Avoiding induction advice

[Anonymous]

All my children have come late, but my current practice wants to induce at 39 weeks as standard policy. I dont want to do that unless there's an actual mefical reason. If I refuse, can they fire me as a patient? Is there a more supportive provider I could switch to? I'm in Fairfax.

[Anonymous]

How old are you? They do this for advanced maternal age due to the placenta deteriorating. I would induce instead having the possibility of a stillborn.

[Anonymous]

Anonymous wrote:How old are you? They do this for advanced maternal age due to the placenta deteriorating. I would induce instead having the possibility of a stillborn.

31. That's not advanced maternal age.

[Anonymous]

Anonymous wrote:How old are you? They do this for advanced maternal age due to the placenta deteriorating. I would induce instead having the possibility of a stillborn.

+1. There is clear evidence if you look at the data. The downsides of waiting far eclipse any upside of avoiding induction.

[Anonymous]

OP I think they have a medical reason. It’s medical advice. You don’t have to “avoid” it, you can just say no. You’ll probably have to say it more than once if your pregnancy is one where the medical guidance clearly supports and induction. They’re going to want to make sure you’re fully informed.

I highly doubt they’d “fire” you and if they do, I’m sure it would be by referring you to someone else.

[Anonymous]

Do you have GD? I mean they don’t recommend induction at 39 weeks for every pregnancy in their office, right?

[Anonymous]

Anonymous wrote:Do you have GD? I mean they don’t recommend induction at 39 weeks for every pregnancy in their office, right?

No GD. I think it's for their convenience.

[Anonymous]

Anonymous wrote:How old are you? They do this for advanced maternal age due to the placenta deteriorating. I would induce instead having the possibility of a stillborn.

I thought it was based on the ARRIVE trial which was also for low risk first time moms. The UK study about older moms jsut compared rates of csection not rates of stillbirth, which is the actual concern with AMA moms from my understanding.

[Anonymous]

Anonymous wrote:How old are you? They do this for advanced maternal age due to the placenta deteriorating. I would induce instead having the possibility of a stillborn.

40 weeks is normal, op would only be 39 weeks so the placenta would not be old.

[Anonymous]

If they fire you for not inducing at 39 weeks, and you are healthy and do not want to induce, then they are not the right practice for you.

There is an over emphasis on early induction right now. The arrive trial demonstrated that women who induced at 39 weeks were a couple percentage points less likely to have their induction lead to a c section than those women who induced at 40 weeks. It is not a significant difference and these few points have been way over magnified, in my opinion, to demonstrate that it is better to induce at 39 weeks. It is also just one study.

There is so much evidence out there that for most women who are having a healthy pregnancy that waiting for baby and mom to go into labor naturally is the highest indicator for a successful vaginal delivery.

If intervention is needed for medical reasons then of course it should be considered, but it should be mindfully used and paced out. So often women are pushed to accept intervention too early and at too high a dosage. If the body is not ready to labor this can lead to labor stalling and if interventions have been exhausted it ups the chances that a c section is needed.

I am oversimplifying a bit here but if you really did in to evidence based info on induction usage in this country you will find that our medical system is overusing intervention.

Trust your intuition and work with a practice that you feel safe with and with solid evidence based track record.

[Anonymous]

OP I think you just need to thank them and say you don’t want the induction, and ask them if they want to continue or refer you to someone else. They probably know who would be good. Disagreements don’t have to be conflicts. It’s okay to just say no.

[Anonymous]

Anonymous wrote:If they fire you for not inducing at 39 weeks, and you are healthy and do not want to induce, then they are not the right practice for you.

There is an over emphasis on early induction right now. The arrive trial demonstrated that women who induced at 39 weeks were a couple percentage points less likely to have their induction lead to a c section than those women who induced at 40 weeks. It is not a significant difference and these few points have been way over magnified, in my opinion, to demonstrate that it is better to induce at 39 weeks. It is also just one study.

There is so much evidence out there that for most women who are having a healthy pregnancy that waiting for baby and mom to go into labor naturally is the highest indicator for a successful vaginal delivery.

If intervention is needed for medical reasons then of course it should be considered, but it should be mindfully used and paced out. So often women are pushed to accept intervention too early and at too high a dosage. If the body is not ready to labor this can lead to labor stalling and if interventions have been exhausted it ups the chances that a c section is needed.

I am oversimplifying a bit here but if you really did in to evidence based info on induction usage in this country you will find that our medical system is overusing intervention.

Trust your intuition and work with a practice that you feel safe with and with solid evidence based track record.

+1. This practice does not sound like they’re following evidence-based practices, if this is truly their standard policy for a low risk, non-AMA pregnancy.

There are plenty of practices out there where early induction wouldn’t even mention early induction unless there was a real medical reason.

[Anonymous]

Anonymous wrote:

Anonymous wrote:How old are you? They do this for advanced maternal age due to the placenta deteriorating. I would induce instead having the possibility of a stillborn.

31. That's not advanced maternal age.

That is nuts, and I do not understand why. I'm turning 38 soon, and also trying to avoid ALL INDUCTION TALK because my kiddos also come late...

[Anonymous]

This is a conversation to have with your medical provider. Ask WHY they are giving you this advice. If they can’t give you a good reason beyond, “this is what we do,” then say no thank you. End of story. If they give you a thorough reason, listen to it and think about it and make your decision.
You have a right to informed consent and can turn down medical procedures such as induction. A good provider will listen to you.

[Anonymous]

I would also say, use the same tactics if they worked with your previous births to get things moving. I swear by the Membrane Sweep, so perhaps you can try that during week 39 and hope you will go into labor on your own.