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

[Anonymous]

Also ask your doctor for the evidence to support 39 weeks 0 days or 39 *completed* weeks, as in 39 weeks 6 days. Those days make a difference for the lung and brain development of the baby.

[Anonymous]

Thank you everyone for your answers, they are all very helpful and I have a detailed list of questions to present to my OB. To clarify, I do have an entire team of MFMs that I have seen since week 12 as well as specialist to make sure conception and myself were as safe as possible for pregnancy. The birth plan with my Dr the entire time has been to watch for preeclampsia and fetal risk. As of my last appointment with MFM, I was told everything was progressing perfectly and I would be fine to go full term as long as my blood pressure and protein levels remained what they are. We had several plans/date milestones in place if preeclampsia developed for early delivery. I have an appointment with them next week for another growth scan and will definitely get their opinion on the 39 week induction. I think the alarm bells I have are because my OB did not bring up anything about the risk being greater for hypertension after 39 weeks or any genuine reasoning at all except to say "39 weeks is full term and the baby just gains weight the last week." In fact, you all posting those great links are the first time I have even heard about the risk of continuing past 39 weeks so i greatly appreciate all the responses. I feel if something was wrong, absolutely, do whatever needs to be done but just to induce because the baby gains weight the last week makes me extremely nervous. I have so much to figure out, you guys have been amazing with your help. Thank you so much again.

[Anonymous]

If you do end up with an induction, ask about natural inductions like stripping membranes, foley catheter, etc. They went straight to drugs with me (cervadil then pitocin) and it wasn't pretty.

[Anonymous]

Anonymous wrote:Also ask your doctor for the evidence to support 39 weeks 0 days or 39 *completed* weeks, as in 39 weeks 6 days. Those days make a difference for the lung and brain development of the baby.

Thank you also, this is a good point. It would be 39 weeks 0 days. And also I saw someone ask this. she said I would be admitted into hospital, have membranes swept, wait 24 hours and then if nothing happens, she said I can go home for the night and come back in the morning to try again. I definitely will ask what "trying again" entails. At the time of the appointment, I was so excited about the possibility of seeing the baby early, safely, I didn't have a ton of questions of the top of my head.

[Anonymous]

I think others have covered both sides of the induce/wait it out argument. I just wanted to contribute some personal experience that I hope helps as you weigh your options.

With my first, I was induced at 39 weeks due to gestational hypertension. I didn't have a prior history as you do, and I wasn't on medication. My BP was quite high, and I was on bed rest for about a week prior to the induction. I was given Cervadil, sent home for the night, and then admitted and started on Pitocin the next morning. The induction failed and I ended up having a c-section, which I repeated for my second child, and will repeat again in a few months for my third.

I was really unhappy about the induction. I regretted my passive approach to it when the doctor scheduled it, and thought my discomfort in late pregnancy made me more likely to go along with the plan instead of to question it. I found a new OB for my second pregnancy who I felt would be supportive of a VBAC (I ultimately decided against it, but it was entirely my decision).

In short, I've been where you are now, more or less. I had the same concerns, and those concerns materialized into reality. I was unhappy about it for a while, but looking back now, I just don't care anymore. It wasn't important. Maybe I could have waited longer before being induced and possibly avoided the c-section, but I came away from it with a wonderful, healthy baby. It took a little while for me to make peace with the fact that the delivery didn't go the way I wanted it to go, but the result was exactly what I wanted.

[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.

No reputable doula would challenge an OB or any other medical staff in an L&D ward. If they did, they would not be invited to come back and provide their services. I used an excellent doula, and she makes very clear up front that she is not a medical care provider and she will not speak directly to hospital staff on my behalf. When, after a long labor, the topic of induction came up, we did talk to her privately about our options. Based on that conversation, we spoke directly to the L&D staff and decided to wait a little bit longer before starting pitocin...and ended up delivering without it. Our doula was helpful in sorting out information, but she would never have intervened on our behalf.

[Anonymous]

Anonymous wrote:I think others have covered both sides of the induce/wait it out argument. I just wanted to contribute some personal experience that I hope helps as you weigh your options.

With my first, I was induced at 39 weeks due to gestational hypertension. I didn't have a prior history as you do, and I wasn't on medication. My BP was quite high, and I was on bed rest for about a week prior to the induction. I was given Cervadil, sent home for the night, and then admitted and started on Pitocin the next morning. The induction failed and I ended up having a c-section, which I repeated for my second child, and will repeat again in a few months for my third.

I was really unhappy about the induction. I regretted my passive approach to it when the doctor scheduled it, and thought my discomfort in late pregnancy made me more likely to go along with the plan instead of to question it. I found a new OB for my second pregnancy who I felt would be supportive of a VBAC (I ultimately decided against it, but it was entirely my decision).

In short, I've been where you are now, more or less. I had the same concerns, and those concerns materialized into reality. I was unhappy about it for a while, but looking back now, I just don't care anymore. It wasn't important. Maybe I could have waited longer before being induced and possibly avoided the c-section, but I came away from it with a wonderful, healthy baby. It took a little while for me to make peace with the fact that the delivery didn't go the way I wanted it to go, but the result was exactly what I wanted.

As a counterpoint I was induced at 39 weeks for gestational hypertension and it went great.

But it is important to point out that OP is at much higher risk than mild gestational hypertension so our stories are not relevant. She has chronic hypertension and a heart problem. In her position I would have gladly induced at 39 weeks.

[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.

No reputable doula would challenge an OB or any other medical staff in an L&D ward. If they did, they would not be invited to come back and provide their services. I used an excellent doula, and she makes very clear up front that she is not a medical care provider and she will not speak directly to hospital staff on my behalf. When, after a long labor, the topic of induction came up, we did talk to her privately about our options. Based on that conversation, we spoke directly to the L&D staff and decided to wait a little bit longer before starting pitocin...and ended up delivering without it. Our doula was helpful in sorting out information, but she would never have intervened on our behalf.

well it is good she didn't interfere directly. But a doula who counseled the mother not to trust her doctor especially in a true high risk situation would still be interfering. in retrospect I am very glad my overly crunchy doula was not there when the decision was made to induce.

[Anonymous]

Anonymous wrote:

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.

No reputable doula would challenge an OB or any other medical staff in an L&D ward. If they did, they would not be invited to come back and provide their services. I used an excellent doula, and she makes very clear up front that she is not a medical care provider and she will not speak directly to hospital staff on my behalf. When, after a long labor, the topic of induction came up, we did talk to her privately about our options. Based on that conversation, we spoke directly to the L&D staff and decided to wait a little bit longer before starting pitocin...and ended up delivering without it. Our doula was helpful in sorting out information, but she would never have intervened on our behalf.

well it is good she didn't interfere directly. But a doula who counseled the mother not to trust her doctor especially in a true high risk situation would still be interfering. in retrospect I am very glad my overly crunchy doula was not there when the decision was made to induce.

Doulas are not supposed to intervene, but they are helpful with coming up with questions for their clients to ask, just as OP is doing now with this thread.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

No reputable doula would challenge an OB or any other medical staff in an L&D ward. If they did, they would not be invited to come back and provide their services. I used an excellent doula, and she makes very clear up front that she is not a medical care provider and she will not speak directly to hospital staff on my behalf. When, after a long labor, the topic of induction came up, we did talk to her privately about our options. Based on that conversation, we spoke directly to the L&D staff and decided to wait a little bit longer before starting pitocin...and ended up delivering without it. Our doula was helpful in sorting out information, but she would never have intervened on our behalf.

well it is good she didn't interfere directly. But a doula who counseled the mother not to trust her doctor especially in a true high risk situation would still be interfering. in retrospect I am very glad my overly crunchy doula was not there when the decision was made to induce.

Doulas are not supposed to intervene, but they are helpful with coming up with questions for their clients to ask, just as OP is doing now with this thread.

But if you get a doula with an agenda then those questions will be biased and based on an agenda. Is there a reason a patient should be having a non-medical professional come up with questions about their care anyway? My friend is just finishing up a kidney transplant, for example, and it would be a kind of bizarre concept to hire a lay person to help ask medical questions about kidneys ...

[Anonymous]

I haven't read the whole thread, but there is some research indicating improved maternal outcomes with induction before 40 weeks, in the presence of complications (eg GD)

http://www.bmj.com/content/344/bmj.e2838

[Anonymous]

Anonymous wrote:

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.

No reputable doula would challenge an OB or any other medical staff in an L&D ward. If they did, they would not be invited to come back and provide their services. I used an excellent doula, and she makes very clear up front that she is not a medical care provider and she will not speak directly to hospital staff on my behalf. When, after a long labor, the topic of induction came up, we did talk to her privately about our options. Based on that conversation, we spoke directly to the L&D staff and decided to wait a little bit longer before starting pitocin...and ended up delivering without it. Our doula was helpful in sorting out information, but she would never have intervened on our behalf.

well it is good she didn't interfere directly. But a doula who counseled the mother not to trust her doctor especially in a true high risk situation would still be interfering. [b]in retrospect I am very glad my overly crunchy doula was not there when the decision was made to induce.

FTR, that's not what our doula did. She did not tell us not to trust our doctor...we asked her, and she suggested we could ask our MW about alternatives, which is what we did. If the MW had said she absolutely thought we should induce, we probably would have. In our case, the only reason it was brought up was that it had been a long time and they had a policy of bringing it up to avoid mothers getting tired.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

No reputable doula would challenge an OB or any other medical staff in an L&D ward. If they did, they would not be invited to come back and provide their services. I used an excellent doula, and she makes very clear up front that she is not a medical care provider and she will not speak directly to hospital staff on my behalf. When, after a long labor, the topic of induction came up, we did talk to her privately about our options. Based on that conversation, we spoke directly to the L&D staff and decided to wait a little bit longer before starting pitocin...and ended up delivering without it. Our doula was helpful in sorting out information, but she would never have intervened on our behalf.

well it is good she didn't interfere directly. But a doula who counseled the mother not to trust her doctor especially in a true high risk situation would still be interfering. [b]in retrospect I am very glad my overly crunchy doula was not there when the decision was made to induce.

FTR, that's not what our doula did. She did not tell us not to trust our doctor...we asked her, and she suggested we could ask our MW about alternatives, which is what we did. If the MW had said she absolutely thought we should induce, we probably would have. In our case, the only reason it was brought up was that it had been a long time and they had a policy of bringing it up to avoid mothers getting tired.

So you were asking your doula for medical advice. My policy is not to ask for medical advice from anyone who does not have a well established professional ethical and legal responsibility for my care, and at least a masters degree.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

No reputable doula would challenge an OB or any other medical staff in an L&D ward. If they did, they would not be invited to come back and provide their services. I used an excellent doula, and she makes very clear up front that she is not a medical care provider and she will not speak directly to hospital staff on my behalf. When, after a long labor, the topic of induction came up, we did talk to her privately about our options. Based on that conversation, we spoke directly to the L&D staff and decided to wait a little bit longer before starting pitocin...and ended up delivering without it. Our doula was helpful in sorting out information, but she would never have intervened on our behalf.

well it is good she didn't interfere directly. But a doula who counseled the mother not to trust her doctor especially in a true high risk situation would still be interfering. in retrospect I am very glad my overly crunchy doula was not there when the decision was made to induce.

Doulas are not supposed to intervene, but they are helpful with coming up with questions for their clients to ask, just as OP is doing now with this thread.

But if you get a doula with an agenda then those questions will be biased and based on an agenda. Is there a reason a patient should be having a non-medical professional come up with questions about their care anyway? My friend is just finishing up a kidney transplant, for example, and it would be a kind of bizarre concept to hire a lay person to help ask medical questions about kidneys ...

A doula is not a lay person when it comes to birth, FFS.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

FTR, that's not what our doula did. She did not tell us not to trust our doctor...we asked her, and she suggested we could ask our MW about alternatives, which is what we did. If the MW had said she absolutely thought we should induce, we probably would have. In our case, the only reason it was brought up was that it had been a long time and they had a policy of bringing it up to avoid mothers getting tired.

So you were asking your doula for medical advice. My policy is not to ask for medical advice from anyone who does not have a well established professional ethical and legal responsibility for my care, and at least a masters degree.

No I wasn't, but what does it matter? My original post was actually to say that a responsible Doula *wouldn't* intervene with a medical care provider. And FWIW, my doula does have an MS in a health-related field, which was part of the reason we chose her. Since this was our first birth and she had been through many, we did appreciate having another person involved in a discussion that the MW had otherwise left up to just myself and DH. If you don't want such a person, don't hire a doula!