hospitals are actually coercing ladies in to induction well before 42 weeks, so far, the people I know who are refusing induction have had to really fight their case. I am not sure where you live country/area wise?

Anyone who goes over their individual areas induction guidelines should be offered a least bi-weekly CTGs and also a weekly scan to confirm amniotic pool depth. Whilst things can go wrong at any time, these should help to assess a number of possible issues. I am very sorry for your friends who have experienced losses, it doesn't really matter at what gestation they happen, it's obviously devastating.

Babies in bad positions can happen at any time, my brother became transverse during labour at just over 40 weeks and had to be an EMCS. I on the other hand was breech at 37 weeks and no one realised and I was a natural delivery. I'm just saying that these things happen inside pregnancies that clearly do fit the 'norm' as it were. I don't think we could ever insinuate that those problems stem just from post date labours.

There is also a lot of evidence that many of the procedures and practices in operation today are not truly helpful. Babies can often become distressed during induction, I am sure there is evidence especially surrounding epidurals and the lead on to instrumental deliveries but I don't have anything to hand to link to. I just think our bodies are amazing, most of the time they know what they need to do and we are losing in touch with that as time goes on and birth becomes more medicalised and dare I say, regulated.

I 100% agree that we intervene too much and it causes problems, there is a massive increased risk when you have an epidural, we are far too medicalised when it comes to birth, none of those things override the need for induction. I live in bedford, i have had given birth in leeds, london and here... The maternity wards i have frequented have turned women away who are in labour, and refused to induce women who are booked in ( been this person myself!) so i am not sure what hospitals you are talking about... Induction is expensive and usually results in more drugs and intervention like you said... But they are a very very necessary thing... I have been induced 4 times now ( 5th will be this year) I have had very hair raising experiences and amazingly positive ones, but i can tell you after delivering a stillborn baby at 37 weeks i wouldn't be so blase about the risks to my baby by going overdue!

 

[jtr2803]

I don't think it's fair to say 'blasé about the risks', I choose to do a lot of research on these subjects and I consider it all when I make my choices. I think that's all we can do and it's ultimately personal choice, I just think anyone who needs to make that choice needs to be presented with ALL available evidence both for and against induction before they decide. Induction is always presented as part of pregnancy these days and most people don't even realise that they can decline or at least attempt to postpone.

My baby centre birth board is full of ladies being told they need to be induced, for a variety of reasons, but are then being left on wards for up to 5 days because they don't have the resources to carry out the process. That makes things worse in my eyes, these ladies are knackered and emotionally and mentally drained before they even have a contraction. If these post date inductions were so medically necessary should they be left that long? Not trying to debate that by the way, it's a musing. So yes, I agree that this is an issue but my point was that ladies are still being TOLD they need to be induced, my previous post was meaning that anyone who doesn't want to be induced is having to really fight the system.

I think we will agree to disagree on this subject we both have the right to do what we feel is best for us and that's something I am grateful for.

I would also like to say how sorry I am for your loss.

 

[maryanne1987]

It really does depend on what study you look at, as different studies quote different figures. Honestly I personally wouldnt refuse, as I wouldnt want to take any chances no matter how small. My son was so ill after being allowed to go the full two weeks over as my placenta wasn't working as it should anymore and he's been left disabled and will likely need care his whole life. But you must do what's best for you and your baby in your situation, as long as your happy that's all that matters. I did how ever refuse a 37 week induction last pregnancy as the only reason it was being performed was they were concerned she was large for dates but I have no faith in growth scans and wanted to wait till 38 weeks. Luckily I went into labour naturally the night before I was due to be induced.

Whoever said they don't start induction and then if it fails it ends in a section, well that's not entirely true. In our hospital procedure is pesery induction. If after three pesseries active labour isn't established you are then sent home for 48 hours only to have to return them for another attempt. If that fails then they will try other options such as breaking waters or a hormone drip all before resorting to a section. I know as I experienced it with my son. Took me to exactly 14 days overdue. Can't say it was a pleasant experience. I have to be induced this time and I'm not looking forward to it but due to multiple medical conditions its what's safest for baby. Although I'm nervous I know the end result will be totally worth it.

 

[jtr2803]

It really does depend on what study you look at, as different studies quite different figures. Honestly I personally wouldnt refuse, as I wouldnt want to take any chances no matter how small. My son was so ill after being allowed to go the full two weeks over as my placenta wasn't working as it should anymore and he's been left disabled and will likely need care his whole life. But you must do what's best for you and your baby in your situation, as long as your happy that's all that matters. I did how ever refuse a 37 week induction last pregnancy as the only reason it was being performed was they were concerned she was large for dates but I have no faith in growth scans and wanted to wait till 38 weeks. Luckily I went into labour naturally the night before I was due to be induced.

Whoever said they don't start induction and then if it fails it ends in a section, well that's not entirely true. In our hospital procedure is pesery induction. If after three pesseries active labour isn't established you are them sent home for 48 hours only to have to return them for another attempt. If that fails then they will try other options such as breaking waters or a hormone drip all before resorting to a section. I know as I experienced it with my son. Took me to exactly 14 days overdue. Can't say it was a pleasant experience. I have to be induced this time and I'm not looking forward to it but due to multiple medical conditions its what's safest for baby. Although I'm nervous I know the end result will be totally worth it.

Ive just gone back to evidence based birth and the three most recent modern medicine studies that were completed suggest a rate of 0.7 to 1.17 up to 42 weeks, so quite a minimal difference in actually numerical terms.

It was me who said about failed induction, probably yet another procedure that seems to vary wildly between areas then as here, induction is started at 41+10 and the process, once started, is followed right through. You can go home after the first process here to labour but if it doesn't work then it's active management until delivery.