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

[Anonymous]

Anonymous wrote:

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.

Agreed. My purpose was only to say that even if OP does end up with a failed induction and c-section, it doesn't matter in the grand scheme of things.

[Anonymous]

Anonymous wrote:

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.

Of course they are. Anyone can legally call themselves a doula. Anyone can acquire the same level of *medical* knowledge about birth as a doula by watching some youtube videos and reading some books. Doulas are support people, not medical people.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

Of course they are. Anyone can legally call themselves a doula. Anyone can acquire the same level of *medical* knowledge about birth as a doula by watching some youtube videos and reading some books. Doulas are support people, not medical people.

What's your point?

[Anonymous]

I don't think there is any real down side to membrane strip at 39w. Are they admitting you after the sweep because of the hypertension? Normally don't they just sweep and send home?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

Of course they are. Anyone can legally call themselves a doula. Anyone can acquire the same level of *medical* knowledge about birth as a doula by watching some youtube videos and reading some books. Doulas are support people, not medical people.

What's your point?

Just responding to the ridiculous assertion that OP needs a doula to interfere with her high risk pregnancy because "inducing at 39 weeks is not ok".

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

Of course they are. Anyone can legally call themselves a doula. Anyone can acquire the same level of *medical* knowledge about birth as a doula by watching some youtube videos and reading some books. Doulas are support people, not medical people.

Uh, that would not be a certified doula then.
You obviously have no idea what you're talking about.
I wouldn't hire someone who wasn't certified. You can look this up, you know.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

Of course they are. Anyone can legally call themselves a doula. Anyone can acquire the same level of *medical* knowledge about birth as a doula by watching some youtube videos and reading some books. Doulas are support people, not medical people.

Uh, that would not be a certified doula then.
You obviously have no idea what you're talking about.
I wouldn't hire someone who wasn't certified. You can look this up, you know.

LOL you mean the certification that requires you read 5 books and take a 16 hour long class, and has zero educational prerequisites? Doulas are lay support people, nothing more. http://www.dona.org/PDF/Birth+Doula_Steps+to+Certification_0914_rev_0316.pdf

[Anonymous]

To the PP's keeping this thread high because of a silly back-and-forth about doulas, please take your discussion to another thread. Your argument is not in any way helpful to the OP and FWIW, OP, I think a doula would possibly be helpful to you in helping you feel more informed and in control if you end up with a managed labor and/or induction; I find that they'll take the time to make sure you understand your options and feel comfortable with what your medical team is telling you... She can also give you tools to manage labor without pain medication, if that's your desire).

[Anonymous]

My cousin's daughter died because the doctor should have induced two weeks early. She was also high risk. One moment she was alive, the next moment gone after strangling on the cord. My own DD is named after her.

Please listen to your doctor. I've had three kids. Don't get sucked into the 'perfect birth' crap.

[Anonymous]

I had HELLP with my first pregnancy diagnosed right before full term (39w + 5 days). Plan this time is induction or c-section at 39 weeks - standard for patients with a particularized risk of HBP/pre-e, which even well-controlled chronic HBP gives you. This is 100% the standard of care.

[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?

Just say no. Maybe get another ob.

[Anonymous]

By the way, as simplistic as the Drs explanation to OP was re: why 39 weeks is the standard of care, it's the right one. Every extra day you are pregnant is dangerous for you and the baby; on the flip side, there is no advantage to you or the baby of gestation beyond 39 weeks. Easy choice in the case of moms with a particularized risk. So easy that its increasingly likely to become the medical standard of care for all mothers going forward -- hence the new ACoG guidelines.

[Anonymous]

Anonymous wrote:I would ask if it would be OK to go to 39.5 or some such and just explain that you really want to feel like you went the distance. I will warn you, though, that you may have to go to get checkups daily if she is really concerned.

If it's OK??? You tell that doctor what YOU want instead of trying to schedule your birth around their vacation. Or go elsewhere--there are plenty of OBs in this area. Preposterous, trying to rush things.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would ask if it would be OK to go to 39.5 or some such and just explain that you really want to feel like you went the distance. I will warn you, though, that you may have to go to get checkups daily if she is really concerned.

If it's OK??? You tell that doctor what YOU want instead of trying to schedule your birth around their vacation. Or go elsewhere--there are plenty of OBs in this area. Preposterous, trying to rush things.

Just wondering -- were you high risk? I was, and I didn't push back when my doctor recommended X or Y. Nor did I tell my doctor, schedule the induction on X date instead of Y date that you advised.

Asking a doctor why or for more explanation is not pushing back. Telling the doctor no I won't follow your medical advice is pushing back.

[Anonymous]

39 weeks is the safest whether the mother is high risk or not. So, certainly in a high risk situation I would listen to the doctor. Evidence and medical school and all of that.