When to schedule induction?

[Anonymous]

If they are making it optional, as in asking you not telling you, the early induction is not necessary and is for their convenience, not your health or your baby's health. I would try to go for a natural arrival, let baby come when baby is ready, and schedule induction as late as they will possibly let you.

[Anonymous]

I think you need to get the platelet count to make a better decision. I've had 3 children and issues with my platelets for all three so I've become a bit of an expert. The diagnosis I have is pregnancy induced thrombocytopenia and here's how my labor and deliveries went:

- 1st baby @ age 32 - platelets dropped to 35 and I was not given an epidural. The options were C-section or vaginal delivery only. I chose un-mediated vaginal and had no problems but the full medical team was standing by in case I had bleeding issues; no complications with either me or the baby; treatment protocol prior to delivery was steroids starting at week 36; delivered at 40 weeks +2 days

- 2nd baby @ age 33 - platelets dropped to around 80 and I was approved for the epidural but baby came before the anesthesiologist could make it to my floor so I had an un-medicated vaginal; no complications with baby or I; i don't remember the treatment protocol but i don't think we did steroids this time; delivered at 38 weeks

- 3rd baby @ age 39 - platelets dropped to 90 and I was able to get an epidural so I had a medicated vaginal delivery; no complications for ether of us; the treatment protocol was baby aspirin starting (I think) at 12 weeks and up until week 38 - I didn't have to do steroids this go around; delivered at 39 weeks

All of these births were at a military hospital and for each I was treated as a high risk pregnancy with weekly platelet checks starting at 34 weeks. They never pushed me to have a c-section but always told me that if I did - it would be under complete, general anesthesia because the risk for bleeding would be so high. I was not induced for any of my deliveries either - the babies just came when they were ready

I'm age 40 now and pregnant with my last, I'm currently 34 weeks and my platelets are at 78 so we are discussing the protocol now. I have been on baby aspirin since 12 weeks the doctor mentioned some new fusion they could do instead of steroids - i'll try to remember to update this thread after my appoint next week with the details. I also take iron supplements throughout my pregnancies but I have always been slightly anemic.

From my perspective, the things you need to question are:
1. what are you platelet counts?
2. what are the c-section options available to you?
3. what kind of treatment can they offer before delivery to help stabilize your platelet? steroids or something else?
4. What kind of treatment can they offer before delivery to help the baby's lungs develop faster?
5. how will they monitor you after delivery?
6. what are the implications for future pregnancies?

[Anonymous]

Anonymous wrote:I think you need to get the platelet count to make a better decision. I've had 3 children and issues with my platelets for all three so I've become a bit of an expert. The diagnosis I have is pregnancy induced thrombocytopenia and here's how my labor and deliveries went:

- 1st baby @ age 32 - platelets dropped to 35 and I was not given an epidural. The options were C-section or vaginal delivery only. I chose un-mediated vaginal and had no problems but the full medical team was standing by in case I had bleeding issues; no complications with either me or the baby; treatment protocol prior to delivery was steroids starting at week 36; delivered at 40 weeks +2 days

- 2nd baby @ age 33 - platelets dropped to around 80 and I was approved for the epidural but baby came before the anesthesiologist could make it to my floor so I had an un-medicated vaginal; no complications with baby or I; i don't remember the treatment protocol but i don't think we did steroids this time; delivered at 38 weeks

- 3rd baby @ age 39 - platelets dropped to 90 and I was able to get an epidural so I had a medicated vaginal delivery; no complications for ether of us; the treatment protocol was baby aspirin starting (I think) at 12 weeks and up until week 38 - I didn't have to do steroids this go around; delivered at 39 weeks

All of these births were at a military hospital and for each I was treated as a high risk pregnancy with weekly platelet checks starting at 34 weeks. They never pushed me to have a c-section but always told me that if I did - it would be under complete, general anesthesia because the risk for bleeding would be so high. I was not induced for any of my deliveries either - the babies just came when they were ready

I'm age 40 now and pregnant with my last, I'm currently 34 weeks and my platelets are at 78 so we are discussing the protocol now. I have been on baby aspirin since 12 weeks the doctor mentioned some new fusion they could do instead of steroids - i'll try to remember to update this thread after my appoint next week with the details. I also take iron supplements throughout my pregnancies but I have always been slightly anemic.

From my perspective, the things you need to question are:
1. what are you platelet counts?
2. what are the c-section options available to you?
3. what kind of treatment can they offer before delivery to help stabilize your platelet? steroids or something else?
4. What kind of treatment can they offer before delivery to help the baby's lungs develop faster?
5. how will they monitor you after delivery?
6. what are the implications for future pregnancies?

This is OP. Thanks- this is really helpful! So my count as of yesterday was 128. It was 135 on August 3 so it is dropping, but not precipitously. My OB scheduled me for an induction on my due date, which is next Saturday. I go back to the OB on Wednesday for another check up, at which point I'll get another platelet test and they'll check my cervix (as of yesterday, no dilation, some effacement, and baby is low). They have told me that at my hospital, anesthesiologists will not do an epidural if platelets are 100 or lower, though this could vary down to 90 depending on the doctor. The c-section option, if it becomes necessary, would be general anesthesia if my count does drop to that point by the time I'm in labor and a c becomes necessary. They have not mentioned any treatment to stabilize my platelets before delivery- I asked and was told there isn't anything you can do for this. With respect to the fourth question, I don't think the baby's lung development is an issue.

The question is whether my count will sharply drop off between now and next week and if not, whether I can push the induction to sometime between week 40 and 41 to give my body more time to go into labor spontaneously. Did your counts drop precipitously? I'm wondering if my count is still in the 120s on Wednesday/Thursday whether I can safely push induction to middle or end of the week of 8/31. They recommend not going past week 41 because of my age so the latest I'd be induced if it doesn't happen naturally would be September 5. My biggest concern is the risk of needing an emergency c and having to go under. It's impossible to control for how likely it is I'll need a c, but that is the main thing I am trying to avoid. Not having the option to have an epidural during labor would suck but it's the unknown c section scenario I'm most concerned with avoiding.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think you need to get the platelet count to make a better decision. I've had 3 children and issues with my platelets for all three so I've become a bit of an expert. The diagnosis I have is pregnancy induced thrombocytopenia and here's how my labor and deliveries went:

- 1st baby @ age 32 - platelets dropped to 35 and I was not given an epidural. The options were C-section or vaginal delivery only. I chose un-mediated vaginal and had no problems but the full medical team was standing by in case I had bleeding issues; no complications with either me or the baby; treatment protocol prior to delivery was steroids starting at week 36; delivered at 40 weeks +2 days

- 2nd baby @ age 33 - platelets dropped to around 80 and I was approved for the epidural but baby came before the anesthesiologist could make it to my floor so I had an un-medicated vaginal; no complications with baby or I; i don't remember the treatment protocol but i don't think we did steroids this time; delivered at 38 weeks

- 3rd baby @ age 39 - platelets dropped to 90 and I was able to get an epidural so I had a medicated vaginal delivery; no complications for ether of us; the treatment protocol was baby aspirin starting (I think) at 12 weeks and up until week 38 - I didn't have to do steroids this go around; delivered at 39 weeks

All of these births were at a military hospital and for each I was treated as a high risk pregnancy with weekly platelet checks starting at 34 weeks. They never pushed me to have a c-section but always told me that if I did - it would be under complete, general anesthesia because the risk for bleeding would be so high. I was not induced for any of my deliveries either - the babies just came when they were ready

I'm age 40 now and pregnant with my last, I'm currently 34 weeks and my platelets are at 78 so we are discussing the protocol now. I have been on baby aspirin since 12 weeks the doctor mentioned some new fusion they could do instead of steroids - i'll try to remember to update this thread after my appoint next week with the details. I also take iron supplements throughout my pregnancies but I have always been slightly anemic.

From my perspective, the things you need to question are:
1. what are you platelet counts?
2. what are the c-section options available to you?
3. what kind of treatment can they offer before delivery to help stabilize your platelet? steroids or something else?
4. What kind of treatment can they offer before delivery to help the baby's lungs develop faster?
5. how will they monitor you after delivery?
6. what are the implications for future pregnancies?

This is OP. Thanks- this is really helpful! So my count as of yesterday was 128. It was 135 on August 3 so it is dropping, but not precipitously. My OB scheduled me for an induction on my due date, which is next Saturday. I go back to the OB on Wednesday for another check up, at which point I'll get another platelet test and they'll check my cervix (as of yesterday, no dilation, some effacement, and baby is low). They have told me that at my hospital, anesthesiologists will not do an epidural if platelets are 100 or lower, though this could vary down to 90 depending on the doctor. The c-section option, if it becomes necessary, would be general anesthesia if my count does drop to that point by the time I'm in labor and a c becomes necessary. They have not mentioned any treatment to stabilize my platelets before delivery- I asked and was told there isn't anything you can do for this. With respect to the fourth question, I don't think the baby's lung development is an issue.

The question is whether my count will sharply drop off between now and next week and if not, whether I can push the induction to sometime between week 40 and 41 to give my body more time to go into labor spontaneously. Did your counts drop precipitously? I'm wondering if my count is still in the 120s on Wednesday/Thursday whether I can safely push induction to middle or end of the week of 8/31. They recommend not going past week 41 because of my age so the latest I'd be induced if it doesn't happen naturally would be September 5. My biggest concern is the risk of needing an emergency c and having to go under. It's impossible to control for how likely it is I'll need a c, but that is the main thing I am trying to avoid. Not having the option to have an epidural during labor would suck but it's the unknown c section scenario I'm most concerned with avoiding.

PP here and happy to help. My platelets do drop quite a bit and somewhat rapidly. I was at 118 at my last check four weeks ago and now I'm at 78 but...again this is par for the course with me. Mine have also dropped considerably low in the past but I have never had high blood pressure, swelling, or any other complications. With me it's simply the platelets and nothing else. The doctors should be looking at all of that as well.

As I mentioned I'm only 34 weeks now so I still have some time to go and my counts will continue to decrease, you're at the very end and your count is great compared to mine so in all likelihood you will probably get the epidural and a vaginal birth if that's what you want. I've never broken a bone or even had stitches so I get anxiety just thinking about anesthesia and surgery. I totally get the concern about the c-section and how anesthesia impacts you and the baby like someone up-thread mentioned.

I think the best you can do is ask all the questions you can and arm yourself with information so you are comfortable with the decision. No need to be shy or hesitant to ask your doctors any questions you want - it's your baby, your life. I was also offered one-on-one discussions with the anesthesiologist so if they haven't offered that to you - I would say definitely push for a consultation as the anesthesiologist can sometimes differ from the doctor and they are the experts when it comes to it. I remember them saying that (with my first) my count was so low, there was a concern with spinal bleeding for an epidural so if I needed a c-section I would be out completely which is something I didn't fully grasp until that one-on-one conversation.

My next appointment is Wednesday so I'll bookmark this thread and update you with what I've learned about treatment. If you have any questions you would like answered, feel free to let me know and I can ask my doctors too. I'm happy to post here or you can reach me at housemail40@yahoo that's just our family junk email account but I'm glad to help in anyway.

[Anonymous]

I have never heard of testing platelet count. I had twins at 38 years old. I went full term and I don’t recall anyone testing my blood besides the 12 week blood draw and GD screen. I did get stress tests starting at 37 weeks.
I’m pregnant again at 42. Due in a month. Should my OB be checking my platelets?

[Anonymous]

Anonymous wrote:I have never heard of testing platelet count. I had twins at 38 years old. I went full term and I don’t recall anyone testing my blood besides the 12 week blood draw and GD screen. I did get stress tests starting at 37 weeks.
I’m pregnant again at 42. Due in a month. Should my OB be checking my platelets?

It's part of the routine blood tests that they take. I think the volume of blood in your body increases so ideally the numbers go up, if they go down then they screen you further. Couldn't hurt to ask your doctor but you're probably fine if they haven't mentioned it, they likely didn't find anything wrong in your normal tests.

[Anonymous]

OP here. To previous poster- they’ve checked my blood a few times throughout the course of my pregnancy- once at the beginning, including what I understand to be standard screenings for STDs, etc. Then again I think at 36 weeks just a complete blood count and now following up on the platelet issue. I’d imagine some periodic bloodwork should be standard practice in pregnancy to just make sure nothing’s wonky.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think you need to get the platelet count to make a better decision. I've had 3 children and issues with my platelets for all three so I've become a bit of an expert. The diagnosis I have is pregnancy induced thrombocytopenia and here's how my labor and deliveries went:

- 1st baby @ age 32 - platelets dropped to 35 and I was not given an epidural. The options were C-section or vaginal delivery only. I chose un-mediated vaginal and had no problems but the full medical team was standing by in case I had bleeding issues; no complications with either me or the baby; treatment protocol prior to delivery was steroids starting at week 36; delivered at 40 weeks +2 days

- 2nd baby @ age 33 - platelets dropped to around 80 and I was approved for the epidural but baby came before the anesthesiologist could make it to my floor so I had an un-medicated vaginal; no complications with baby or I; i don't remember the treatment protocol but i don't think we did steroids this time; delivered at 38 weeks

- 3rd baby @ age 39 - platelets dropped to 90 and I was able to get an epidural so I had a medicated vaginal delivery; no complications for ether of us; the treatment protocol was baby aspirin starting (I think) at 12 weeks and up until week 38 - I didn't have to do steroids this go around; delivered at 39 weeks

All of these births were at a military hospital and for each I was treated as a high risk pregnancy with weekly platelet checks starting at 34 weeks. They never pushed me to have a c-section but always told me that if I did - it would be under complete, general anesthesia because the risk for bleeding would be so high. I was not induced for any of my deliveries either - the babies just came when they were ready

I'm age 40 now and pregnant with my last, I'm currently 34 weeks and my platelets are at 78 so we are discussing the protocol now. I have been on baby aspirin since 12 weeks the doctor mentioned some new fusion they could do instead of steroids - i'll try to remember to update this thread after my appoint next week with the details. I also take iron supplements throughout my pregnancies but I have always been slightly anemic.

From my perspective, the things you need to question are:
1. what are you platelet counts?
2. what are the c-section options available to you?
3. what kind of treatment can they offer before delivery to help stabilize your platelet? steroids or something else?
4. What kind of treatment can they offer before delivery to help the baby's lungs develop faster?
5. how will they monitor you after delivery?
6. what are the implications for future pregnancies?

This is OP. Thanks- this is really helpful! So my count as of yesterday was 128. It was 135 on August 3 so it is dropping, but not precipitously. My OB scheduled me for an induction on my due date, which is next Saturday. I go back to the OB on Wednesday for another check up, at which point I'll get another platelet test and they'll check my cervix (as of yesterday, no dilation, some effacement, and baby is low). They have told me that at my hospital, anesthesiologists will not do an epidural if platelets are 100 or lower, though this could vary down to 90 depending on the doctor. The c-section option, if it becomes necessary, would be general anesthesia if my count does drop to that point by the time I'm in labor and a c becomes necessary. They have not mentioned any treatment to stabilize my platelets before delivery- I asked and was told there isn't anything you can do for this. With respect to the fourth question, I don't think the baby's lung development is an issue.

The question is whether my count will sharply drop off between now and next week and if not, whether I can push the induction to sometime between week 40 and 41 to give my body more time to go into labor spontaneously. Did your counts drop precipitously? I'm wondering if my count is still in the 120s on Wednesday/Thursday whether I can safely push induction to middle or end of the week of 8/31. They recommend not going past week 41 because of my age so the latest I'd be induced if it doesn't happen naturally would be September 5. My biggest concern is the risk of needing an emergency c and having to go under. It's impossible to control for how likely it is I'll need a c, but that is the main thing I am trying to avoid. Not having the option to have an epidural during labor would suck but it's the unknown c section scenario I'm most concerned with avoiding.

PP here and happy to help. My platelets do drop quite a bit and somewhat rapidly. I was at 118 at my last check four weeks ago and now I'm at 78 but...again this is par for the course with me. Mine have also dropped considerably low in the past but I have never had high blood pressure, swelling, or any other complications. With me it's simply the platelets and nothing else. The doctors should be looking at all of that as well.

As I mentioned I'm only 34 weeks now so I still have some time to go and my counts will continue to decrease, you're at the very end and your count is great compared to mine so in all likelihood you will probably get the epidural and a vaginal birth if that's what you want. I've never broken a bone or even had stitches so I get anxiety just thinking about anesthesia and surgery. I totally get the concern about the c-section and how anesthesia impacts you and the baby like someone up-thread mentioned.

I think the best you can do is ask all the questions you can and arm yourself with information so you are comfortable with the decision. No need to be shy or hesitant to ask your doctors any questions you want - it's your baby, your life. I was also offered one-on-one discussions with the anesthesiologist so if they haven't offered that to you - I would say definitely push for a consultation as the anesthesiologist can sometimes differ from the doctor and they are the experts when it comes to it. I remember them saying that (with my first) my count was so low, there was a concern with spinal bleeding for an epidural so if I needed a c-section I would be out completely which is something I didn't fully grasp until that one-on-one conversation.

My next appointment is Wednesday so I'll bookmark this thread and update you with what I've learned about treatment. If you have any questions you would like answered, feel free to let me know and I can ask my doctors too. I'm happy to post here or you can reach me at housemail40@yahoo that's just our family junk email account but I'm glad to help in anyway.

OP again- thank you! I’ll also be at the dr Wednesday and will ask about checking with an anasthesiologist. Then hopefully I’ll have updated counts on Thursday morning and see what makes sense. I’d really rather not be induced so maybe if the count is still above 115 then I can push the date at least a few days to give myself more time.

[Anonymous]

Anonymous wrote:I have never heard of testing platelet count. I had twins at 38 years old. I went full term and I don’t recall anyone testing my blood besides the 12 week blood draw and GD screen. I did get stress tests starting at 37 weeks.
I’m pregnant again at 42. Due in a month. Should my OB be checking my platelets?

They also run a CBC panel that includes it when you are admitted to the hospital.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think you need to get the platelet count to make a better decision. I've had 3 children and issues with my platelets for all three so I've become a bit of an expert. The diagnosis I have is pregnancy induced thrombocytopenia and here's how my labor and deliveries went:

- 1st baby @ age 32 - platelets dropped to 35 and I was not given an epidural. The options were C-section or vaginal delivery only. I chose un-mediated vaginal and had no problems but the full medical team was standing by in case I had bleeding issues; no complications with either me or the baby; treatment protocol prior to delivery was steroids starting at week 36; delivered at 40 weeks +2 days

- 2nd baby @ age 33 - platelets dropped to around 80 and I was approved for the epidural but baby came before the anesthesiologist could make it to my floor so I had an un-medicated vaginal; no complications with baby or I; i don't remember the treatment protocol but i don't think we did steroids this time; delivered at 38 weeks

- 3rd baby @ age 39 - platelets dropped to 90 and I was able to get an epidural so I had a medicated vaginal delivery; no complications for ether of us; the treatment protocol was baby aspirin starting (I think) at 12 weeks and up until week 38 - I didn't have to do steroids this go around; delivered at 39 weeks

All of these births were at a military hospital and for each I was treated as a high risk pregnancy with weekly platelet checks starting at 34 weeks. They never pushed me to have a c-section but always told me that if I did - it would be under complete, general anesthesia because the risk for bleeding would be so high. I was not induced for any of my deliveries either - the babies just came when they were ready

I'm age 40 now and pregnant with my last, I'm currently 34 weeks and my platelets are at 78 so we are discussing the protocol now. I have been on baby aspirin since 12 weeks the doctor mentioned some new fusion they could do instead of steroids - i'll try to remember to update this thread after my appoint next week with the details. I also take iron supplements throughout my pregnancies but I have always been slightly anemic.

From my perspective, the things you need to question are:
1. what are you platelet counts?
2. what are the c-section options available to you?
3. what kind of treatment can they offer before delivery to help stabilize your platelet? steroids or something else?
4. What kind of treatment can they offer before delivery to help the baby's lungs develop faster?
5. how will they monitor you after delivery?
6. what are the implications for future pregnancies?

This is OP. Thanks- this is really helpful! So my count as of yesterday was 128. It was 135 on August 3 so it is dropping, but not precipitously. My OB scheduled me for an induction on my due date, which is next Saturday. I go back to the OB on Wednesday for another check up, at which point I'll get another platelet test and they'll check my cervix (as of yesterday, no dilation, some effacement, and baby is low). They have told me that at my hospital, anesthesiologists will not do an epidural if platelets are 100 or lower, though this could vary down to 90 depending on the doctor. The c-section option, if it becomes necessary, would be general anesthesia if my count does drop to that point by the time I'm in labor and a c becomes necessary. They have not mentioned any treatment to stabilize my platelets before delivery- I asked and was told there isn't anything you can do for this. With respect to the fourth question, I don't think the baby's lung development is an issue.

The question is whether my count will sharply drop off between now and next week and if not, whether I can push the induction to sometime between week 40 and 41 to give my body more time to go into labor spontaneously. Did your counts drop precipitously? I'm wondering if my count is still in the 120s on Wednesday/Thursday whether I can safely push induction to middle or end of the week of 8/31. They recommend not going past week 41 because of my age so the latest I'd be induced if it doesn't happen naturally would be September 5. My biggest concern is the risk of needing an emergency c and having to go under. It's impossible to control for how likely it is I'll need a c, but that is the main thing I am trying to avoid. Not having the option to have an epidural during labor would suck but it's the unknown c section scenario I'm most concerned with avoiding.

PP here and happy to help. My platelets do drop quite a bit and somewhat rapidly. I was at 118 at my last check four weeks ago and now I'm at 78 but...again this is par for the course with me. Mine have also dropped considerably low in the past but I have never had high blood pressure, swelling, or any other complications. With me it's simply the platelets and nothing else. The doctors should be looking at all of that as well.

As I mentioned I'm only 34 weeks now so I still have some time to go and my counts will continue to decrease, you're at the very end and your count is great compared to mine so in all likelihood you will probably get the epidural and a vaginal birth if that's what you want. I've never broken a bone or even had stitches so I get anxiety just thinking about anesthesia and surgery. I totally get the concern about the c-section and how anesthesia impacts you and the baby like someone up-thread mentioned.

I think the best you can do is ask all the questions you can and arm yourself with information so you are comfortable with the decision. No need to be shy or hesitant to ask your doctors any questions you want - it's your baby, your life. I was also offered one-on-one discussions with the anesthesiologist so if they haven't offered that to you - I would say definitely push for a consultation as the anesthesiologist can sometimes differ from the doctor and they are the experts when it comes to it. I remember them saying that (with my first) my count was so low, there was a concern with spinal bleeding for an epidural so if I needed a c-section I would be out completely which is something I didn't fully grasp until that one-on-one conversation.

My next appointment is Wednesday so I'll bookmark this thread and update you with what I've learned about treatment. If you have any questions you would like answered, feel free to let me know and I can ask my doctors too. I'm happy to post here or you can reach me at housemail40@yahoo that's just our family junk email account but I'm glad to help in anyway.

I would also factor in the additional risk that comes with induction + low platelets (they both have an increase risk of hemorrhage). Is induction going to put you at a potential higher risk of severe blood loss/transfusion and maybe therefore something to avoid as long as possible?

[Anonymous]

Could you visit an MFM? Mine is fantastic at discussing risks (and after discussing risks/benefits with me, gave me a two-week range of when it would be medically advisable to deliver and let me make the final decision).

[Anonymous]

I’ve never heard of induction just for ama alone.

[Anonymous]

Anonymous wrote:I’ve never heard of induction just for ama alone.

welcome to obstetric medicine, where they instantly accept the findings of one study that supports an intervention they like to use liberally, while evidence from multiple studies that shows an intervention causes more harm than good takes 20+ years to stop using.

[Anonymous]

I would induce at 39 weeks because of the ARRIVE study.

My concern if I were you is that you very likely could end up with an induction regardless. If you’re going to get an induction, you’ve got to have access to the epidural.

I’ve had 2 long inductions, one where the epidural failed. I was begging to die. They ended up knocking me out as soon as baby came out and I was grateful.

The 2nd induction, the epi worked and it wasn’t bad at all!

My fear would be that you wait, you don’t go into labor naturally, then your platelets drop too low for epi and you have to get induced anyway because you’re going too long. If that scenario happened to me I think i would choose a csection over a first time induction with no epi.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’ve never heard of induction just for ama alone.

welcome to obstetric medicine, where they instantly accept the findings of one study that supports an intervention they like to use liberally, while evidence from multiple studies that shows an intervention causes more harm than good takes 20+ years to stop using.

just to clarify, they are not recommending induction for AMA alone. They are recommending it because of low platelet count and possible risks that come with waiting. I guess it is their policy to recommend higher risk AMA pregnancies be induced between 39 and 40 weeks generally, but that isn't what is happening with me and I don't feel pushed based solely on my age. I personally wouldn't be comfortable waiting until 42 weeks for an induction (if it came to that), but I did want until 41 if possible to give my body time, but the platelet count is a complicating and unpredictable factor.