What happens if i refuse to be induced? - Page 3

[mamatoady]

I have a couple thoughts here, but don't know how to post multi-quotes.

Cytotec is not FDA approved and when I recently researched it, found that the makers of it DO NOT think it's a good idea to use for induction. (I googled FDA approved and unaproved drugs for labor and delivery).

Secondly, My 7#5oz. baby (1st child) had a head 1/2 inch bigger around head than my 2nd baby, born at 9# even. Both were born at 10 days early. Both were also pushed out in less than 20 minutes.

It think it is important to talk to your provider about not pulling to hurry the birth. I intend on doing this as well. The only time I want her hands in me is if there's a clear case of shoulder distocia, which shouldn't be happening since I spend my entire labor in hands and knees and squatting position.

Sarah

ETA: dd's head was 14.5" which is a pretty big head...

[SandraS]

They'll hold a gun to your head?

Nothing. It's your body, you are in charge of it. Period. This is not even up for negotiation.

[MegBoz]

Originally Posted by SandraS

They'll hold a gun to your head?

Nothing. It's your body, you are in charge of it. Period. This is not even up for negotiation.

Once again.. I say it's just not that simple.

I don't think 31W is too late to switch at all. If you have options, I'd encourage you to explore them. Check with your tribal area here on MDC, LLL, etc. to find natural-birth friendly providers (consider HB, a free-standing birth center, or work to find the most NCB-friendly hospital with good MWs or consider a Family practicioner doc instead of OB or work to find a good NCB-friendly OB.)

I really don't think it's a wise choise to continue care with an HCP you don't trust and just coninually refuse everything. OK, you can, and SHOULD refuse induction for going past 41W.: Considering Mittendorf's research shows the average 1st time Mama goes to 41W1D on AVERAGE, yeah, induction for being 41W0D is idiotic.

HOWEVER.. what if you chose to get an NST & they say results are not reassuring? What if you DO get pre-eclamptic & induction is best? Do you trust your HCP when moving forward in that situation - where you may NEED their involvement?

All that aside, what if you go into labor naturally & everything is peachy-keen, but they see problems with the baby's HR? What if they say after birth they're concerned about bleeding & want to treat you (say with pit or something.)

Again, I state, do you REALLY want to continue care with an HCP whom you don't trust & "JUST SAY NO! It's my body!" Um, I don't think that's a wise course of action.

For example, I had a picture-perfect awesome birth, but my MW was concerned about some retained membrane from the BOW. She was massaging my uterus but still a little concerned. She wanted DS to BF... he wasn't interested! I tried with the help of my doula, but he just looked at us - wouldn't open his mouth. I'm on camera saying to him, "C'mon, help me out."

My MW watched & waited, but since he wouldn't BF, she wanted to give me pit to make sure that membrane all came out. She offered me the option of IM (intramuscular- a shot) or in IV. I had NO concerns trusting her. None! I'd HATE to have to constantly second guess my HCP. Not fun!

Besides, if your HCP DOES differ from your outlook, um, yeah, I don't think I'd want to be arguing & "saying no" & arguing & debating through my whole labor, birthing & PP period! Talk about annoying, distracting, inhibiting, infuriating, etc.

In other words - I don't advocate a strategy of "Just say no" (Do whatever you want anyway, stick with an HCP you don't trust).

[SandraS]

Originally Posted by MegBoz

Once again.. I say it's just not that simple.

In other words - I don't advocate a strategy of "Just say no" (Do whatever you want anyway, stick with an HCP you don't trust).

But it IS that easy.

There were a lot of things I simply said "no" to, and I love my doctor. I'm not sure why it's believed that every time one wants to say no to a procedure the doc gets defensive and it becomes a fight. It's not so.

Do you want prenatal testing? No thanks. Okey dokey. No fights.

My doc says - you want me to induce so you have the baby for the tax deduction this year? I say nope. She said okey dokey.

Where was the battle?

Before labor, she said do you want to be checked for dilation? I said nope. She said cool. In labor, she says, you want me to check you? I said no thanks... she said Okey dokey. No battle.

Every time you make your wishes known it doesn't mean it's going to be a fight. Doctors really do respect patients who know what they want, who come in armed with information. Really.

And yes, there is no question whatsoever that YOU are in charge when you are in the doctor's office. That absolutely is not debatable. A doctor won't even debate that.

Good luck.

[Pirogi]

Originally Posted by mamatoady

Cytotec is not FDA approved and when I recently researched it, found that the makers of it DO NOT think it's a good idea to use for induction. (I googled FDA approved and unaproved drugs for labor and delivery).

Cytotec (generic name misoprostol) is FDA approved *for reducing the risk of gastric ulcers.* It is used off-label by some OBs for inducing labor. Yes, definitely shouldn't be used for that. But, there was an interesting thread on the Birth Professionals forum a few months ago about using it to control PPH that doesn't respond to conventional drugs or herbs. Interesting read.

Originally Posted by mamatolevi

yes, to check amniotic fluid levels. I have heard, someone who knows better please confirm!!, that a proper diagnosis for "low fluid" needs to be done over two u/s. So if the one comes up "low" get into bed, drink a ton of water, rest and see if it doesn't go up in a day or two. Most folks I know have had their levels go right up after that.

Gloria Lemay (famed Canadian midwife) says that low amniotic fluid can't be properly diagnosed via ultrasound. She contends that the only true way to detect low amniotic fluid is via palpation, which is primarily a midwifery skill. She has an interesting blog about the biophysical profile on her website.

[MegBoz]

Originally Posted by SandraS

But it IS that easy.

There were a lot of things I simply said "no" to, and I love my doctor. I'm not sure why it's believed that every time one wants to say no to a procedure the doc gets defensive and it becomes a fight. It's not so.

No, that's not what I said. Not at all. Not in the least. I said the reason I don't advocate retaining the services of a Health Care Provider you frequently disagree with:

1. You MAY actually need medical help! If that happens, do you trust the HCP to do the right thing?
2. (i.e. the doc may TELL YOU you need what they think you need, such as induction, because it's what they personally want to do! How are you to know the difference?!? Because yes, sometimes induction really IS medically necessary.)
3. I think most women don't really want to HAVE to say "no" over & over again during labor, birth, and postpartum (just annoying.)
4. The doc may do things without even telling you, let alone awaiting your permission (happens All.The.Time.)
5. What if you are unable to advocate for yourself to continue saying no because you're physically just too exhausted from laboring that you cave and give in? (Birthing tends to be draining on women, mentally & emotionally as well as physically.)

Is that clear? I can try to describe it another way....

Again, NONE of the reasons listed out above have anythign to do with the doctor arguing with you when you DO say "no." Is that clear?

Originally Posted by SandraS

My doc says - you want me to induce so you have the baby for the tax deduction this year? I say nope. She said okey dokey.

Where was the battle?

Right.....
But that was YOUR experience. I'm glad you had that experience. That's great. I'm glad your doc was so respectful & reasonable. But... that's your experience and all too often, that is not the case. That's the point I'm trying to make here - all too often, that is not the case.

Originally Posted by SandraS

And yes, there is no question whatsoever that YOU are in charge when you are in the doctor's office. That absolutely is not debatable. A doctor won't even debate that.

I've said this to you before and I'll say it again, please read some books such as "Pushed" by Jennifer Block and "Born in the USA" by Dr. Marsden Wagner in addition to reading birth stories. This isn't just my personal opinon here... it's been documented extensively in numerous sources. It's not my personal paranoia.

This is simply not true. Perhaps the majority of doctors "would not debate that you [patient] are in charge" but there ARE many MANY doctors who think they are in charge! Many don't respect a patient's autonomy - presenting what they are about to do as if there are no options or bullying them into what the doc wants. But worse, many don't even INFORM patients that they are about to perform a procedure before they move forward with it (amniotomy being a common example.)

Heck, there are even many PATIENTS who think the Doc is in charge! How often do we hear of women saying, "My doc will let me go to 41W then he induces." ... we've all heard things like that before. So you really mean to tell me all docs and all patients alike think that "it is not debatable that the patient is the one in charge?" Really?

[SandraS]

Fine.

I try to express to women on here, again and again and again, that doctors are not all the devil. That there are more great doctors than bad doctors. That just because one wants an OB doesn't mean they're setting themselves up for a period of interventions and hell the entire time.

Women never talk as much about their great experiences with doctors and hospitals as they do their horrible ones (the old adage that you tell 10 people about a bad visit to a restaurant but only tell 2 people about a good one). So yeah, more people hear about how terrible their (rare) doc was.

I try. I try to tell women that doctors can be great, doctors can be supportive, they absolutely unquestionably are out there, but I just get beat up at every turn with people who want to say that their aren't. Good doctors and good hospitals are much more abudant than bad ones. Having a hospital birth can be intervention free and lovely. Doctors will follow a patient's wishes. Maybe I need to write a book about that so that there's a counterpart to the negative books. Even though I would've loved to have had home births, I can't complain about my OB and my hospital.

And there's millions and millions of women out there who say the same thing. I just wish we could all pass on more positive messages here rather than focusing on the (rare) negatives.

Outta this thread now.

[purplepaperclip]

Originally Posted by SandraS

Fine.

I try to express to women on here, again and again and again, that doctors are not all the devil. That there are more great doctors than bad doctors. That just because one wants an OB doesn't mean they're setting themselves up for a period of interventions and hell the entire time.

Women never talk as much about their great experiences with doctors and hospitals as they do their horrible ones (the old adage that you tell 10 people about a bad visit to a restaurant but only tell 2 people about a good one). So yeah, more people hear about how terrible their (rare) doc was.

I try. I try to tell women that doctors can be great, doctors can be supportive, they absolutely unquestionably are out there, but I just get beat up at every turn with people who want to say that their aren't. Good doctors and good hospitals are much more abudant than bad ones. Having a hospital birth can be intervention free and lovely. Doctors will follow a patient's wishes. Maybe I need to write a book about that so that there's a counterpart to the negative books. Even though I would've loved to have had home births, I can't complain about my OB and my hospital.

And there's millions and millions of women out there who say the same thing. I just wish we could all pass on more positive messages here rather than focusing on the (rare) negatives.

Outta this thread now.

Well said! I am one of the ones who have had a kick ass intervention free hospital experience! I totally try to pass that info on because it does seem that all you hear about are the horrible experiences. Good ones can be had and there are supportive, amazing OBs out there.

[MegBoz]

Originally Posted by SandraS

I try to express to women on here, again and again and again, that doctors are not all the devil. That there are more great doctors than bad doctors. That just because one wants an OB doesn't mean they're setting themselves up for a period of interventions and hell the entire time.

Good point & you're right - there are fabulous OBs out there - just like there are awful MWs.

BUT... I think the important takeaway here is be informed! Ask questions! Yes, there are many horror stories so you can't blindly trust your HCP! & if you find that you are having to say "no" to lots of anti-evidenced based stuff your OB wants to do (such as induction for reaching 41W), well, maybe that is a red flag. Maybe instead of "Just say no" it might be better to get outta there & find another HCP (if there are numerous red flags.)

The other issue I have here is that I'm NOT advising people to be cautious because I had a bad experience. It wouldn't make sense to caution women against using the services of all OBs because I personally had a bad experience with one OB ya know?

But my advice for caution is based on facts & stats!

Originally Posted by SandraS

Good doctors and good hospitals are much more abudant than bad ones. Having a hospital birth can be intervention free and lovely.

Well, tecnically, having an intervention free hospital birth really is less likely than having interventions. That's just the facts again.
When you add up CS, induction, augmentation & instrumental deliveries, natural birth is in the minority in America today. (& that's not even counting epidurals! Epidural rates in many hospitals are in the high majority - 80+%!)

Again, if 10% of docs were doing awful things, I wouldn't pound the point into the ground... But the CS rate is near 33%, induction + augmentation makes up like another 30% or so. (I forget exactly, but I remember reading in "Born in the USA" that it WAS over 50% when those were totalled. Dr. Wagner made a funny point like "What has happened to the uteruses of American women that they don't functioin properly & must be flogged into shape with drugs?")

& I wouldn't worry about everyone thinking OBs & hospitals are evil. There are PLENTY of books that tell women to "trust your HCP" unquestioningly. While I have no stats, I would venture to guess the majority of books on PG & birth fall into that category. & I base my guess on the fact most Americans believe this. (As I mentioned before, we've all heard sentences such as "This doc will let you go to 41W." - it doesn't even occur to people that then can 'say no'.

[womenswisdom]

Originally Posted by Zumbi

Yikes I'm scared about this also. I have some awesome midwives and am doing a drug free homebirth....but they told me that in New Mexico (at least where I am close to the Mexico border) it is actually illegal to give birth outside of a hospital past 42 weeks. I really don't want to go to a hospital and I definitely really don't want to be induced. My mom was always late with her 3 kids - into the 42nd week and sometimes 43rd week. We were all fine. Since she was always late and my periods are just like hers - irregular and longer than 28 days I think this may happen to me. How can I delay or cause the baby to come naturally at home? If I refuse induction then I'm told they can arrest me.

Did your midwives tell you this? I would double-check that for sure. No one can be forced to submit to any medical procedure in the absence of a court order. And good luck getting one for an induction. It very well may be illegal for them to attend your birth past 42 weeks if that is a restriction on practice in their state, but it most definitely is not a criminal act for you to refuse induction. Also, you might want to discuss your "guess date" with your midwives, as a cycle longer than 28 days should be taken into consideration when determining your due date and it should be adjusted accordingly.

[Mirrormonkey]

I am pregnant with my second, I am using a different dr this time around. With my first he induced me ON MY DUE DATE! Apparently I did not know when I got pregnant... I am only 9 weeks along so far, haven't even met my new dr and am already panicking.

Just had to share, this thread is making me stress.

[pinksprklybarefoot]

Originally Posted by womenswisdom

It very well may be illegal for them to attend your birth past 42 weeks if that is a restriction on practice in their state, but it most definitely is not a criminal act for you to refuse induction.

I would guess that this is the case. I can't imagine some sort of "mandatory induction" law being passed. Although I've been surprised before.

[Turquesa]

Originally Posted by SandraS

My doc says - you want me to induce so you have the baby for the tax deduction this year?

That's a new one...

[SandraS]

Originally Posted by Turquesa

That's a new one...

My due date was January 1st, she figured I'd go early (like I did with two of my other ones), but come December 26, still no baby...

I had her on my due date - the first baby of the new year... and no, they don't give you a year's worth of diapers like in the movies... LOL!

[cappuccinosmom]

I have had three hospital births. the first I didn't know I could say "NO" to anything.

The second and third births it was "No.No.No.No.No...." endlessly for the 16 days they went past 40 weeks. My midwives were great about it. They had concerns but didn't push hard. Their backups, who I had to see past 41 weeks were snarky and snotty and ugly about it. But they couldn't make me induce, and couldn't make me schedule a section.

[Kelly1101]

Originally Posted by SandraS

But it IS that easy.

There were a lot of things I simply said "no" to, and I love my doctor. I'm not sure why it's believed that every time one wants to say no to a procedure the doc gets defensive and it becomes a fight. It's not so.

Do you want prenatal testing? No thanks. Okey dokey. No fights.

My doc says - you want me to induce so you have the baby for the tax deduction this year? I say nope. She said okey dokey.

Where was the battle?

Before labor, she said do you want to be checked for dilation? I said nope. She said cool. In labor, she says, you want me to check you? I said no thanks... she said Okey dokey. No battle.

Every time you make your wishes known it doesn't mean it's going to be a fight. Doctors really do respect patients who know what they want, who come in armed with information. Really.

And yes, there is no question whatsoever that YOU are in charge when you are in the doctor's office. That absolutely is not debatable. A doctor won't even debate that.

Good luck.

This, this, this, this.


The important thing, of course, is that you MUST trust your hcp, whether it's a doctor, midwife, whatever. Yes, it is totally within your rights to refuse any treatment. But it's a good idea to be able to talk to your hcp, tell him/her your concerns, and be able to make informed and comfortable decisions about what you want to consent to, and what you want to refuse. It does you NO good to be paranoid that your doctor is going to force you into things, panicking you into a state of automatic refusal. Because (I know that the odds are against this, and not trying to scare) there is a tiny chance that, if something were to go wrong, you need to know that your doctor wants what is best for you and the baby-- WHILE also being sure that your doctor knows your philosophy on birth and what you want out of it.

I had a "mainstream" OB, but he was aware of my desire to go with minimal intervention and no epidural. Circumstances arose where he suggested augmenting with pitocin-- he didn't force it on me, he didn't bully me-- he asked me and let me decide. Being able to choose is the important thing, no matter what your choice is.

Originally Posted by Mirrormonkey

I am pregnant with my second, I am using a different dr this time around. With my first he induced me ON MY DUE DATE! Apparently I did not know when I got pregnant... I am only 9 weeks along so far, haven't even met my new dr and am already panicking.

Just had to share, this thread is making me stress.

Don't stress. Talk to your new doctor about your past experience and your concerns. If you get a bad vibe, drop him/her and find another. But likely the new doctor will be understanding.

[Mirrormonkey]

In regards to SandraS post about her doctor respecting her saying "no".

You are lucky and sound like you have a great understanding doctor. Where I live there is a doctor shortage and I did not get to choose who I used.

An example of my experience while I was pregnant with my son. I mentioned my wish to not use a vaccuum or forceps in the delivery and that I would rather have a c-section, he said no and that if that is the case he would have to take his fist and shove the baby back into me to avoid using forceps or vaccuum. Most of my requests were met wit the response that I should stop reading so much about pregnancy and child birth and to just go with what he said.

Not suprisingly a few months after my son was born he left family medicine and went into anesthesia...

[ladyg]

Induction

I was with an excellent CNM and OB practice until week 34 with my first. Then it became apparent to me that our philosophies were simply not going to work together and that I was going to cause them problems-- and they me.

I do not demonize them -- I simply found that they would not suit my needs. They felt that with me at 5 ft and my husband over 6'2", and a history of large family babies, that I was not going to be able to carry a larger than 7 1/2 pound baby. I argued that my sister was 9 pounds 10 oz, at 44 weeks and breech and my mom had her in two hours, to no avail. They were adamant that I was going to need induction early and a section.

After my husband and I discussed it, we called several area HB midwives and transferred care. We were very happy with that decision.

My son was born at 5 days post dates (not unusual especially since we were unsure of our dates)- more than two weeks after they were planning to induce, at 22.5 inches and 8 pounds 10 oz, in a 3 hour labor.

Clearly doable.

My point is to not be afraid to call around and see if you can get a better match!

[erin_brycesmom]

I was induced with my first at 42 weeks and 4 days. With my second, I really wanted to avoid induction. I spent the 2 years in between those birth studying post term pregnancy extensively (we're talking hours daily). I changed providers three times (including during the third trimester) when the doctor would start showing his true colors about induction. Even the last group agreed not to push for induction before 42 weeks unless there was a medical indication. I agreed to do the NSTs that they wanted me to do. Well what do you know...a few days before 42 weeks they insisted on an induction even though I just passed an NST/BPP with flying colors. It was not as easy as "just saying no". I said no and I got the dead baby card played BIG TIME. I knew my stuff though so I discussed it with the OB and then asked for evidence to back up what he was saying. He actually brought out an obstetrical text books and showed me a bunch of graphs to try to back up what he was saying. One of the graphs showed that the mortality rate for babies born at 42 weeks was just as high as babies born at 22 weeks. Turns out he was actually misrepresnting the data but he was very good at doing so. I wasn't giving in so they told me I'd have to sign an Against Medical Advice waiver. It stated that I had been informed that I was putting my baby's at risk for death by not agreeing to the induction. I went ahead and signed it. I walked away but I definitely felt shaken. I started to doubt myself briefly. I can totally see why so many women give in to their doctors. If I hadn't done so much research, I know I would have given in too.

I ended up having my baby on my own right at 42 weeks. It was a really wonderful natural hospital birth. I just had my third baby almost 4 weeks ago and this time I had a homebirth. It was so nice not to have to fight, not to have to go through so much all along the way to avoid induction. I had this baby at 41 weeks and 2 days...my first to be born before 42 weeks! I think being able to stay relaxed and stress free did make things progress sooner. If there is another provider you can switch to that would respect your wishes on letting your baby come on his/her own then I would definitely switch asap.

[MegBoz]

Originally Posted by ladyg

My point is to not be afraid to call around and see if you can get a better match!

& my point has been that you need to call arond to see if you can get a better match (IF you find yourself having to 'say no' often.)
Look around & try to find the best match, instead of 'just saying no.'