Dr wants to induce early because "no reason to go full 40 weeks"??

[Anonymous]

Op I can't comment on the decision to induce but want to let you know I was induced with my first at 39 weeks for low fluid (it wasn't really but whatever). I was upset and harbored some resentment for a while but the truth is, the induction was quite easy. 10 hours from start to finish. 90 min of what I would call "labor". It might go just fine for you too. Either way, best of luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
OP,

Despite your heart condition, as long as your hyper tension is under control, I really don't see WHY you need to be induced at 39 weeks.

I suggest you seek a second opinion.

While it's true that anything after 38 weeks is considered full-term, there is research out there showing that babies benefit from coming out *when they want to come out*, instead of being induced before they're ready. Pregnancy is NOT a one size fits all kind of thing! Some babies need that extra time in the womb.

It is true that the risk of still birth dramatically increases AFTER 41 weeks. 40 weeks is fine. 41 weeks is fine. 42 weeks is very dangerous.

I would ask to be induced after the end of the full 40 weeks. Meanwhile, you can try all the old-wives methods to trigger your labour - the most efficient of which are intercourse and nipple stimulation.

PLEASE stop giving medical advice out over the internet! OP has a heart condition and pre-existing hypertension. Her doctor is recommending induction because she wants to keep this high-risk mother and her baby alive.

Amen! This is a high risk pregnancy where the mother has been medicated from the beginning. The OP may need to talk to her OB more to better understand why her OB is recommending this specific course of action but some of the advice being given by non medical professionals with no knowledge of Op's condition is misguided and reckless.

And how do you know I am not a medical health professional??? Doctors and other medical experts have conflicting opinions all the time.
It's better to present OP with all the viewpoints so she knows what options she has.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
OP,

Despite your heart condition, as long as your hyper tension is under control, I really don't see WHY you need to be induced at 39 weeks.

I suggest you seek a second opinion.

While it's true that anything after 38 weeks is considered full-term, there is research out there showing that babies benefit from coming out *when they want to come out*, instead of being induced before they're ready. Pregnancy is NOT a one size fits all kind of thing! Some babies need that extra time in the womb.

It is true that the risk of still birth dramatically increases AFTER 41 weeks. 40 weeks is fine. 41 weeks is fine. 42 weeks is very dangerous.

I would ask to be induced after the end of the full 40 weeks. Meanwhile, you can try all the old-wives methods to trigger your labour - the most efficient of which are intercourse and nipple stimulation.

PLEASE stop giving medical advice out over the internet! OP has a heart condition and pre-existing hypertension. Her doctor is recommending induction because she wants to keep this high-risk mother and her baby alive.

Amen! This is a high risk pregnancy where the mother has been medicated from the beginning. The OP may need to talk to her OB more to better understand why her OB is recommending this specific course of action but some of the advice being given by non medical professionals with no knowledge of Op's condition is misguided and reckless.

And how do you know I am not a medical health professional??? Doctors and other medical experts have conflicting opinions all the time.
It's better to present OP with all the viewpoints so she knows what options she has.

I doubt there is any doctor in the world who would not advise OP to just go back and talk to her own doctor and get a second opinion from an MFM if necessary. Also, there is no way you are an OB. Maybe a doula.

[Anonymous]

Anonymous wrote:My Dr wants to do a gentle induction at 39 weeks because she says there's no real reason to wait until 40 weeks and there's a risk of still born after 41 weeks. I am high risk but everything has been controlled with medication so far and I have had no complications. I did not want pitocin or epidural and was trying to avoid csection unless it was an emergency. I feel like membrane sweeping is just going to lead to pitocin which will just lead to csection. I tried to express concern about not wanting to push anything until my body was ready and was told "this is what was best and recommended."

I feel like I've lost complete control over my labor and delivery and am surprised because the entire pregnancy, my ob was on board with my wishes. It's too late to get another dr at this point and I know if she is not in agreement of my birth wishes, there's no way the hospital will be. Has anyone dealt with this before? If it were emergency, I would do anything for the baby. But why suggest the early induction if nothing is wrong? Did membrane sweeping work for you? Or is this just a csection waiting to happen?

Mine too and I'm also high risk, on a bunch of meds, and over 40. I'm as granola as one can be but I'm trusting my doc on this one.

[Anonymous]

I know one baby born at 43 weeks, apparently in Europe this is not a big deal.

[Anonymous]

OP, the few things that I'd be thinking about and discussing with my doctor include:

- You said your hypertension was being well managed. Does that change things as opposed to someone for whom medication is not controlling it?
- How certain are you of your dates? Even if a 39 week induction really is the way to go, you want to be sure you're in fact 39 weeks, as opposed to 37-38. As a pp suggested, might be worth trying to get to 39.5 to give the baby a little extra time to cook. I think the importance of this is highlighted by the shift from ACOG of considering 37 weeks to be full term to now recognizing there are real benefits of getting to 39 weeks, and their changing recommendations.
- A good discussion of how to avoid the slippery slope of pitocin to c-section, which I think is real. Obviously plenty of people have pitocin with out a C, but certainly the rates go up once interventions start. So, having a good discussion with your doctor about your concerns and how you can avoid going down that path might help give you some comfort.

Good luck!

[Anonymous]

OP I suggest you make a appointment with a reputable MFM to get a second opinion. You need to have confidence in your doctor which you do not have. When you call for an appointment I suggest crying and really begging. I switched doctors late because the doctor I was seeing was talking about a c section for no reason. It was easy for me to switch because I was at Georgetown and just saw a different doctor there. The second doctor had a completely different view and I went into labor naturally at 39 weeks. You cannot take medical advice from people here. It's too important and time sensitive. You need a second opinion from someone you can trust. Dr Landy at Georgetown is great.

[Anonymous]

Anonymous wrote:OP, the few things that I'd be thinking about and discussing with my doctor include:

- You said your hypertension was being well managed. Does that change things as opposed to someone for whom medication is not controlling it?
- How certain are you of your dates? Even if a 39 week induction really is the way to go, you want to be sure you're in fact 39 weeks, as opposed to 37-38. As a pp suggested, might be worth trying to get to 39.5 to give the baby a little extra time to cook. I think the importance of this is highlighted by the shift from ACOG of considering 37 weeks to be full term to now recognizing there are real benefits of getting to 39 weeks, and their changing recommendations.
- A good discussion of how to avoid the slippery slope of pitocin to c-section, which I think is real. Obviously plenty of people have pitocin with out a C, but certainly the rates go up once interventions start. So, having a good discussion with your doctor about your concerns and how you can avoid going down that path might help give you some comfort.

Good luck!

You forgot that OP has a heart condition, and that ACOG's recommendation on full-term deliveries have to do with *low risk* pregnancies where induction is not recommended. The whole point of induction is that the baby does not benefit from "extra time to cook" in that particular baby's case. Induction can certainly be recommended at 39 weeks in cases of chronic hypertension or other medical conditions. And the premise that pitocin = c section is wrong. It's not a slipperly slope. Induction actually reduces c sections, per the most recent studies.

[Anonymous]

OP scheduling an induction and/or having an induction doesn't mean your OB doesn't have your best interest at heart and it doesn't mean your OB won't be supportive of your wishes for natural childbirth, avoiding a c-section etc. I had an EASY pregnancy but also risk factors that made induction the right choice for me. No one on the internet can tell you what's right at this point in your pregnancy. Just because there's lots of talk on the internet about over-medicating child birth doesn't mean that an induction, epidural, c-section, etc. aren't the right choices sometimes. If you've liked your OB this far, why not trust them? If your OB hasn't done anything else to make you distrustful, I wouldn't let this be the thing. Just talk through your concerns with your OB. I bet you can find a compromise that you both are on board with (I did - my Dr. wanted to induce and we negotiated on exactly how long I could go before induction).

[Anonymous]

Wow. You need a labor support doula to help be a voice for you, especially in situations like yours. Inducing at 39 weeks is not ok.

[Anonymous]

Anonymous wrote:Wow. You need a labor support doula to help be a voice for you, especially in situations like yours. Inducing at 39 weeks is not ok.

Doulas don't even have to have college degrees! You really think a doula should overrule the opinion an OB has about when a high-risk pregnancy should be induced?

[Anonymous]

I can't speak to your specific risk factors, of course, but it's not clear to me what is actually being proposed here. I had a membrane sweep at 40 weeks and nothing happened. I will be induced at 41 weeks because my OBGYN's practice is to induce between 41 and 42 weeks and I picked the earliest date. Has your doctor explained what the plan is if the membrane sweep is not effective?

[Anonymous]

I've had two spontaneous unmedicated births at 38 weeks and 39 weeks, am generally a "trust the process" kind of person, and would have no hesitation in having my membranes swept at 39 weeks given your circumstances. Doing so doesn't mean you need to start pitocin or anything else, and in fact, it may do nothing anyway. I would ask your doctor what her plan would be if the sweep doesn't do anything, and relax and trust that you picked the right provider. Being anxious and stressed does nothing for getting labor going!

[Anonymous]

I was also high risk but for other reasons not including hypertension. Because I was high risk I trusted my doctors, especially my MFM because I certainly don't have the knowledge and expertise they do. My OB was happy to default to what my MFM decided so that's what we went with. I was induced for all 3 of my pregnancies in the 38th week. First was born at 39w, second at 38w5d and third 38w6d and all were born healthy with great apgars. If I had questions I asked them, but never felt like they were pushing me into something that was bad for me and my baby. And everything went great and it was easier for me to plan my work schedule and for someone to watch my other kids.

I guess I'm just trying to say that sometimes it's not a terrible idea.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Wow. You need a labor support doula to help be a voice for you, especially in situations like yours. Inducing at 39 weeks is not ok.

Doulas don't even have to have college degrees! You really think a doula should overrule the opinion an OB has about when a high-risk pregnancy should be induced?

You're right, they wouldn't necessarily have MD's, but it certainly doesn't mean they don't have college degrees. They are actually highly educated and trained with having to maintain 12-16 CEU's per year, in addition to their certifications. I didn't mean that she shouldn't listen to her doctor; I simply meant it would be a good idea to consider having a labor support doula in the hospital for delivery, they can be a calming voice for the mama, and help with the labor/delivery process.

"Other studies have shown that having a doula as a member of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40%, and requests for an epidural by 60%.

Doulas often use the power of touch and massage to reduce stress and anxiety during labor." http://americanpregnancy.org/labor-and-birth/having-a-doula/