Needing some reassurance - Happy Update!

[AutumnAir]

I'm 43+1 weeks pregnant today. DD was born at 43+1 weeks, so really I shouldn't be shocked to find myself here. I did prepare a bit, by fudging my dates, so that my 'official' date is a week behind. But, honestly, I really believed that though this baby might come 'late' it would at least come a little earlier than my first...

I've already had two monitoring sessions at the hospital - everything checks out just fine; baby's heartrate, fluid levels, etc. They are tentatively supporting me in my homebirth plans as long as everything stays okay, but have also booked me in for an induction next Friday morning, as they won't support expectant management beyond 43 weeks maximum.

My cervix (checked by me) is still very posterior and not very dilated or effaced as far as I can tell. I've been attempting to do membrane sweeps on myself a few times a day for the last week or so to no avail, obviously. I've also tried every single method of natural induction you can think of, many many times over.

Logically, I feel like I'm making the right decision to continue to wait. I have a family history of long gestation, a previous long but healthy pregnancy which finally ended in spontaneous labour. I've done loads of research on the risks and benefits of induction vs. expectant management and feel that while baby is still healthy and passing NSTs well, moving well etc. there are more risks to induction.

I also *really* want to have a healing homebirth experience this time. This will be my last baby, and we had an extremely traumatic hospital transfer last time. I desperately want things to go 'right' this time around.

But emotionally I'm feeling really low and weak right now. I just feel that everyone thinks I'm utterly crazy - like last time - even though I warned them all that this baby was likely to come late too. I'm even worried that I'll never have this baby - which of course is nuts.

Today I decided that the best thing to do was simply to accept that I'm not going to go into spontaneous labour, and that I may as well just accept that I'll have to go in to be induced and end up with another traumatic birth, or likely even a C-section. That takes the pressure off in a way - I don't have to desperately keep trying to go into labour, and I don't have to spend every day wondering, waiting and hoping, only to be disappointed every single time. But it's also made me feel really depressed...

TBH - I don't really know what I'm looking for here. Reassurance. Hugs. Just to get it out there. BTDT stories. Gimme whatever you've got.

[tireesix]

If t gives you hope, my last two babies my cervix was always high and posterior (I seemed to bounce, sometime was low and more forward then a couple of days later I would be back high and posterior) and then wham, went into labour........... My Second baby I was just bit under where you are now, about 43 weeks and baby number 3 I was 40 weeks but it all happened after a very difficult membrane sweep (I know lots of people don't like them but I was really suffering with pain from fibro and EDS and I didn't want to end up resorting to an induction).

Any help????

[AutumnAir]

Originally Posted by tireesix

If t gives you hope, my last two babies my cervix was always high and posterior (I seemed to bounce, sometime was low and more forward then a couple of days later I would be back high and posterior) and then wham, went into labour........... My Second baby I was just bit under where you are now, about 43 weeks and baby number 3 I was 40 weeks but it all happened after a very difficult membrane sweep (I know lots of people don't like them but I was really suffering with pain from fibro and EDS and I didn't want to end up resorting to an induction).

Any help????

Yes, thanks. I know the day before I went into labour with DD my cervix was still high, posterior and completely closed, so it obviously doesn't mean much in terms of my body either... Good to know you 'bounced' too - I checked myself a couple of days ago and was much thinner and stretchier than I had been. Then the next day it was back to the way it had been for weeks before that - it was just really discouraging to feel that I was going backwards.

[MsBlack]

: imagine yourself surrounded by all the love and wisdom, patience and trust of women throughout time, and all over the world...no, REALLY, take a moment, close your eyes, breathe deep, and feel us there with you. Repeat as often as necessary!

thinking of you and how brave you are, and how that courage serves you, your family, and US, too! You are an inspiration!

You will have this baby...you really will. Try to let go, any moment that you can, and remind yourself that you really will have this baby...much sooner now, than 5mos ago, 2wks ago, or even yesterday!

Hang in there mama...you can and will do this. Baby will be in your arms....love on you, your mate and your baby every second!

[triscuitsmom]

Originally Posted by MsBlack

: imagine yourself surrounded by all the love and wisdom, patience and trust of women throughout time, and all over the world...no, REALLY, take a moment, close your eyes, breathe deep, and feel us there with you. Repeat as often as necessary!

thinking of you and how brave you are, and how that courage serves you, your family, and US, too! You are an inspiration!

You will have this baby...you really will. Try to let go, any moment that you can, and remind yourself that you really will have this baby...much sooner now, than 5mos ago, 2wks ago, or even yesterday!

Hang in there mama...you can and will do this. Baby will be in your arms....love on you, your mate and your baby every second!

Yes this!

Many many many to you Mama. You've been in my thoughts a lot lately. I was a 43+2 Mama with my first. In fact today four years ago I was 43 weeks with him. His birthday is Monday. I remember those days and hours and weeks well.

FWIW my cervix was doing nothing at all productive when my labour started with him. Same with my second. It takes me for.ever to get to 4 or 5cm and then baby is in my arms shortly after (like 15 minutes after with #2 ). My HCP don't tend to believe me when I say it's time because the signs all point to not. (I think my midwife will believe me this time though because she was at DS2 birth lol)

I am sending you positive energy, birthy vibes, and easy labour vibes. Many many good thoughts from me to you. I remember, and I know the challenge that is being a 43 week Mama in a culture that doesn't at all seem to know what to do with 43 week Mamas.

Much peace and love to you and your sweet baby.

[AutumnAir]

Okay, so I'm still here. Now 43 + 4 weeks. Have another monitoring session at the hospital tomorrow, and planning to meet with the head MW to discuss my options.

Basically, for whatever reason, it doesn't look like I'm going to go into labour any time soon - and I'm starting to wonder if there might be a reason for that.

They have scheduled me in for an induction first thing Friday morning. Originally I was planning to ask tomorrow if I could at least have another monitoring session before that, so I could make a final fully informed decision - i.e. if all was still okay with baby that I might wait over the weekend, giving myself an extra few days.

But thinking it over during the last few days I've come to the realisation that I am absolutely terrified of induction. I was a victim of birth rape last time after transferring to hospital in a very anti-homebirth country, and I was also raped as a teenager - both of which mean that I have specific issues around sexuality, birth and bodily autonomy. Having an induction means basically ceding any 'rights' I might have. They will require continuous monitoring. I will not be allowed to move, use a tub or shower or even a birth ball. I will be forced to lie on a bed, strapped down, with people sticking their hands into me every hour. If I get to push I'll be doing so in stirrups. I am having a panic attack just thinking about it.

Plus, I'm too well-educated about birth. I know full-well how all of these 'required' things are far more likely to do harm than good, even in an induction scenario.

And the fact that I have an unfavourable cervix, baby's nowhere near engaged, I had a previously malpositioned baby with a very difficult labour - add in the fear inhibition, the physical obstacles, the fact that no natural induction techniques have done anything and that my body doesn't respond particularly well to medication, and I would estimate my chances of ending up with a C-section at something like 90%.

So, the way I see it, my choice is either; 1) go in, be induced, have a hard difficult long labour, be 'forced' to do so many things I don't want to that it completely breaks my spirit, and finally after a couple of days almost inevitably end up with a C-section and quite likely an infection after all the interventions. I would be starting my parenting journey at an all time low, and I'm not sure I could recover mentally or physically from there. 2) Refuse an induction and insist that if they truly believe that baby needs to come out now they will have to go straight to a C-section. (I'm not sure how well this will be received - one of the things I need to talk to the head MW about).

I hate that I'm in this position. I hate both of those choices, but ultimately think that I might have a chance of recovering without too many psychological scars from a straight C-section, but I'm almost certain I would be completely broken by the induction experience. I'm already starting to resent my poor baby for putting me into this situation, and I fear that I wouldn't be able to parent it properly (or at all) if I had another very traumatic birth.

Thoughts? Suggestions? Hugs? Anything welcome.

[GoBecGo]

I'm sorry you're in this position.

Is the baby malpositioned? There are so many things which are mysterious to us before our babies are born. My last labour was stop start, weird and in some ways scary (if i used nipple stim to bring things on, which i did a few times, my uterus went hard for up to 3 minutes and the baby stopped moving) - DD2 was born with a true knot and a healthy but weird placenta (heart-shaped, velamentous marginal insertion). Luckily she got herself here safely. My MW was telling me about a woman she once had who they thought was having twins - no u/s to confirm as mama preferred not, but two backs seemed palpable and even 2 heartbeats seemed audible. Mama got to 43 weeks and eventually went in for monitoring and a u/s it turned out to be a very large frank breech girl, jammed in a position which meant she couldn't engage. They went straight to c/s.

In your position (as someone who endured 7 years of SA as a child and a few months of an abusive relationship as a teen, but thankfully was lucky enough to avoid birthrape) i would go to a cs rather than induce. Unless i had a VERY favourable cervix (i.e. for ME it would need to be : i am dilated to 2 or 3, baby is at zero or lower and in a good position, NOTHING abnormal had been found during monitoring and i was very trusting and close with my doctor to even consider induction) i would go to a cs at 43 or 44 weeks.

If you KNOW you cannot bear induction then also know you need not consider it. Do you feel you will have "given up" if you go for a cs? Don't allow the guilt inherently tied up in rape to creep into your choices here. Every single one of us makes the best decision our situations and realities allow. If you feel cs is the best choice for you then it almost certainly is.

[Megan73]

Originally Posted by AutumnAir

Having an induction means basically ceding any 'rights' I might have. They will require continuous monitoring. I will not be allowed to move, use a tub or shower or even a birth ball. I will be forced to lie on a bed, strapped down, with people sticking their hands into me every hour. If I get to push I'll be doing so in stirrups. I am having a panic attack just thinking about it.

Only you can decide what's right for you but I just wanted to ask, are you sure this is what you'll be facing if you do induce?
I consented to induction at 38w because my previous pregnancy ended in stillbirth at term. But I wasn't strapped down (they had telemetry units), I could have used the tub or birth ball if I'd wanted and I had a total of one vaginal exam. The hospital had squatting bars and the staff encouraged me to push in any position I wanted.
Henci Goer has a great fact sheet on reducing the risk of induction and my reading of it is that induction dramatically increases the risk of section only in women who haven't had a vaginal birth before.
In my case, we started with cervadil and moved on to pitocin and I refused AROM until I was in active labor because I didn't want to be on the clock.
I won't lie. My induction WAS grueling, there were definitely times I had to be assertive and it was emotionally difficult having lost a baby before.
But I personally felt like I remained in control of my induction.

[rightkindofme]

You are in a hard spot. In your position I don't think I could submit to an induction, but I'm not you. I don't think I have any good advice, but I hear you and see your struggle and I want to validate how insanely hard it is.

[MyFullHouse]

Ultimately, you know what's best for you. Nobody's opinions on c-section vs. induction are going to change that.

In my layperson's opinion, I do think you're picturing a worst-case scenario that is not as likely as you think. Which still isn't to say it's right for you, but you may want to investigate the reality a bit more.

I'm assuming your previous births were vaginal (?), which betters your odds for success. Personally, none of my 3 inductions involved hourly cervical checks, and I've only used the stirrups once, when I had an epidural. Even when I've had "c"EFM, I've unhooked now and then for bathroom trips and to stretch my legs at the very least. Not that rolling an IV pole around was pleasant!

FWIW, I even spent a couple hours in the tub with my last induction, which was a pleasant surprise.

Again, you have to go with what you're most comfortable with. But maybe try to find out how accurate a comparison you're really making.

[MegBoz]

Originally Posted by MsBlack

imagine yourself surrounded by all the love and wisdom, patience and trust of women throughout time, and all over the world...no, REALLY, take a moment, close your eyes, breathe deep, and feel us there with you. Repeat as often as necessary!

LOVE THIS! What a fantastic image. & so true in a way.

I think I'll use this the next time I'm feeling depressed & bitter about how sick I've been this 1st trimester. That's awesome. It's beautiful & uplifting.

AutumnAir,

I totally understand how you'd opt for the CS over the induction experience.

If you do feel induction is warranted, is there any way you could go to another hospital? ANYWHERE else more NCB-friendly? Even if it means driving hours away?

While you may have to make some compromises (like having an IV for your pitocin, obviously, I dont' think it's possible to decline an IV in an induction & I suppose that would also mean you couldn't labor in a tub) there's NO REASON you should be forced to endure other crap like hourly VEs & pushing in stirrups!!!

Again, if you know it will be that bad, then, as GoBecGo wrote, "If you feel cs is the best choice for you then it almost certainly is."

But if there's any way to try induction at a place that is not so, well, awful, then maybe it's worth trying.

I'd also personally try to lean on my logic, reason & research & try to weigh that most heavily in my mind & just find methods to cope with my anxiety & fear - rather than having my anxiety & fear drive my decision making. If YKWIM.

[jeminijad]

I am very sorry that you face this.

But you should know that many inductions do go "as planned." The majority, in fact, if you define majority as more than half. The interventions, while often not evidence based, are not "far more likely" to do harm than good. Some of them are kind of a wash, IME.

I guess my point is that while induction not as good as spontaneous labor, it is villified here to an unrealistic extent, and many women have relatively uncomplicated induced labors.

[ParisApril]

With my first pregnancy at 42+4 I had my water broken at the hospital and then went home to labor and had my baby girl there with my family and midwives. Is this an option?

[bella99]

A friend of mine was induced at 39 weeks for IUGR. All she needed was ther cervadil and then birthed her daughter with no pain meds or an IV.

Some inductions do go very smoothly.

[alegna]

What all have you tried? Ds was 43 weeks 5 days and I think vaginal EPO and a heck of a good massage concentrating on acupressure points helped kick him out.

good luck!

-Angela

[NewMoonMum]

Just wanted to say I don't think AT ALL you are being silly or anything like that.
I also had to be induced early with DS, and ended up having a pretty traumatic labor and birth-though I did manage to deliver vaginally.
But it messed me up, and I've come apart a few times during this pregnancy over the possibility of facing another induction.
I suppose you need to try to weigh the benefits you feel you could get from one procedure over the other, against what you feel the risks are-for both procedures.
And you are in no way odd for hoping like mad to go into spontaneous labor!!
It's an awful position to be in, and I hope you can find some peace of mind whatever your decision.
Most of all I hope you go into labor in the next few days!!!

[triscuitsmom]

I'm pretty sure to be fair that the OP knows that many many inductions do go smoothly, and "as planned" (being no cesarean, ending in birth of a live baby vaginally). She has stated why she feels that is less likely to be the case for her, and also stated some pretty big obstacles at the hospital that aside from induction are not exactly conducive to a good birthing experience.

OP I have a similar history as you with respect to rape and birth rape. The difference between you and I is that my body does seem to react well to induction, however, my being in a position of having to make that choice (to be in the hospital again) is terrifying to me.

In your shoes, with this pregnancy, with my own personal and obstetrical history, I would likely be induced with cervadil. However, that is only because it has worked for me once before. If I had reason to believe it wouldn't, or likely wouldn't, plus with the added stress of worrying about baby's well being, and wanting to avoid another birth rape, I would go for the cesarean. I'm about an anti-"elective" cesareans for myself as I could be, but my mental health is more important than a birth. My mental health would be worth protecting myself, as much as I could, from the deep lasting trauma that I know birth rape can be.

I understand that many inductions end in a "successful" vaginal birth. I also understand that there are many factors that go into those statistics on both sides. Further... I think deciding to have a cesarean for the sake of your mental health *is* a valid medical reason. We aren't talking about taking this baby at 36 weeks for vanity. We are talking about real health consequences to your mental health that could affect you and your baby for a long time. There isn't a right or wrong answer here.

I wish you peace Mama. I am behind you 100% whatever your choice is, and I cannot wait to hear about your sweet baby's arrival into this world. You are in my thoughts.

[AutumnAir]

Thanks everyone for weighing in - it does help a bit.

MsBlack - thank you for your lovely words. I'm not completely giving up, even though it might sound like it, but I need at this point to consider all the possible options. I hope that doesn't count as negative thinking, but after months and months of positive visualisations etc. and not even allowing myself to contemplate anything but a successful healthy homebirth, I don't think I'm being a Debbie Downer to face up to the lack of support for postdates pregnancies and look at what kind of options I have. (Not saying at all that you were saying I was being negative!!)

GoBecGo - I'm sorry for all that you have endured. I don't know if baby is in a bad position, as such, but it still hasn't engaged, and moves around quite a bit. This is what DD did too, and when labour started she managed to get herself jammed in an OP asynclitic position. I know my pelvis is quite tilted (one leg shorter than the other) despite spending hundreds of pounds on chiro and osteo work during the pregnancy, so I'm wary of that happening again. I have quite a few positions and techniques that I can use this time around if it happens again (working with my doula) but they pretty much all depend on my being able to move around quite a bit in labour. Thanks for your support.

Megan73 - I'm meeting with the head MW today to see exactly what he has to say about induction policies and procedures, but I'm fairly sure that what I've described is pretty accurate. Here hospital births are divided between MLUs (Midwife Led Units) where the 'low risk' women go - they have quite a bit of freedom, can use pools, birth balls, different pushing positions, etc. The other births take place in the Delivery Suite under the OBs. This includes inductions. They don't even have birth pools in the DS, I've heard a couple of women from my homebirth group who ended up in there saying that they were basically confined to the bed for the duration of labour - no telemetry and they just don't 'do' intermittent monitoring with doppler. And they like to have a good view of things during pushing - so stirrups are pretty much a given too. If I were to be induced, your plan of attack would be pretty much what I would choose too - according to Henci Goer the use of cervadil, even in women with fairly high Bishop's scores, does improve outcomes. And I definitely wouldn't want my water broken first thing. But I'm just not sure if I'm mentally capable of fighting constantly throughout my labour.

rightkindofme - It *is* insanely hard. Thank you!

MyFullHouse - I will be talking with the head MW today to see exactly about induction policies and what I can and can't avoid, but having talked to some women who've been through it I'm fairly sure that the picture I have is reasonably accurate.

MegBoz - There isn't really anywhere else that would be different. They all pretty much have the same policies here, since they're all public hospitals run by the NHS (and no we can't afford a private hospital - but they're even more interventionist anyway!) At least at this hospital I've made contact with the head MW, he's pretty supportive of me, and may be an ally in negotiating if I need him. I have been strongly 'leaning on my logic, reason and research' (love it!) but I'm now finding myself coming to my own grey area. With my family history I was prepared to wait till 44 weeks, but I'm not sure how much further past that I'm happy with waiting. I'm also not really comfortable having a UC after 44 weeks either, which is what I'd essentially be looking at, since they won't support homebirth after 43 weeks max. (44 by my count). I guess I can always just wait until I go into labour, eventually, and then go to the hospital, but I wouldn't be able to use the MLU then either, as I'd be 'high risk'...

jeminijad & bella99 - Yes, I know many inductions go very smoothly, but I have quite a few reasons to believe that it wouldn't for me. I might be wrong, but I'm not sure I'm prepared to take that risk. If I could know for sure that it would go 'smoothly' then I'd definitely go for induction over C/s. There's something awful about agreeing in cold blood to allow someone to cut you open to take your baby out for pretty arbitrary reasons...

ParisApril - I really doubt that would be an option, but it's certainly one idea I'll bring up today. I was also wondering if they might just give me cervadil and let me go home... I think I know the answers, but we'll see.

alegna - I think it would be faster to list what I haven't tried!! I've been taking EPO orally and vaginally since about 35 weeks. RRL tea all through pregnancy and since about 35 weeks I've been drinking a 1 litre pot every day, made up with about 3 or 4 times the amount recommended. Lots of walking, stairs, sex. Eating pineapples and curry. Even a few enemas. Nipple stimulation for the last couple of weeks - about an hour a day, sometimes more. Bouncing and doing fast circles on birth ball. Inversions and lots of OFP. 3 acupuncture sessions. A reflexology induction session. Chiro and osteo. Acupressure - my acupressure points have permanent large bruises all around them from pressing them so hard every single day. I've also been doing DIY stretch and sweeps every day for the last couple of weeks. No castor oil or herbs because I can't get them here.

NewMoonMum - sorry you had a bad experience Thanks for the support and for saying I'm not crazy!!

triscutsmom - Thank you!! Your post was so understanding and supportive it made me cry! I think you really get where I'm coming from. I'm feeling really guilty at thinking about robbing my baby of even the chance of a vaginal birth, but I also know that I won't be able to cope at all as a parent to either of my kids if I get to the same mental place as last time. I was hanging on by a mere thread for DD's first year, and came very close to suicide a number of times. (I've never admitted that before...) I want to be a good mum to my kids and I'm trying desperately to choose the least bad option that will help me to do that.

Again, thanks everyone for weighing in. We're off to the hospital for monitoring now, so send me good vibes!

[MsBlack]

I hope all went well today with the monitoring session.

Clearly, you are an unusually unusual case in a variety of ways...and I hear how tough this has been. With birth, we must be pro-active and also surrender to forces larger than ourselves...we benefit from independent thinking/choosing, yet still must live in the cultural milieu that surrounds us...I can really see how it looks as if csec may be preferable to induction, for a lot of reasons!

Maybe if you don't start labor on your own by your deadline, you can try induction without taking it out to the nth degree, KWIM? You can make a plan where you and baby get to try labor--and you both get benefits of laboring--but you let your HCPs know in advance that you reserve the right to call for a cesarian at any point. I know that women (and babies) typically have great endurance for labor...and I also know that a long-drawn-out labor followed by csec can make the whole thing more of an ordeal for both, and for a longer time, post-surgery. My sister had 2 cesarians--one for FTP, after 24hrs labor. The other was planned, for breech, and took place prior to labor's onset. She marvelled at how much easier recovery was the 2nd time--and knew it was because she didn't start by being so exhausted prior to the surgery.

When I called for my own csec during labor with my last baby, I had this in mind. Not that I was thinking about it actively--it was just a piece of data in the files, as it were. I labored for 17hrs, starting with only a couple hours sleep when labor began. My doc said that we could wait longer--but given baby's very troubling signs along with my wish to have the surgery BEFORE I was all done in--well, we went to OR sooner rather than later. For a few reasons clarified upon surgery, it was just as well. And then I knew that choosing surgery sooner instead of taking things out to the nth degree of 'trying for a natural birth', not only spared my baby nearly inevitable problems at birth (very likely necessitating a NICU stay)--but also, it left me in reasonably good shape to handle surgery, and recover from it. And so my baby did great, never had to leave my arms, and we were home in 48hrs with a speedy recovery.

all the best for you both....know that you are supported in making your own wisest decisions!

[HappyHappyMommy]

Thinking of you and sending support

AutumnAir. It sounds like you are being thoughtful about situation and your options. I truly believe in your strength and spirit and have confidence that you will continue to make the best choices possible for you. Each of our paths are unique and we all have different things we encounter on our paths.

I'm also going to send you a PM, but as there may be others reading this for support, I wanted to share a little of where I'm coming from. I had some complications in my pregnancy...some of which were rare (one affects less than 1 in 300 women and another affects less than 8% of women). I also have some past history that affected me emotionally with regards to birth.

While I recognize that some of these complications are rare and I am careful to say so when people ask about my experiences, I do feel like it's important to acknowledge and speak of them. I felt very lonely at times during my pregnancy and afterwards when I would hear (well-meaning, I'm sure!) comments like "Well, that's really unlikely to happen, so there's no need to worry about it." or "Well, that hardly ever happens, so it's not really something to think about." or "If you just think positively, it will all be fine." I think it's important to be aware of statistics and likelihoods and use that in your planning and thinking, but also to be aware of and honor your own experiences and factor that into figuring out what's best for you.

I also hope that, as communities of women, we can grow towards being more understanding and inclusive of all women's experiences, not just those that follow the typical path or have happy outcomes. I tend to be a fairly private person, so I didn't share a lot of details of my challenges with family or friends. Again, I found myself lonely at times especially when people would say things like "It's really too bad you had an induction. I'm sure your doctor said was medically necessary, but that's probably just because she wanted your birth to happen on her schedule." or "You would had a better birth if you just said no to the induction and did X and Y and Z." or "I'm glad your baby is ok, but I try to give my baby a healthier start and avoid any interventions. They are so unnecessary."

I'm so sorry for your experiences in the past and I hope that your appointment today went well and that your birth, however it unfolds, feels joyous, safe, and good for you. I celebrate you and your strength and wisdom!