at what point would you consider induction?

[readytobedone]

just wondering...i'm trying to collect some opinions and perspectives on this in case i need to end up talking with my doctor about it. i know he will start "talking" induction at my next appointment if i don't go on my own before then...

my current feeling on it is that i won't do it at any point unless there is a true, verifiable medical danger. and so far, thank goodness, there's not. i certainly won't do it before 42 weeks.

is there any reason, in your opinion, to consider induction at 42 weeks just due to being "late?" is post-dates, in and of itself, ever a reason for induction in your opinion? and do you think having NSTs is worthwhile, and if so, at what point would you consent to one?

if it matters at all, my EDD is extremely accurate. i was charting and the doc went off of that due date, which was confirmed by u/s as well.

[artgoddess]

I'd go the caster oil route before allowing a medical induction. Not that Caster Oil is great, from what I've heard.

[readytobedone]

Originally Posted by artgoddess

I'd go the caster oil route before allowing a medical induction. Not that Caster Oil is great, from what I've heard.

does it even work? i'd heard it's basically a crapshoot, like all other natural induction methods...

it's on my VERY back burner, just because it can be so invasive/volatile.

[SleepyMamaBear]

i personally will NEVER have another hospital medical induction EVER again.
not even if i am 43 weeks.
not happening.
if i were uncomfortable after 42 weeks i would do some EPO orally and vaginally, lots of sex, walking, and RRL tea.
after being induced with my DD i know just what a terrible experience it can be.
NEVER again will that happen

[pamamidwife]

if my membranes had been ruptured with a fever or signs of infection.

the only way, really.

but I'm not pregnant so it's easy to say. I remember buying a bottle of castor oil when I was 37 weeks pregnant and it was 102' outside.

[readytobedone]

Originally Posted by AddysMama

i personally will NEVER have another hospital medical induction EVER again.
not even if i am 43 weeks.
not happening.
if i were uncomfortable after 42 weeks i would do some EPO orally and vaginally, lots of sex, walking, and RRL tea.
after being induced with my DD i know just what a terrible experience it can be.
NEVER again will that happen

do you mind telling me more about your experience? you can PM me if you want.

[MommytoTwo]

I took castor oil. Twice. I was like 41 weeks + ... didnt work.

Anyway induction isnt really an option for me as I have had two c/s but if it was I would maybe consider it at 42w+ IF my cervix was ready to go. I dont know. I had a horrible experience with my sons birth which was an induction at 38 weeks, so I dont know. At 42w you are likely to go any minute anyway so unless baby is having a problem I dont really see the point...why put yourself through it.

[huggerwocky]

Not at all just for being overdue. I'd agree to a NST at 7 days overdue.

[HeatherB]

I'd be up for monitoring the baby more (i.e, an u/s or two - maybe NSTs, but not sure) as well as the placenta. As long as everything looked good, I'd also not induce. I'm sure by 42weeks I'll be doing things like taking lots of EPO and drinking RRL and having DH help me out... But I wouldn't do anything invasive like castor oil or a hospital induction unless it was very clearly indicated. And, thankfully, I have a wonderful MW whom I can trust for her opinion! So if she thinks we need to do something, I'd probably do it after discussing it with her.

[ckhagen]

My c-section was a result of a failed induction at 40w1d.

Induction obviously is no longer an option for me, but if I were a first-timer and it was an option...
I would start NSTs and a BPP at 42 weeks. If I felt the results were concerning and I was absolutely positive of my dates AND I had a very good Bishop Score, I would induce with Cervadil and then a low dose of Pit if necessary.

Yes, my induction was a complete 38 hour long nightmare... but it didn't have to be, I just went about it all the wrong way... no reason for it (OB pressure), Bishop Score that was obviously pointing to failure, massive doses of Pit followed by AROM, etc...

[grniys]

Interesting thread. I'm actually facing this myself right now. I'm only 2 days overdue, but I've had the option of inducing this week if I don't have the baby by then. I've opted not to, but at 41 weeks if I'm still pregnant I have to go in for tests and monitoring and stuff and make sure the placenta is ok and my little guy is ok in there still. I'll continue doing that until 42 weeks (although if at any time the baby shows signs of stress or whatever I'll allow them to induce immediatly), but at the 42 week point it's my midwife's policy to induce for the health of the baby. I know some people don't agree with that, but for me I think it's a good, reasonable solution. But to each her own! Good luck!

[SleepyMamaBear]

for reasons completely her own the CNM who was my HCP when i was pregnant with Addy decided that i MUST be induced on 7-14, the day before my "due date"
never once was i measuring big, nor was Addy.
i later found out she was also inducing another mama the same day, so it was total convenience for her. :

i went in at 7 am. got into the room and hooked up to an IV by 7:45 and by 8 pitocin was running through my veins.
because i was being induced i was unable to labor out of bed without getting yelled at by the CNM and the nurses.
if i got up to pee, rushing in they would come to tell me to get back into bed and rehook up all the monitors.
i felt strapped to the bed.
long long story short:
failure to dilate past 3cm after quite a few hours on Pit. bullied/scared (threatened with a c-sec) into an epidural and pain drugs.
pushed on my back for 2 hours unable to feel my legs, or lift them, unable to squat or get on hands and knees... just a lump on my back...
Dd was stuck in my pelvis (due to me being on my back!!!!) and her stats started dropping, so did mine.. and was taken in for an urgent c-sec.
i now know that the epidural and pitocin both played a BIG part in why i was sectioned.
they both aided in screwing up both DDs and my stats.
and in the end i was left healing a c-sec for weeks, had a baby that didnt want my breast because the bottle was easier(dont get me started on hospital LCs!) and not only do i have a physical scar but a very deep emotional one too. and Addy was cheated out of the best birth experience. instead of being welcomed into the world via birth canal into her mamas arms with soft voices and a warm breast, she was yanked (yep yanked, DH watched) out of my abdomen after her head was dislodged from my pelvis via a nurse and her hand up my vagina, then whisked off to have all her protective vernix washed off her, she was cold, scared, alone, and didnt even get to meet me face to face for another hour and a half after she was born.

so yeah i am a bit against inductions.

but not just because of what i went through, but because of the facts. pitocin is NOT healthy for mama or baby. nor are epidurals. they just ARENT.

[mikayla's mama]

I was induced with my first DD because of a small tear in the bag of water. It was a horrible experience, I would do anything to avoid pitocin. HOwever, I had NST's done regularly (every appointment) for the last week of my pregnancy with DD#2. I don't see the harm in doing them, it's reassuring to know that baby's heartbeat is doing well and seeing where your contractions are.

With my last I consented to having my membranes stripped multiple times to jumpstart labor. I did this starting at almost 40 weeks because US showed that she was getting quite large and I was hoping to avoid her getting too large in utero as my first daughter had shoulder dystocia. Also, I was afraid of the OB wanting to pressure me for a pitocin induction.

If natural methods don't work, sex, walking, nipple stimulation etc., I would allow my OB to strip my membranes again. It's kind of painful but nothing compared to pitocin. Also, I had a nurse who "stretched" my cervix, I think that helped to get labor going too. After all the messing around down there I was dilated to a 6 and when labor started the next morning it went really quick, from labor to baby in 2 hours.

[ChristieB]

Originally Posted by grniys

but at the 42 week point it's my midwife's policy to induce for the health of the baby. I know some people don't agree with that, but for me I think it's a good, reasonable solution. But to each her own! Good luck!

That's because you've never experienced a hospital induction. I'm not trying to be snarky, but I honestly haven't talked to anyone who's had one who would submit to another without a very good reason.

As for the OP's question, no, being post dates all by itself is not a reason to induce. IMO, based on my experience, monitoring can serve a purpose. After 42 wks., according to what I've read, there are some risks. But monitoring can catch problems early enough to keep things safe.

With my first, I went to 42 1/2 wks. I was getting ultrasounds starting at 42 wks. (that was the legal cut-off for my midwives -- no home birth if I wasn't monitored). At the first, the amniotic fluid was lower than they would have liked, but still safe. At the second, it was almost gone. My midwives were thinking of all possibilities, and in case the second u/s was bad, they scheduled it for the morning of the day that their back-up dr. was on duty. If they hadn't done that, I would have ended up with a c-section. BTW, the u/s was right (I was convinced it was wrong), there was virtually no fluid. And my midwife inspected the placenta and it was old and wouldn't support a baby much longer.

I went in for the induction, labor was awful, and I ended up asking for something for the pain. They gave me something (fentanyl?) in my IV, and it didn't really help with the pain, but allowed me to rest between contractions, which allowed me to dialate (from 4, where I'd been stuck for hours, to 10 in an hour). I then pushed for 4 or 5 hrs. (I think it was 4, the hospital says 5). I have been assured that any other dr. at that hospital, or any other, would not have allowed me to push that long. It was awful, and because my body didn't go into labor itself, and so did not have all the hormonal activity it needed, I did not stretch like I should have and ended up with 4th degree tears. Two hours of stitching and 4 months before I could sit without a pillow.

I had tried every natural induction method I knew of, and nothing worked. The only thing I hadn't given a good chance was acupuncture. I started it too late, and I had only had one treatment, and he said that it often takes two. I just didn't have a chance for the second before things were out of control.

So, this time, since I was soooo worried about needing to be induced again, and I knew how long natural methods can take, I started acupuncture treatments at 40 weeks. And he gave me some Chinese herbs to take, too. I delivered, at home , at 40 wks. 5 days, just 2 days after my second treatment, and after taking 3 doses of the herbs.

I don't know if the acupuncture helped, or if I would have gone into labor on my own anyway. But I would have continued to get acupuncture treatments 2x a wk. until labor started (and my acupuncturist is 2 hrs. away). I feel that strongly about avoiding hospital induction!! And I must say, home birth beats hospital birth hands down! But that's another thread.

Christie

P.S. I was very sure of my dates both times, too. No question.

[kkar]

Originally Posted by ChristieB

That's because you've never experienced a hospital induction. I'm not trying to be snarky, but I honestly haven't talked to anyone who's had one who would submit to another without a very good reason.

Permit me to be the outlier then. I had a horrrrrible birth experience with #1, and was shocked to find my induction with #2 so much easier! It was equally painful, much shorter (6 hours compared to 32 hours), and if I needed to again, I wouldn't hesitate.

I agree that you need to weigh the risks, but if you have to for medical reasons, and know your doctor and hospital will honor your wishes, it's really not the end of the world.

[ChristieB]

Originally Posted by kkar

Permit me to be the outlier then. I had a horrrrrible birth experience with #1, and was shocked to find my induction with #2 so much easier! It was equally painful, much shorter (6 hours compared to 32 hours), and if I needed to again, I wouldn't hesitate.

I agree that you need to weigh the risks, but if you have to for medical reasons, and know your doctor and hospital will honor your wishes, it's really not the end of the world.

I stand corrected. I'm glad your experience was better this time. It sounds like it was needed, though, and I said that the women I knew (including myself) wouldn't do it again without a very good reason. With a good reason, though, I would certainly have done it again. But I sure didn't want to. I was all about preventing that.

I agree that the risks must be weighed. And that's what I was saying, although in a more long-winded way. What I didn't say, though, is that there are risks with induction. It's not just that it's uncomfortable. That's another reason to not do it just because of being "late". Due dates are an estimate, and 40 weeks is the average length of a pregnancy. Doctors these days are acting like 40 weeks is the maximum, and anything past that is so abnormal.

And while I agree that it's not the end of the world, I'll admit that 2 months ago it sure felt like it would be.

Christie

[mamabadger]

Originally Posted by ChristieB

I agree that the risks must be weighed. And that's what I was saying, although in a more long-winded way. What I didn't say, though, is that there are risks with induction. It's not just that it's uncomfortable. That's another reason to not do it just because of being "late". Due dates are an estimate, and 40 weeks is the average length of a pregnancy. Doctors these days are acting like 40 weeks is the maximum, and anything past that is so abnormal.

I agree. There's been a trend toward more and more induction based on dates alone, but it hasn't resulted in better birth outcomes.

I wouldn't accept an induction for dates alone, period, only in case of a serious problem which called for induction.
I'm not convinced that the NST is actually that useful, but I might have one if I was postdates and it would keep the OB off my back for another week or so.
I don't think I'd go with castor oil (I've had 2 clients who used it successfully, but it was nasty!) but I might try herbs, sex, acupuncture, things like that.

[artgoddess]

Originally Posted by readytobedone

does it even work? i'd heard it's basically a crapshoot, like all other natural induction methods...

it's on my VERY back burner, just because it can be so invasive/volatile.

I don't know how well it works, My son who went 10 days past EDD, we went for long walks, did nipple stimulation, I ate spicy food and had sex to get things going. I think that nothing will work well unless your body and baby is ready for labor. I had a friend who went with pitocin on her due date, and her body never started having contractions, after 24 hours of pitocin and no contractions she had a c/s. She had a 6 lb baby which is perfectly okay, but not by any means huge. I doubt caster oil would have worked with her because frankly i don't think her daughter was ready to be born yet.

From what I have heard Cater Oil is no picnic it brings on a fast hard labor. But so does pitocin, and with pitocin you are hooked up to monitors and and IV and aren't able to move or have your freedom to labor in varying positions to ease your labor pains.

[~pi]

One thing to keep in mind is that induction raises the risk of c/s and such especially for first time mamas. Inductions for second, third, etc. babies generally go better.

I had a hospital induction at 40 weeks, which was actually 2 weeks after the physician-recommended date. (At many hospitals, it is routine to induce type 1 diabetic women at 38 weeks.)

It was a reasonable choice given my risk status. However, I would not do it again. I ended up with a classic cascade of interventions, a C/S for me, a NICU stay for DS, and months of tears and nightmares.

I would (and did) have NSTs, though.

[alegna]

I would not induce for dates. If there were a medical reason I would consider it. A true medical reason. Not a trumped up medical reason (big baby, not enough fluid, etc are trumped up reasons)

-Angela