Induction at 39+4

[Anonymous]

I had a very experienced OBGYN feel my stomach at 39 weeks and say "wow I think this baby is big". She was 100% right, he was over 10lbs. She had me induced at 40w1d and when they announced how big he was my first thought was "thank God I got induced".

Induction with a cervix that is ready to go (soft and dilating) is much better than with a closed, hard cervix.

But ultimately, you have to decide what is right for you, with your doctor's advice. I tend to lean on the doctors who do this all day every day.

[Anonymous]

I meant time for him to come on his own. Yeah, it’s negligible and who knows if it’ll make a difference (40 wk vs 39 wk) but it can’t hurt if there are zero other issues?

[Anonymous]

Anonymous wrote:Hey! I am a 32 yo FTM scheduled for a 39 + 4 induction (this Thursday) for the *exact* same reasoning re head size (99%) and overall expected size (86%). I have had no issues throughout the pregnancy aside from this new information in our most recent (36 week onwards) ultrasounds and feel very pressured by my OB practice to deliver early (“he’s a take home baby!”). I went ahead and requested a reschedule for the induction for our due date next week. I am and have been doing all the induction tips and tricks (acu, tea, dates, sex!) and seeing if any of that helps get him coming - but from what I hear they come when they want to come - either way, given his estimated large size I am ready to induce next week, and if those extra few days between the originally scheduled date and the new date don’t help at all at the very least I’ll be glad I gave him some more time!

Good luck. They put a lot of pressure on everyone to induce since it is better for their schedules. Inductions go best if you are already effaced. If you aren’t, ask if they can bump it out a few days. They make it seem like a big deal but it’s ok to ask. Either way, your baby will be here soon - enjoy!

[Anonymous]

Thank you for this! The pressure is stressful.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hey! I am a 32 yo FTM scheduled for a 39 + 4 induction (this Thursday) for the *exact* same reasoning re head size (99%) and overall expected size (86%). I have had no issues throughout the pregnancy aside from this new information in our most recent (36 week onwards) ultrasounds and feel very pressured by my OB practice to deliver early (“he’s a take home baby!”). I went ahead and requested a reschedule for the induction for our due date next week. I am and have been doing all the induction tips and tricks (acu, tea, dates, sex!) and seeing if any of that helps get him coming - but from what I hear they come when they want to come - either way, given his estimated large size I am ready to induce next week, and if those extra few days between the originally scheduled date and the new date don’t help at all at the very least I’ll be glad I gave him some more time!

Good luck. They put a lot of pressure on everyone to induce since it is better for their schedules. Inductions go best if you are already effaced. If you aren’t, ask if they can bump it out a few days. They make it seem like a big deal but it’s ok to ask. Either way, your baby will be here soon - enjoy!

Then baby also bumps out a few more days!

[Anonymous]

Anonymous wrote:

Anonymous wrote:As a first time mom, I’m a little nervous about an induction given that it might be more painful or result in a C-section. But my OB suggested as an option because baby is measuring big (95%, and head size >99%) and also said evidence suggests it may prevent a C-section. I’m already 1 cm dilated as of 36 weeks with a “soft” cervix. Been eating dates and drinking raspberry leaf tea to see if I can go into labor naturally before my induction date. Also considering a membrane sweep at 39 weeks to further things along. Any thoughts or recommendations on this plan..?

Highly suggest the membrane sweep…I did this (and a few times) even during labor when things were slow moving from 4cm- 5cm for example. I would even get the sweep before 39weeks.

They will not do the sweep before 39 weeks in my experience and it can take 24-48 hours to work so may not be doable logistically or help but def explore this option.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As a first time mom, I’m a little nervous about an induction given that it might be more painful or result in a C-section. But my OB suggested as an option because baby is measuring big (95%, and head size >99%) and also said evidence suggests it may prevent a C-section. I’m already 1 cm dilated as of 36 weeks with a “soft” cervix. Been eating dates and drinking raspberry leaf tea to see if I can go into labor naturally before my induction date. Also considering a membrane sweep at 39 weeks to further things along. Any thoughts or recommendations on this plan..?

Highly suggest the membrane sweep…I did this (and a few times) even during labor when things were slow moving from 4cm- 5cm for example. I would even get the sweep before 39weeks.

They will not do the sweep before 39 weeks in my experience and it can take 24-48 hours to work so may not be doable logistically or help but def explore this option.

For my first I had the sweep earlier at maybe 38 weeks and some days but it didn’t do much. I’m sure the doc was “light” with it because it barely hurt. Then I did another closer to 40 weeks and it helped and did the trick. Delivered 40 weeks and 2 days. For my 2nd, I had Group B strep so I was hesitant to do it early so waited until week 40 which it didn’t do much until week 41 and then the doctor really went in there and it hurt! I went in at 41 weeks and a day…and even during labor I had the nurse perform another sweep. My original L&D nurse did not know how to do it right since the baby was lower than my cervix at that point. I was maybe 5cm or 6cm so she called another nurse. An angel I call her - amazing and experienced. She went in there, seamless, and it was not even painful. She sweeped and things started to move very fast after that! I swear by the sweeps now and think they are super effective at moving things along - and to avoid an induction.

I do think some doctors are weird about it - one practice I remember said it was their “policy” not to sweep unless you’re close to delivery time which was bizarre because my current practice has different protocols. I do feel like docs lean towards inductions as a means to have things scheduled and to each their own for all mamas choosing this route. There is no wrong way of doing things & we’re ultimately at the mercy of the docs anyways.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As a first time mom, I’m a little nervous about an induction given that it might be more painful or result in a C-section. But my OB suggested as an option because baby is measuring big (95%, and head size >99%) and also said evidence suggests it may prevent a C-section. I’m already 1 cm dilated as of 36 weeks with a “soft” cervix. Been eating dates and drinking raspberry leaf tea to see if I can go into labor naturally before my induction date. Also considering a membrane sweep at 39 weeks to further things along. Any thoughts or recommendations on this plan..?

Highly suggest the membrane sweep…I did this (and a few times) even during labor when things were slow moving from 4cm- 5cm for example. I would even get the sweep before 39weeks.

They will not do the sweep before 39 weeks in my experience and it can take 24-48 hours to work so may not be doable logistically or help but def explore this option.

For my first I had the sweep earlier at maybe 38 weeks and some days but it didn’t do much. I’m sure the doc was “light” with it because it barely hurt. Then I did another closer to 40 weeks and it helped and did the trick. Delivered 40 weeks and 2 days. For my 2nd, I had Group B strep so I was hesitant to do it early so waited until week 40 which it didn’t do much until week 41 and then the doctor really went in there and it hurt! I went in at 41 weeks and a day…and even during labor I had the nurse perform another sweep. My original L&D nurse did not know how to do it right since the baby was lower than my cervix at that point. I was maybe 5cm or 6cm so she called another nurse. An angel I call her - amazing and experienced. She went in there, seamless, and it was not even painful. She sweeped and things started to move very fast after that! I swear by the sweeps now and think they are super effective at moving things along - and to avoid an induction.

I do think some doctors are weird about it - one practice I remember said it was their “policy” not to sweep unless you’re close to delivery time which was bizarre because my current practice has different protocols. I do feel like docs lean towards inductions as a means to have things scheduled and to each their own for all mamas choosing this route. There is no wrong way of doing things & we’re ultimately at the mercy of the docs anyways.

Yes, I think the OBs feel very justified in pushing inductions because overall the health outcomes are the same at a population level. But I have seen enough friends have 2 day labors now going with the scheduled induction because they were not dilated/effaced whatsoever and I don’t think people always understand that the OBs don’t really factor the labor experience into their recommendation. And to be fair, many moms don’t care either. In retrospect my advice is not to do one vs the other but my advice would be 1) ask lots of questions about why they are recommending it and 2) ask “What’s the longest you think I can go before induction, if I want to delay it as much as humanly possible?” Get multiple OBs to give you their opinion if you are in a rotating practice.

obviously if there are complications/risks factors the case for induction makes more and more sense. But I still think it makes sense to ask the providers their reasoning. I had a complication in my second pregnancy and the first OB wanted to deliver at 34 weeks! The next I asked said 36 or 37. So I saw MFM and they recommended waiting til 38-39 weeks and I was really surprised but it makes more sense now that the OBs get more nervous with risk factors than the MFM who is more experienced and can give more informed judgment.

[Anonymous]

Sounds like a reasonable plan, OP. A lot of folks swear by the sweep, but keep in mind there’s a small risk that it will break your water but labor won’t start (so you’ll end up with a full induction anyway). Ask your OB about this. Personally I declined the 39 week sweep with my second as I was GBS positive. My practice would have done it, but I didn’t want to risk infection.

Your doctor is right about decreased c-section rates with induction (read about the ARRIVE trial), but a lot of this depends on how your practice operates and their (and your) patience for how long it can take. Especially for a first-time mom.

As fast as big babies, anecdotally I have seen OB and ultrasound predictions turn out pretty accurate for some and wildly off for others (as in the baby was not big).

Good luck!!

[Anonymous]

I had horrific inductions with my ginormous-headed babies but their horrificness didn't have to do with the induction itself, or with the baby's head size. Both were ultimately born vaginally with normal-shaped (but big) heads (both 99%). Having a patient practice is key; I'd recommend getting that cervix better prepped lazily first with some kind of cervical ripener.

[Anonymous]

Anonymous wrote:I had horrific inductions with my ginormous-headed babies but their horrificness didn't have to do with the induction itself, or with the baby's head size. Both were ultimately born vaginally with normal-shaped (but big) heads (both 99%). Having a patient practice is key; I'd recommend getting that cervix better prepped lazily first with some kind of cervical ripener.

They won't give the ripener after your first pregnancy, that I do not understand.

[Anonymous]

Anonymous wrote:Sounds like a reasonable plan, OP. A lot of folks swear by the sweep, but keep in mind there’s a small risk that it will break your water but labor won’t start (so you’ll end up with a full induction anyway). Ask your OB about this. Personally I declined the 39 week sweep with my second as I was GBS positive. My practice would have done it, but I didn’t want to risk infection.

Your doctor is right about decreased c-section rates with induction (read about the ARRIVE trial), but a lot of this depends on how your practice operates and their (and your) patience for how long it can take. Especially for a first-time mom.

As fast as big babies, anecdotally I have seen OB and ultrasound predictions turn out pretty accurate for some and wildly off for others (as in the baby was not big).

Good luck!!

This is true, but both my sweeps did not lead to any water breaking - it's literally one of their fingers opening the cervix, they definitely do not go that far up that would hurt a lot. Both my waters broke literally at the end of laboring, once at 8cm and once at 9.5cm when the doc finally convinced me to break my waters after laboring for hours, no epidural, she broke my water herself - so none of the sweeps actually effected the water breaking. You're right to ask a bunch of questions, and do what is comfortable for you, but I think it's very effective and wish doctors would push this more than just an induction...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As a first time mom, I’m a little nervous about an induction given that it might be more painful or result in a C-section. But my OB suggested as an option because baby is measuring big (95%, and head size >99%) and also said evidence suggests it may prevent a C-section. I’m already 1 cm dilated as of 36 weeks with a “soft” cervix. Been eating dates and drinking raspberry leaf tea to see if I can go into labor naturally before my induction date. Also considering a membrane sweep at 39 weeks to further things along. Any thoughts or recommendations on this plan..?

Highly suggest the membrane sweep…I did this (and a few times) even during labor when things were slow moving from 4cm- 5cm for example. I would even get the sweep before 39weeks.

They will not do the sweep before 39 weeks in my experience and it can take 24-48 hours to work so may not be doable logistically or help but def explore this option.

For my first I had the sweep earlier at maybe 38 weeks and some days but it didn’t do much. I’m sure the doc was “light” with it because it barely hurt. Then I did another closer to 40 weeks and it helped and did the trick. Delivered 40 weeks and 2 days. For my 2nd, I had Group B strep so I was hesitant to do it early so waited until week 40 which it didn’t do much until week 41 and then the doctor really went in there and it hurt! I went in at 41 weeks and a day…and even during labor I had the nurse perform another sweep. My original L&D nurse did not know how to do it right since the baby was lower than my cervix at that point. I was maybe 5cm or 6cm so she called another nurse. An angel I call her - amazing and experienced. She went in there, seamless, and it was not even painful. She sweeped and things started to move very fast after that! I swear by the sweeps now and think they are super effective at moving things along - and to avoid an induction.

I do think some doctors are weird about it - one practice I remember said it was their “policy” not to sweep unless you’re close to delivery time which was bizarre because my current practice has different protocols. I do feel like docs lean towards inductions as a means to have things scheduled and to each their own for all mamas choosing this route. There is no wrong way of doing things & we’re ultimately at the mercy of the docs anyways.

Yes, I think the OBs feel very justified in pushing inductions because overall the health outcomes are the same at a population level. But I have seen enough friends have 2 day labors now going with the scheduled induction because they were not dilated/effaced whatsoever and I don’t think people always understand that the OBs don’t really factor the labor experience into their recommendation. And to be fair, many moms don’t care either. In retrospect my advice is not to do one vs the other but my advice would be 1) ask lots of questions about why they are recommending it and 2) ask “What’s the longest you think I can go before induction, if I want to delay it as much as humanly possible?” Get multiple OBs to give you their opinion if you are in a rotating practice.

obviously if there are complications/risks factors the case for induction makes more and more sense. But I still think it makes sense to ask the providers their reasoning. I had a complication in my second pregnancy and the first OB wanted to deliver at 34 weeks! The next I asked said 36 or 37. So I saw MFM and they recommended waiting til 38-39 weeks and I was really surprised but it makes more sense now that the OBs get more nervous with risk factors than the MFM who is more experienced and can give more informed judgment.

Really awesome of you seeking out different opinions - many practices won't even see you, let alone let you speak to another OB once you're far along - so it's great to hear that they were willing to speak to you - and it's really nice to know there are reasonable and less risk-averse docs like the MFM who let you wait a bit longer...34 vs. 39 weeks makes a big difference!

[Anonymous]

I wish I had induced with my first but my midwives got me to drink the Koolaid and had me firmly believing I needed to go into labor naturally. I delivered an 8.5 pounder at 41 weeks after that labor started naturally. Had a horrific labor and that baby was so big for my petite body that she had to be ripped out with a vacuum, despite all my Spinning babies, yoga, acupuncture, dates, and raspberry leaf tea. Ha. My pelvic floor and vagina will never be the same. I also got preeclampsia and my placenta was deteriorating. Worst experience of my life. Went with a scheduled C at 39 weeks for my next one and became a complete convert and believer that for a lot of women who are older and not planning big families that a scheduled C section is much better way to give birth. Trust your doctors, Op. The doctors don’t schedule inductions for their convenience. They will see you during their L and D shift or not regardless. Their schedules don’t change - they have their L and D days, and their office days. It’s not some big conspiracy to rob you of mother natures most wonderful experience. Once you feel real contractions you realize real quick that Mother Nature is an absolute biotch.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had horrific inductions with my ginormous-headed babies but their horrificness didn't have to do with the induction itself, or with the baby's head size. Both were ultimately born vaginally with normal-shaped (but big) heads (both 99%). Having a patient practice is key; I'd recommend getting that cervix better prepped lazily first with some kind of cervical ripener.

They won't give the ripener after your first pregnancy, that I do not understand.

PP, and They gave me cervical ripening for both my first and second labors. So... not sure what you mean. Is this specific to your doctors?