38.5 weeks no progress, should people be bringing up induction?

[Anonymous]

I'll be 39 weeks pregnant on Friday, and I'm wondering if I should bring up induction at my appointment tomorrow. I've had no progress as far as labor goes (tons of BH, baby's dropped, but no dilation and only 70% effaced, still all plugged up). Every time I go I get a different doctor (I'm at RHJ) and it seems like they're always like oh this is cool you're almost there. No one's brought up induction, and I kind of think that they'll just be like oh wait your due date passed, oops. I'm not particularly anxious about labor, I'm just worried that I'm going to get lost in the mix and there might be some sort of placenta issue and the baby will die. I hear these stories of still born babies at 39 weeks and it really really scares me.

People at RHJ, when did anyone start bringing up induction? Did you have to bring it up? Is it weird that no one's mentioning anything?

[Anonymous]

I had my first at RHJ and was induced. They won't be like "oops, we forgot about you." They just don't schedule inductions generally before 41 weeks (especially for your first). You are only at 38.5 weeks, so quite frankly, you could still have 3.5 weeks before induction truly becomes necessary. If you want to talk about it with them at your next appointment, by all means do so, but they tend to be able to do no right on these boards. If they bring it up before 40 weeks, it will seem like they are pressuring you to induce. If they don't bring it up early, it must be b/c they are a big practice and don't have a personal interest in you.

If you are anxious, bring it up. But otherwise, I don't think RHJ schedules inductions until you are actually past 40 weeks (nor should they).

[Anonymous]

I'm also about where you are. They can't schedule inductions until 2 weeks within the induction date and inductions are usually scheduled about a week past your due date. I wouldn't worry at all.

I'm at just past 38 weeks and I'm not even dialated and have no other progress other than the baby dropping into position. Just went to the doc today and she said things are "getting ripe" for labor, but nothing has started. From what I understand, all of the pre-labor stuff doesn't really mean anything as far as timing when you will go into real labor. For example, you could be walking around for days after you start to dialate, or you could begin dialating and give birth that day.

You still have another week and a half until your due date. I would take it easy. In another few days or a week, you should schedule an induction date just in case you go past 40 weeks. My doc said that if I go past my due date they will have me come in to monitor the baby to make sure she's doing ok, then schedule induction for not more than a week past.

[Anonymous]

Progress means absolutely nothing aside from it being x amount less you do in active labor.

You could go into labor as I'm typing this or you could be pregnant for another 3 weeks if not induced. It really isn't anything to stress about at this point. I'm of the understanding that it is 41 weeks at which point you really see fetal mortality increase significantly.

[Anonymous]

Since there have been countless studies showing that early induction carries significant harm to the baby, RHJ are following sound medical practice in not even discussing an induction with you. Frankly, most doctors prefer you to go until 42 weeks. While some will induce you on your due date, most don't advise it. If you are off even slightly with your conception dates (and many women are) then you risk having a low birth weight baby. The baby will come when it is ready. I know it's hard to wait and you want the baby to be healthy, but it's healthiest for the baby to come on its own when it is ready. Trust me, a big type practice will NOT let you go past the "safe" time for delivering this baby. If anything, most of those places are a bit too eager to induce.

[Anonymous]

Dilation and effacement in advance of labor have absolutely NO bearing on when you'll go into labor.

Due dates are notoriously unreliable. First time moms deliver on average 10 days past their due date. A healthy full-term pregnancy is anywhere from 38 to 42 weeks (not 41!), and 95% of babies born between 42 and 44 weeks are still healthy. The best measure of true postmaturity is low amniotic fluid.

A natural start to labor has great benefits to the baby. Rushing the process could mean the baby misses out on days or weeks of needed time in the womb for lung development, among other things. In addition, if your body isn't ready for an induction, you havbe a greater chance if ending up with a c-section due to lack of progress.

Labor should be induced only when medically necessary.

[Anonymous]

FWIW, I delivered at GU and they don't schedule an induction until after you are 41 weeks. I wouldn't worry about getting lost in the shuffle - there's simply no reason to rush at this point.

[Anonymous]

You shouldn't even consider an induction until your placenta is showing signs of aging. The average time of gestation for first time moms is 41w1 day. Also, if you try to induce and your body isn't ready, you are more likely to end up with a c-section.

I didn't go into labor with my second until 41w6d.

[Anonymous]

OP here. Thanks everyone for the responses. I wouldn't have really thought about getting induced but my sister (a doctor who had her first baby two months ago) was really weirded out by the fact that they hadn't scheduled an induction for me. She said her doctor scheduled one for her at 39 weeks (she went into labor a couple of days before). I didn't want to pry as to why they would do that so early, but it made me think that maybe I was getting sub-standard care.

Thanks everyone for making me feel like my doctor's aren't forgetting me.

[Anonymous]

Anonymous wrote:OP here. Thanks everyone for the responses. I wouldn't have really thought about getting induced but my sister (a doctor who had her first baby two months ago) was really weirded out by the fact that they hadn't scheduled an induction for me. She said her doctor scheduled one for her at 39 weeks (she went into labor a couple of days before). I didn't want to pry as to why they would do that so early, but it made me think that maybe I was getting sub-standard care.

Thanks everyone for making me feel like my doctor's aren't forgetting me.

Your sister is in serious need of a refresher class (or perhaps just a subscription to a newspaper with a weekly health section) if she thinks there is anything abnormal about not scheduling an induction for a woman who's a week and a half from her due date.

[Anonymous]

Mine didn't talk about induction until 40 weeks, and it was because I asked, and they said, we'll talk about it at 41 weeks if we have to. And we did talk about it at my 41 week appt and made plans to do it at 42 weeks if neccesary, but then I went into labor that night.

Hang in there!

[Anonymous]

FWIW, in my last few weeks with my 2nd baby, I was getting nowhere, effaced but no dilation for weeks. Then, suddenly, in my 38th week, I went from nothing to having the baby that night. It surprised everyone. I had been to my OB that morning, too and was still not dilated. Relax. Your baby is fine, you've got weeks to talk about induction. And, PS, induction is no fun. I was induced with my 1st, not b/c she came late, but because my labor did not progress on its own after a day of hard contractions. Enjoy these last few days and let your body do what it will naturally!

[Anonymous]

As PPs have mentioned, a "normal" pregnancy lasts from 37 to 42 weeks. My due date is at week 40. If your pregnancy has been otherwise uneventful, I think it's GREAT that no one is talking to you about induction yet, though honestly, like your sister, I'm a little surprised. It seems like a lot of doctors at least mention it as something to think about if you go "too long" these days.

[Anonymous]

I have found that different regions of the country have different "standards". My SIL in NY has a 20 week, 29 week and 36 week ultrasound. I have a 20 week and that is it.

I know it is hard to not hear and compare. As others have said, your dr is actually aligned with what some of the current information is. Good luck with the rest of your pregnancy.

[Anonymous]

One important point that I think is getting lost here: There is a difference in talking about scheduleing an induction, versus actually doing it.

I agree with everyone who said that I would personally not DO an induction unless someone made a very compelling case to me that it was necessary. On the other hand, I do not think it is premature to be talking about it, and even SCHEDULING it.

I went very very late with both of my kids. I was at RHJ. I remember coming in at 41 weeks with my first, and the doctor said, "when is your induction scheduled for?". I said "Induction? Induction? No one has even mentioned an induction to me!" Then there was this panic, because the induction slots at Sibley were full, and as I'm sitting there in the office, with the doctor and the scheduler, they say "The only slot they have is tonight." (This is at 3 in the afternoon and my husband is 90 minutes away). I love RHJ, but this is one of their weaknesses.

I was really upset about the whole thing, as there was nothing "wrong" with the baby, and I didn't want to be pushed into an induction at 41 weeks, when otherwise I would've been able to go closer to 42 weeks.

Ultimately I gave the doctor a rather stern lawyer look, and said "I have to tell you, I'm really upset about this. I don't want an induction, no one in this office has even mentioned it to me prior to today, and now I'm being told that my only option is to go immediately to the hospital and have it done. There must be a better solution here." She went away, and came back with a solution... go home... and they'd work something out. I finally went into labor naturally at 41 weeks, 5 days (the night before my scheduled induction).

So, the moral of the story is this: If you have strong feelings about waiting as long as possible to be induced... it makes sense to book your slot for as late as possible. But BOOK IT EARLY!