Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

I had absolutely no idea about any of this during my geriatric pregnancy - I knew one person whose sister had a stillbirth at 8 months but my understanding was that this was anomalous. Then mine stopped moving at 37 weeks. Emergency C-section saved him. Doc was spooked and told me a similar thing had happened on the ward with a different practice the week before, and the outcome was not so lucky. I’m seeing so much more literature about this in the past few years, and wish I had known. I hope you’ll be absolutely fine Op and that kind of this is relevant to your scenario in any way, but they aren’t telling you this just to randomly try to bum you out

I feel for OP and get where she’s coming from. Stillbirth is scary and the doctors are right to present evidence and recommendations. I will say that the evidence pretty clearly does show that a 4th time older mom is at lower risk for stillbirth than a young first time mom, and yet only the former would normally get the induction recommendation. That’s current ACOG guidelines but it’s not exactly evidence based.

For many women stillbirth is frankly a fairly remote but yes totally real possibility. It can happen to anyone, and it can happen before any doctor following sound practices would ever suggest an induction. It’s reasonable to have informed conversations about these things.

What? Stillbirth risk is much higher for older moms at more than 39 weeks than younger moms, regardless of prior births.

I was trying to quickly retrace where I remember reading this and only did this quickly.
See table 1 here.

Maybe there’s contrary evidence out there (I’m open to it), but for conversation’s sake this is what I was thinking of.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

I had absolutely no idea about any of this during my geriatric pregnancy - I knew one person whose sister had a stillbirth at 8 months but my understanding was that this was anomalous. Then mine stopped moving at 37 weeks. Emergency C-section saved him. Doc was spooked and told me a similar thing had happened on the ward with a different practice the week before, and the outcome was not so lucky. I’m seeing so much more literature about this in the past few years, and wish I had known. I hope you’ll be absolutely fine Op and that kind of this is relevant to your scenario in any way, but they aren’t telling you this just to randomly try to bum you out

I feel for OP and get where she’s coming from. Stillbirth is scary and the doctors are right to present evidence and recommendations. I will say that the evidence pretty clearly does show that a 4th time older mom is at lower risk for stillbirth than a young first time mom, and yet only the former would normally get the induction recommendation. That’s current ACOG guidelines but it’s not exactly evidence based.

For many women stillbirth is frankly a fairly remote but yes totally real possibility. It can happen to anyone, and it can happen before any doctor following sound practices would ever suggest an induction. It’s reasonable to have informed conversations about these things.

What? Stillbirth risk is much higher for older moms at more than 39 weeks than younger moms, regardless of prior births.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

I had absolutely no idea about any of this during my geriatric pregnancy - I knew one person whose sister had a stillbirth at 8 months but my understanding was that this was anomalous. Then mine stopped moving at 37 weeks. Emergency C-section saved him. Doc was spooked and told me a similar thing had happened on the ward with a different practice the week before, and the outcome was not so lucky. I’m seeing so much more literature about this in the past few years, and wish I had known. I hope you’ll be absolutely fine Op and that kind of this is relevant to your scenario in any way, but they aren’t telling you this just to randomly try to bum you out

I feel for OP and get where she’s coming from. Stillbirth is scary and the doctors are right to present evidence and recommendations. I will say that the evidence pretty clearly does show that a 4th time older mom is at lower risk for stillbirth than a young first time mom, and yet only the former would normally get the induction recommendation. That’s current ACOG guidelines but it’s not exactly evidence based.

For many women stillbirth is frankly a fairly remote but yes totally real possibility. It can happen to anyone, and it can happen before any doctor following sound practices would ever suggest an induction. It’s reasonable to have informed conversations about these things.

My point being that it’s always going to be a personal calculation and it’s always going to be a gamble in one direction or another. Interestingly, the premise of the ARRIVE trial was what if we induce ALL pregnant women at 39 weeks? Would that reduce stillbirth? Surprisingly (to me) the answer was not really, not by much. The study admits as much.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

I had absolutely no idea about any of this during my geriatric pregnancy - I knew one person whose sister had a stillbirth at 8 months but my understanding was that this was anomalous. Then mine stopped moving at 37 weeks. Emergency C-section saved him. Doc was spooked and told me a similar thing had happened on the ward with a different practice the week before, and the outcome was not so lucky. I’m seeing so much more literature about this in the past few years, and wish I had known. I hope you’ll be absolutely fine Op and that kind of this is relevant to your scenario in any way, but they aren’t telling you this just to randomly try to bum you out

I feel for OP and get where she’s coming from. Stillbirth is scary and the doctors are right to present evidence and recommendations. I will say that the evidence pretty clearly does show that a 4th time older mom is at lower risk for stillbirth than a young first time mom, and yet only the former would normally get the induction recommendation. That’s current ACOG guidelines but it’s not exactly evidence based.

For many women stillbirth is frankly a fairly remote but yes totally real possibility. It can happen to anyone, and it can happen before any doctor following sound practices would ever suggest an induction. It’s reasonable to have informed conversations about these things.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

I had absolutely no idea about any of this during my geriatric pregnancy - I knew one person whose sister had a stillbirth at 8 months but my understanding was that this was anomalous. Then mine stopped moving at 37 weeks. Emergency C-section saved him. Doc was spooked and told me a similar thing had happened on the ward with a different practice the week before, and the outcome was not so lucky. I’m seeing so much more literature about this in the past few years, and wish I had known. I hope you’ll be absolutely fine Op and that kind of this is relevant to your scenario in any way, but they aren’t telling you this just to randomly try to bum you out

I feel for OP and get where she’s coming from. Stillbirth is scary and the doctors are right to present evidence and recommendations. I will say that the evidence pretty clearly does show that a 4th time older mom is at lower risk for stillbirth than a young first time mom, and yet only the former would normally get the induction recommendation. That’s current ACOG guidelines but it’s not exactly evidence based.

For many women stillbirth is frankly a fairly remote but yes totally real possibility. It can happen to anyone, and it can happen before any doctor following sound practices would ever suggest an induction. It’s reasonable to have informed conversations about these things.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

I had absolutely no idea about any of this during my geriatric pregnancy - I knew one person whose sister had a stillbirth at 8 months but my understanding was that this was anomalous. Then mine stopped moving at 37 weeks. Emergency C-section saved him. Doc was spooked and told me a similar thing had happened on the ward with a different practice the week before, and the outcome was not so lucky. I’m seeing so much more literature about this in the past few years, and wish I had known. I hope you’ll be absolutely fine Op and that kind of this is relevant to your scenario in any way, but they aren’t telling you this just to randomly try to bum you out

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

I’m so sorry for your sister and her loss. I think it’s worth noting that a loss at 39+3 may be very difficult to prevent, as sometimes freak awful things happen. ACOG recommends induction during week 39 for older mothers, but a planned induction at 39+6 would be within these guidelines. Follow the evidence, yes. Unfortunately awful things can happen at any time.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Change your providers. Being treated like that is not okay and not normal.

If they're discussing induction it's likely too late to change providers. Most OBs won't want to take a switched patient super late.

It looks like the ACOG does recommend induction at 39 weeks for moms 40 and older and they will base that on statistics and science. So if you have any other complicating factors, at least have a conversation about it. But they shouldn't just be telling you, they should be laying out stats and reasoning.

OP here - my biggest problem is that there have been no complications. Stress tests, ultrasounds, blood work - everything has been stellar. I understand the need to inform but it just seems beyond that at this point

My sister had zero complications whatsoever. Completely smooth pregnant. Baby had no heartbeat at 39 weeks and 3 days.

Follow the evidence.

The evidence was someone didn't do their job right or they didn't know the reason for stillbirth. So they're pushing for induction and/or C-section at 37th or 39th week without following the medical science.
Scare tactic is their way.

Her stillbirth had an unknown cause despite genetic testing of embryos, fetal autopsy, and pathology of fetal and placental tissue. Somewhere between a quarter and half of stillbirths have no known cause, so her situation is not anomalous.

The risk of stillbirth increases, particularly for older mothers, after 37 weeks. Of course, that risk has to be balanced against the risk of complications from being born a bit earlier. The recommendation of induction at 39 weeks for older mothers is a reasonable one that’s evidence based and balances protection of neonatal health with reduction in the risk of stillbirth.

I’m thrilled that presenting the risk of stillbirth to a mother sounds like a “scare tactic” to you. There have now been two stillbirths in my family (same generation) from two different mothers despite no prior family history. Both stillbirths had no known cause. Both had healthy pregnancies. Both had two other live births. These outcomes were totally devastating and, in my opinion, should be avoided at all costs.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Weirdly I'm 38 and I keep going "I know I'm old" and my OB keeps saying "You're really not".

In the US now more babies are born to Women over 40 than women under 20 (this does have more to do with the falling teen birth rate but the 40+ group has risen too).

See, here’s the thing. Just because more women over 40 are having babies now than women under 20 doesn’t mean that having a baby over 40 is safer or that women over 40 are getting any younger. What twisted logic.

It isn’t safer but it’s certainly better to have a baby after 40 then at 20.

Women over 40 are also still young, not old.

Anonymous wrote:OP, YOUR KID DOES NOT WANT A CHRISTMAS EVE OR CHRISTMAS BIRTHDAY!

It distracts from their special day. It screws up birthday party timing.