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Let's talk about refusing 42+ inductions

post #1 of 19
Thread Starter 
Unless I go into labor in six more days I will have to transfer from MW to a Dr for a hospital birth (state regs). Realistically, I need to prepare myself mentally for this change of plans.

Sure, anything might happen between now and then but I've tried all the natural methods that I feel comfortable with and I'm tired of "failing," Frankly I just don't have much faith in these anymore and don't want to keep trying and dealing with the disapointment. So anyway, I have one more prenatal with my MW and we will be discussing the logistics of transfering me to a Dr's care. Presumably that Dr will be suggesting an induction. I will be decining the induction unless there is reason to believe that my baby's health will be at risk.

However, I'm not really sure what tests are legit and safe measures of baby's well being and how these results are interpreted.

Realistically, my baby will be at least 8 lbs probably more because my first was almost 9 lbs on her due date. I'm not worried about the size but I'm sure this will come up. Any suggestions for difusing that argument?
post #2 of 19
I don't have a lot of advice about diffusing the situation, but having gone to 42.5 with DD I can tell you what tests they did. Starting at around 41 weeks my midwife started having me come in for Non-stress tests. She was very laid back about this though - it wasn't a panic if the baby was sleeping at the time, etc. I would tell her when the baby moved and we would look to see the corresponding heartrate movement.

At 42 weeks I went in for an u/s which was called a 'fetal assessment'. They rated the health of my baby on a scale of 1 to 10 (she got a 10) based on things like amniotic fluid, responsiveness, etc (I don't know all the factors). At least where I went her weight was not discussed and no one ever mentioned it to me (although my midwife did feel from feeling my belly that this was a larger baby - at least 9lbs at that point). All the docs were surprised to hell when she came out 10lbs 8oz, so I really doubt anyone looked at the u/s for weight. (However, I would be nervous about this anyway)

Those were the only tests we did. I never 'refused' the induction, but the reason I went as long as I did is my midwife did not inform the backup doctors I was 42 weeks unitl I reached 42 weeks, so they couldn't schedule my induction until 42 weeks and 3 days - that bought me more time as I know if she had told them earlier they would have insisted on scheduling ON 42 weeks. We continued trying natural methods, but sadly I came down with a fever/infection at 42 weeks and 2 days and had to transfer for an induction anyway (I would have been induced the next day)

Good luck and I hope that helps somewhat.
post #3 of 19
Wow, I'll be watching this one too.

I have two more days before I get transferred to the doctor. He's such a jerk I don't want him in the same room with me, let alone managing my birth. : But unless I do an unplanned UC and tell them "It just happened too fast", I don't have much of a choice. Our midwife center also won't do births at the center after 42 weeks, though the midwives will come to the hospital.

I'm totally non-confrontational usually. But this situation is bugging the heck out of me. 2 weeks ago, the doc, who I don't know and have only seen once, briefly, and who never even examined me except for 30 seconds gazing at the u/s screen, had the midwives suggest a planned c-section for suspected big baby (over 9 lb). This week he's been hammering the induction idea, in spite of the fact that this baby is just fine (confirmed by 2 nst's and my keeping track of his movements and regular heart rate checks!) and in no danger at all. They put me on the schedule to get Cervadil today, "just in case" I decide to do it, but I told them I absolutely would not be there! They can take a coffee break or something, in my time slot.

No ideas, but thanks for a good place to vent. :LOL :
post #4 of 19

acupuncture induction

I have not heard anyone mention acupuncture as a form of induction. I know that you said you have tried all the natural methods...I don't want to frustrate you with suggesting another. Just that many don't about it and saved me from the drug type inductions 3 times.
post #5 of 19
I don't have anything to add, really, just a note at how pissed off I am that homebirth midwives are having to adhere (or choosing to adhere??) to these ridiculous medical model myths regarding pregnancy and birth.

It just makes me so angry when I see posts like these. Isn't there anyway to refigure your due date? Suddenly "remember" that your LMP was a week after?
post #6 of 19
I'm with panama-Lie like.... and buy yourself and your babe some time,Babies come on their birthday not their due-date.
post #7 of 19
Yep, I would too...if I had been more educated with dd I would have waited. I was induced at almost 42 weeks, it didn't work, and I had a c-sect. Not doing that again! Good luck to you and I hope you have a wonderful birth. Let us know how it goes.
post #8 of 19
With my first child I went 18 days past my due date. Planned a homebirth but ended up in the hospital bc/ I was so late, luckily my midwife was able to deliver the baby there, though. EVERYONE was breathing down my neck to get induced but you know what? they can't Make you do a doggone thing if you don't want to. MW had me and my husband sign a release form saying that we understand the risks that we are taking and that was that. Right after we signed the form she was like, "..and you know I have one woman who has five kids and she is a month late every time!" Now you tell us!

As far as tests go it was U/S and non-stress test every week until ds was born. All I can say it, stay strong and follow your gut and instincts. If you don't want to be induced, don't let them bully you into anything that you don't want to do if you feel that they don't have a valid reason.
post #9 of 19
I wouldn't transfer, and have chosen not to in the past. I have been in your situation 5 times. Its not fun. I hate the stupid law and it really does nothing good for mothers or babies. Your midwife can drop you. If you choose to go through with the transfer and deny any attempts at induction the dr can drop your midwife. If the dr has half a brain he wouldn't, but it is a possibility.

Is there anyway for you to fudge your dates? This is the biggest reason I am not getting an u/s this time. I don't want to know exactly when I am due, I have no wiggle room then.

One time I did see the dr for BPP he said that at 16 days past due he would see me again and have another BPP and proceed from there. But since I was already 4 cm and contracting every 7 mins (and had been for a week : ) that he would most likely just send me to the hospital and break my water. So knowing that, we went ahead and did arom the day we were supposed to transfer, but at home. Baby was born 2 1/2 hours later.

I also had a great dr. My biggest concern is what is the transfer dr like? Is he gonna be pushing for induction after a bpp that shows calcified placenta? Low fluid? I personally would be trying everything at home before I set foot in a drs office. For me I would choose to have my midwife discontinue care legally and just birth uc with her there .

Hopefully your baby will make its appearance before you have to worry about it.

Michelle
post #10 of 19
Thread Starter 
Quote:
Isn't there anyway to refigure your due date? Suddenly "remember" that your LMP was a week after?
My MW have hinted that we aren't totally stuck w/my due date because I wasn't totally sure of my LMP but I did have an US at 14 (?) wks so there's only so much we can wiggle.

Really though, my biggest concern is how best to monitor the baby's safety after 42+ wks. I've been trying to research this a bit and can't find much other than the Henci Goer articles. I'm having a hard time sorting out which tests are BS and which really give important info regarding the baby's well being.
post #11 of 19
well, you could always say that you found your calendar and know the day you conceived! seriously, even at 14 weeks, u/s dates can be a week off.

I prefer NSTs over BPP. It seems with the BPP, there is so much subjective info (too little amniotic fluid, which is normal in late preg, etc). If you do a BPP, drink plenty of water the day and night before the test.

NSTs can be done in your home with your mw. They are a good way to tell if baby is doing fine.
post #12 of 19
Quote:
Originally Posted by natashaccat
My MW have hinted that we aren't totally stuck w/my due date because I wasn't totally sure of my LMP but I did have an US at 14 (?) wks so there's only so much we can wiggle.
I had no clue of how far along I was (I've had very inconsistent periods) and had an US. It was determined that I was at 12w6d but the report said that the margin of error is +/- 7 days. that is 7 full days you could wiggle with.
so technically you could say that even though we think I'm, say, 42 weeks, I could also just be at 41 weeks because of the US's margin of error. but if you say something like that, they might bite you back saying that it might also mean that you're actually 43 weeks and that is an additional reason to induce.

I have not been in your shoes before, but this scenario came up while interviewing one of the MWs (guess why we didn't ebnd up picking her ).
post #13 of 19
Thread Starter 
Quote:
Originally Posted by pamamidwife
well, you could always say that you found your calendar and know the day you conceived! seriously, even at 14 weeks, u/s dates can be a week off.

I prefer NSTs over BPP. It seems with the BPP, there is so much subjective info (too little amniotic fluid, which is normal in late preg, etc). If you do a BPP, drink plenty of water the day and night before the test.

NSTs can be done in your home with your mw. They are a good way to tell if baby is doing fine.
What is a BPP? If the baby is moving frequently and vigorously will a NST tell me anything that we can't tell just from frequency of fetal movement?

I know that my best LMP guess date can't be more than a week later than the number that we used as a best guess. So realistically I will probably not allow myself to go longer than 42 wks and maybe about five days.

Presumably, OB fears for overdue babies aren't totally unfounded, how can I be sure that this baby really is safer in-utero? This is my second baby and as of last thurs I was 2 cm dilated, about 30% effaced, and the baby's head is fairly well engaged. I suspect that I've made more progress since then (I know that the baby's head has dropped lower and I think I might be loosing my mucus plug FWIW).

From what I've read, it seems likely that a 42+ wk induction would probably be successful based on my body's indications of readiness and I'd have to be at the hospital for this birth anyway, is it really worth the stress and axiety to wait it out?
post #14 of 19


Simone, I am sorry you're dealing with this. I'm the user formerly known as Mamapenelope, and I also live in Fairbanks and had two of my babies with the birth center midwives, which is where I presume you are receiving care.

Dana was my midwife when I went 19 days "over" with my 2nd daughter, who was born beautifully healthy at 8lb, 0 oz at the birth center. I did do a non-stress test, which didn't really tell me anything I didn't already know. BPPs are a huge scare-trip, there is always SOMETHING the ultrasonographer doesn't like to see...w/ my 3rd baby it was the typical "too little fluid." (They also suggested he was "too big," and he was 7lb, 10 oz at birth!

I say listen to your heart. Maybe have your midwife strip your membranes (this always triggers labor w/in 20 hours for me) if that will help you feel like you're doing something proactive.

Blessings and happy birthing!

Oh, and if you do choose to transfer, Marybeth Gardner is the first midwife in Fairbanks to have hospital priveledges (sp), she works w/ Dr. Karl Baurick at Interior Womens' Health).

Penelope
post #15 of 19
I recently lost all my book marks but the reasons dr fear overdue babies is because they account for 30% of all malpractice lawsuits. Its so easy for someone to say, If the dr would only have induced me....

BPP - Bio physical profile is a nst and u/s which looks for things like amount of fluid, breathing movements from the baby, size of the baby, placenta calcification, and meconium. I say you could probably tell if a placenta is calcified based on u/s but the other things its really really hard to get a good estimate. Some are totally bogus like looking for meconium - it could be vernix. Size of the baby on u/s is notorius for being wrong.

My fear of medical induction is cascade of intervention. Your contractions will be harder, you will have an iv, you will have to be on continous efm...so on. If you feel your baby moving frequently, you have no fever, your membranes have not ruptured and you can monitor these things at home then you and your baby are most likely fine. There is nothing they would do in the hospital besides constantly listening to the hb to tell you the baby is fine.

YOu have to weigh the pro and cons. What you comfortable with? I still say try everything naturally you can. Natural induction carries much less risk than a medical one.

Michelle
post #16 of 19
there's a thread in Birth & Beyond on going past 42 weeks. I have a post in there with some good info, as well as this article: http://www.midwiferytoday.com/articl...=1&q=postdates


And, yes, docs are known to do things that are not evidence-based. It happens 90% of the time in modern obstetrics. Makes no sense, but in a court of law, the most intervention rules.
post #17 of 19
Oh! This whole system could make a momma grumpy!

I'm reading Henci Goer's Smart Women's Guide and just can't get over how crazy the docs are about using their little interventions, which are rarely proven to do a darned bit of good.

hh
post #18 of 19
Quote:
Originally Posted by natashaccat
I'm having a hard time sorting out which tests are BS and which really give important info regarding the baby's well being.
Check out the Gentle Birth Archives on postdates (and other things) - http://www.gentlebirth.org/archives/postdates.html - they talk about what tests and protocols they use - I was poking through this yesterday and found some interesting info, its just archives from a discussion list so keep that in mind, but might be able to give you a better feel for some of these tests.
post #19 of 19
How are you, Mama?
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