to induce or not to induce...

[e(Lisa)beth]

I'm hoping you ladies can give me some advice.

I had thought that my doctor would not let me go past 41 weeks before inducing labor. That would be July 3. (My due date is this Friday, 6/26.) This baby has made absolutely no signs that she wants to join the real world, so I had it fairly well fixed in my head that July 3 was going to be her birthday. I wasn't thrilled about the idea of induction, and of course I hoped that she would come on her own before that time, but I was pretty much resigned to the possibility.

I saw my doctor yesterday and I learned that she will actually let me go to 42 weeks before induction, which would be July 10. At first I was thrilled. More time for her to come on her own, yay! But the more I think about it, the more I'm inclined to schedule an induction on July 3 anyway. I've been pretty committed to birthing as naturally as possible and an induction is certainly contrary to that, but there are some fairly compelling reasons to do it anyway.

Here are the pros and cons that I have thought of, please review and let me know what you think, and feel free to add any pros or cons you think of.

PROS:
--My doctor is on call the weekend of the 3rd. We have a great relationship and I trust her completely. If she suggests an intervention of any sort while I'm in the hospital, up to and including a c-section, I will accept her assessment of the situation. Her two partners, on the other hand, are very nice but not as natural-minded as my primary doc, and I don't really trust them to do everything that can be done before jumping on the intervention bandwagon. Having my own doc at the delivery will do a great deal for my peace of mind.
--I have no reason to believe that she's going to come on her own before 42 weeks, which means I would be induced on 7/10 regardless, and my doc isn't on call that weekend.
--The baby is already 9 lbs (plus or minus 1). I realize that the science behind that assessment isn't 100% accurate, but my ultrasounds are done at the high-risk OB's office, and they have a great track record. So if we wait another two weeks we're looking at the possibility of a 10lb baby. My own doc would probably roll with that and stay the natural course, but her partners won't and will whip out the word 'c-section' before very many hours of labor has passed.
--I have already started my maternity leave, and my husband's last day at work is 7/2 (unless the baby shows up before then). Every day that passes before the baby is born is one day less that we can be with her after the birth.
--This one is completely selfish, but I have to admit it: I've had it in my head for weeks that, come hell or high water, I was going to have my baby on or before the Fourth. The mental adjustment required to accept that that might not happen is proving very difficult.

CONS:
--It's an induction, with all that implies. Increased risk of other inventions, all of that stuff.

Thoughts, comments, suggestions? What would you do?

Thanks!

[Carlin]

Having just gone through a 13 hour long, induced labour, with no other meds, I'd highly recommend avoiding it unless it's absolutely medically necessary. At one point during transition they turned the pit off when baby started having decels, and the difference between those natural contractions and the induced ones was amazing.

Obviously only you can make this decision. s

[apparitions]

I can only share my experience...

I labored for 16 hours before I ended up with a c-section.
My water broke at 8am and my contractions weren't doing diddly squat. The started me on Pitocin and I started to dilate (finally!)... I pushed for an hour and a half and my baby's head never got past my pelvic bone and I ended up in a c-section.

I was like you-- I was soo much more comfortable because I had MY doctor. She wasn't the on call but I'd gone in at 5am-ish that morning (a Wednesday) and she'd checked on me all day and she stayed with me that night. I went in about 9:45pm for the c-section. I was so happy just to have her be the one that was there, even though the on-call was floating around too.

I had an epidural, though. I wasn't originally going to get one but contractions caused gallbladder attacks and between the two I was getting exhausted and hyperventilating, etc... so I got the epidural and then things got better.

If you want your doctor, I'd do the induction. I know how much of a relief that was to me.

[2boyzmama]

Jumping in from Sept DDC (I like to lurk the birthing months!)

I am usually 100% against elective inductions, however, come about 36-37 weeks into my pregnancy, even *I* am crying for one! Heck, I'd take a c-section maybe even Thankfully I have a wonderful husband who reminds me of why I want to do things naturally, and I have friends around me who show me loving support.

For me, it's just an overwhelming feeling of being "done".

The one thing that usually helps to get my mind back in the right place is to remember that there's very likely a REASON that baby hasn't come on her own yet. Maybe you ovulated late and she's just not mature enough. You don't want an baby in NICU-even for a few hours-because you encouraged her to come a week early. The difference between 41 and 42 weeks might be huge for her, but you'll never know unless you let HER pick her due date.

I also am comforted by the fact that there are LOTS of tales of women who go to their dr in the morning only to be told that they won't be going into labor anytime soon, then they have a baby in their arms by that evening. Medicine does not yet fully understand what brings on labor, sometimes there are the subtle signs that suggest it is nearing, other times it just HAPPENS, suddenly, without warning. So although you say there are no signs today, that doesn't guarantee you won't be holding your little one tomorrow. Little comfort, I know, but something to grasp for if you need it come July 4th!

An induction is not the worst thing in the world, even a c-section isn't the worst thing, but you've already stated that you believe in a more natural approach and WANT a more natural approach...maybe spend the next week working on your mental place. Try to get more comfortable with the idea of having a baby after the 3rd. Spend more time talking to the baby. See what you come up with. You might find that you still really want the 3rd, or you might surprise yourself and find that you're okay with waiting a while longer.

There's no overall right or wrong answer here, just a right and wrong for YOU. Just make sure that you're evaluating the choice for YOU with as clear a head as possible. Easily said, I know

[amandaleigh37]

--I have no reason to believe that she's going to come on her own before 42 weeks, which means I would be induced on 7/10 regardless, and my doc isn't on call that weekend.

That's still 15 days away. Most women will deliver before 42 weeks. There's a very good chance she could come before then. Think positive

The baby is already 9 lbs (plus or minus 1).

Those estimates can be off by a lot more than 1 lb... A close friend was made to induce because she had a "huge" baby who ended up weighing < 6 lbs. at birth.

Thoughts, comments, suggestions? What would you do?

I'm just speaking from my own experience here - I was induced with DS and it is no walk in the park... It's pretty terrible, in fact. And not just because the contractions on pitocin are hellish, and the risk of other interventions skyrockets, but it's very hard on the baby as well. I really regret that I agreed to it last time.

I totally understand wanting your doctor there, and being ready to meet your baby, and all of that... I get it. But if it were me, I'd avoid it at all costs - unless there was a good medical reason (IMO the baby's estimated size isn't a real reason - women birth 10lb + babies all the time!). JMO.

[herwitsend]

ITA with the others, but, if you decide to do it, make sure your cervix is favorable by finding out your Bishop's Score. A score of 8 or higher increases your chances of having a successful induction. I wouldn't do it otherwise...

[KarlaC]

I've had 2 natural & 1 inducted all without pain meds, I have to say I'd avoid induction if at all possible..the contractions are just ridiculous.

[h@ppy mama]

I had a good experience with induction. The first cervix pill was inserted at 7 am, water broke at 10am. Active labor by 12pm helped with pitocin. I had an epidural in there somewhere which wore off as I was going through transition but I made it through. My daughter was born at 7:14pm after 3 pushes! All in all, it was pretty quick. I feel my body was ready and just needed some help to get going.

BTW, she was my first baby.

[Ianthe]

I would start a natural induction before I did a hospital induction...

[DevaMajka]

I'm totally biased against Pit inductions because I had a horrible horrible experience with it. The whole thing was just one intervention after another, leading to lots of bad stuff at the end (ds was perfectly fine though- that might be the ONLY part that went well!!).

I agree with trying natural methods- I would totally consider a stretch and sweep in your position. There's also Evening Primrose Oil, if your cervix isn't softened yet.

I was just reading something (don't remember where, but I can try to find it again if you want) that said that even though it is commonly thought that 10% of women go to 42w, that when the dates are adjusted to be more accurate that percentage goes down to 2%. So the chance that you won't go into labor on your own by 42w is very slim.

Originally Posted by e(Lisa)beth

PROS:
--My doctor is on call the weekend of the 3rd. We have a great relationship and I trust her completely. If she suggests an intervention of any sort while I'm in the hospital, up to and including a c-section, I will accept her assessment of the situation. Her two partners, on the other hand, are very nice but not as natural-minded as my primary doc, and I don't really trust them to do everything that can be done before jumping on the intervention bandwagon. Having my own doc at the delivery will do a great deal for my peace of mind.

This would be the only thing on your "pro" list that would really affect my decision (if I were in your shoes). I definitely understand wanting someone who you trust isn't going to try to push unecessary interventions. But I'd try some natural induction stuff first! I'd personally even go the castor oil route before Pitocin!!

[lexbeach]

I wouldn't do it an earlier than absolutely necessary. Perhaps it's different at the hospital where you plan to birth, but generally speaking, you don't get to see much of the OB on-call when you're in labor. The nurses will be your labor support. If the OB you like is especially naturally-minded, then I can't imagine she would support you choosing to induce a week ahead of when she'd otherwise recommend it.

I've never been induced, but being induced brings you a lot closer to having a c-section, and I've had two of those. I'd do whatever you can to increase your chances of a natural birth, in which case, medical induction would be off the list.

Your body was made to do this. Your body CAN do this. Your body knows how to go into labor on its own and push a baby out.

My wife is 40 weeks today. Yesterday she had zero signs of approaching labor. Today she lost her mucus plug and has been having contractions every 10 minutes or so for several hours. There's no way to predict what your body will do in the next two weeks.



Lex

[apparitions]

Originally Posted by amandaleigh37

Those estimates can be off by a lot more than 1 lb... A close friend was made to induce because she had a "huge" baby who ended up weighing < 6 lbs. at birth.

I know it doesn't happen often, but I went the other way.

Ultrasound (and my Dr. based off of feeling my belly) estimated 7 and a half to 8 lbs.


Lucas was 9lbs 5oz!

[seafox]

I almost faced induction w/ my birth, luckily went into labor at 41wks 1 day. (baby didn't come tho until 41wks 4days, and that night!)

my bishop's score at 40wks 4days was terrible (I was only 1cm, not effaced at all) so I was told it would most likely end in c-section if I did get induced. As it turns out, I ended up having pitocin during my labor anyway as an augmentation. And I can't say I really noticed it - it brought the contractions closer together and made them more distinct (no mini ones after one) but labor wasn't that different w/ it than not. Even with the pitocin, my contractions slowed down to 5min during pushing too which is odd.

and I was told 9lbs at 41wks 1day, at birth (3 days later) Z weighed 7lb 9oz! Those u/s are pretty off.

[rivkah]

Never had an induction, so I can't weigh in on that. I do want to chime in with another, "you never know when labor will start," though. I've had three babies, all post-term, and my labor (including the first) always starts pretty intense without any signs beforehand.

This time I did opt to have membranes stripped at 41.5 weeks. I went into labor that night. Who knows if that is what did it though.

[jamie79]

I am not for inducing at all. I have been induced 2 times and dont really know any different. however, people I know that have had a natural and induced birth say the inductions are much more painful.

If you go that route, i would say make sure you are progressed somewhat on your own first. I was dilated to 3 and 80% effaced when I was induced with my first and he was a 6 hour labor. Beginning to end. It was not too bad. With my 2nd, I was not as far progressed and the labor was a bit longer.

Every woman and baby and delivery is different, this is just my experience.

jamie
(from late dec 2009/early jan 2010 ddc)

[NewMama2007]

I was induced on my due date because the baby's measurements for her shoulders were past normal - they were concerned about shoulder dislocation or the shoulders getting stuck. In our case, for this baby, it worked out very well - she was 9 lbs 6 ounces, and if she would have been any bigger, the shoulders WOULD have been an issue. I went in at 3 cm dilated, -2 station though, so I had progressed on my own before starting the induction.

[e(Lisa)beth]

Thank you for all your comments, ladies! I have a bit of an update.

I narrowly missed getting an induction on 6/26 after my appointment with the high-risk OB (I go there twice a week for monitoring because I have hypertension). The staff there seemed to think that "but you're 40 weeks today" was reason enough to induce, although they were using two dips in the baby's heart rate as their stated reason. My wonderful regular OB's cooler head prevailed, and as a compromise I went to the hospital for two additional hours of fetal heart monitoring. Everything looked great and I got to home.

But when I went back yesterday, I was so nervous that the possibility of an immediate induction would come up again that my bp was high. I fibbed and told them I had an induction scheduled for Friday and they didn't push taking immediate action. Then I had an appointment with my regular OB (where my bp was absolutely fine because I wasn't nervous anymore!) and we did discuss induction. I told her that I couldn't go back to the high-risk doc anymore because I knew that the nervousness-leading-to-high-bp cycle would occur every time, and I'd end up with an unplanned induction. When all is said and done, if I'm going to have an induction, I'd rather it be on my own terms, you know?

So we decided I'd skip the second high-risk appointment for this week - I'm only able to get away with that because of the holiday - and we scheduled an induction for Tues 7/7 (41 weeks and 4 days), which was the latest we could push it before I would really have to go back to the high-risk doc if I were still pregnant. My primary OB will be on vacation that week so she won't be there, but I ultimately decided it was more important to give the baby as much time to come on her own as I could.

I'm still not thrilled with an induction, but I feel like it's the best decision giving all the various factors at play. Although I'm still really hoping she comes on her own before then - go, baby, go!

[rivkah]

:

Sending labor vibes your way.

[maxwill129]

On a positive note, you KNOW you will be holding your baby on or before 7/7! That being said, I hope you will relax enough to send your body into labor on it's own!

[EmmaJean]

I hope that you go into labor on your own too! But you know if you are induced, it will probably be not a huge deal b/c your body will be so ready!! Hope you're holding your baby soon!