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Induce at 38 weeks?

post #1 of 25
Thread Starter 
Hey all, I'm writing for a friend who is pregnant with twins, her first pregnancy. She is going to do a hospital birth with a midwife and ob and she's been talking to them a lot about how things are going to go. Generally she's happy with her midwives and Dr. They have told her that if she gets to 38 weeks that they'll induce. She's asked about this again and the OB said it just isn't safe, the placenta might break down and that all the stats are that after 38 weeks it's best to just induce. She's also being told over and over that she'll probably go early since most folks with twins do. She isn't convinced that she wants to be induced at 38 weeks and doesn't know how much say she has in that. Could you mamas let me know if most of you were early with your twins and if you know of folks who got to 38 weeks and chose not to induce? Thanks!!
post #2 of 25
Oooh! I'm really glad you posted this. My OB has said the same thing, and I'm struggling with it too. :
post #3 of 25
My research showed that the ONE study showing a benefit to early induction was not well done and outdated.

I would not personally consent to it.

post #4 of 25
Thread Starter 
Yeah, I hope I get more posts. She and I have talked about this a couple times. I think I'm also going to remind her that she can certainly ask the OB about what would happen if she got to 38 weeks and refused to be induced.....just to see. I always forget that those kind of questions are valid. It's good to know.
post #5 of 25
Pllthtpppthpppthh (me blowing a raspberry). Stupid. She needs to tell her OB to calm down.

I have 10 years of L&D nursing under my belt. I have seen many 40 week twins. She may go early, she may not, that is up to her body to decide, not a bag of pitocin. Not all twins go early. Also, the "placenta breaking down" at 38 weeks is total bunk. The placenta is designed to be a 40+ week organ, regardless of how many babies are attached to it. If the doc is worried about placental function, the answer to that is to perform non stress tests, not induce. Geez.

Bottom line, twin pregnancy alone is not a valid medical reason for induction. Period. It sounds to me like her doctor is inexperienced with multiples and is nervous. JMHO. If I were her I'd switch OBs if I could.
post #6 of 25
My OB won't do a voluntary induction (meaning no medical reason, mom just wants babies out) until 39 weeks and is fine w/ me going 40 weeks. I highly doubt this will happen. I'm 34 weeks and I'm already starting labor and on meds to stop it. When I asked more about the dates, ect. my OB said he's only had one mom go the full 40 weeks, and most go by 37-38 on their own. The 'average' I've found elsewhere is 35-37 weeks, but that includes early inductions. I've noticed on a more mainstream board that most girls are getting sectioned/induced by 37 weeks, so I don't see your friend's Dr. as totally out of line w/ the mainstream practices, KWIM? I don't really know how much say your friend will have in the final stages, I guess that depends on her OB and MW, and also on how both she and babies are doing. Best of Luck to her!
post #7 of 25
Well I went to 40 weeks 1 day and my babies were perfect and so were the placentas. There is no medical reason to induce twins at 38 weeks. Good nutrition is extremely important and if your friend is eating as she should and drinking plenty of water (at least a gallon) there is no reason to think the placentas will start to deteriorate at 38 weeks. All babies are different and some are ready before others, but they should not be forced out before they are ready. That is a good way for you friend to end up with a c-section, if she is induced before her body is ready.
post #8 of 25
I don't like blanket policies. I'm sure *some* placentas begin to deteriorate. I don't think, however, anyone can be confident that 38 weeks is the magical number. I know of at least one study showing that healthy twin pregnancies should be allowed to continue to a minimum of 38 *completed* weeks (38w6d), because the babies have fewer problems.

Eating well is crucial in maintaining healthy organs. If there is some concern, NSTs and biophysicals can help determine the status.

For what it's worth, my twins were born 40w2d.
post #9 of 25
My babies were born 2 days shy of 38 weeks and that placenta was perfectly fine. I asked my OB if he induced at 38 weeks and he said, "why would I do that?"
post #10 of 25
That is the primary reason I left the military medical care I'd had when I found out I was having twins--"you will be induced at 37 weeks." Um, no, I don't think so. One spurious, outdated study supports it, more do not. I proceeded to search for an OB who was confident in women's bodies and the birth process as much as his practice allowed (rare, I know!).
As another pp mentioned (esp if she is stuck with her providers and can't convince them otherwise), she can also decline to show up for an induction.
post #11 of 25
I wasnduced at 41 weeks. It was awful and it failed! I ended up going into labor on my own soon after, but I think it was the result of all those $#@* drugs! And one of my babes always seemed a little undercooked to me. She didn't need any medical help, but I just feel she would have been happier with a few more days roasting.

Unless there is a reason for it, let the babies come when they are ready.
post #12 of 25
Early on my ob said he might have to induce at 37 weeks but wanted to see how things went. I'm almost at 35 weeks now and he changed his mind awhile ago. I've been doing really well and following a really good diet, etc. All of my tests are coming back really well. I do have both of my little guys in there sideways and they're big babies. In my case and with a previous delivery where an 8lb. baby was stuck/born with problems I will have to have a c-section, but my ob has decided that as well as everything is going he's going to do it as 39 weeks. I think if they were smaller and turned properly he'd probably let me go with a natural birth whenever they decided to come. I have all the paperwork done, etc just in case these guys come early but so far there are no signs they plan to be here early. I will have to say a lot of women I've talked with seem to be delivering at between 35 and 37 weeks on their own, but that may also be that I'm getting so close myself that I'm noticing it more.LOL! I also know of a few women who managed to go to 40+ weeks without any problems. Every pregnancy is different. Rather than forcing an induction just because it's "the standard date" though I'd really want to know if they could just see how the mother and babies are doing as that date arrive and see if it's really needed from there.
post #13 of 25
post #14 of 25
I had heard a lot of "they won't let you go past 37-38 weeks" when I was pregnant, so I asked my OB. He looked at me like I was nuts and said "I'll 'let' you go full term if your body wants to do so!" He delivers a fair amount of multiples so I trusted his judgment.

I ended up having my babies at 29 weeks, which obviously was in nobody's plan.
post #15 of 25
Originally Posted by Clairesoula View Post
Could you mamas let me know if most of you were early with your twins and if you know of folks who got to 38 weeks and chose not to induce? Thanks!!
In my own pregnancies (including the twin pregnancy) I was hard-pressed to come up with valid reasons to induce. In my mind, in most cases, an acute situation might warrant a c-section (and I'm pretty rampantly-anti-c-section!) or else those babies are fine to keep on baking!

The OB I finally settled on did not advocate induction at any "magic stage" in the pregnancy. I was +40wks with our older kids and 39wks4days with our twins.

The placenta looked perfect. Noteable only for being much larger than a singleton's placenta, and for having a small (dime-sized) cyst within it - that obviously hadn't caused any sort of issues.

Originally Posted by Free Thinker View Post
I don't really know how much say your friend will have in the final stages, I guess that depends on her OB and MW, and also on how both she and babies are doing.
Respectfully, I think the degree of "say" your friend has in the final stages has a lot to do with human rights and very little to do with her OB and MW. Your body, your responsibility. Stand up for yourself in the face of intimidation and rhetoric. . . yada yada yada.

Clairesoula, congratulations to your friend! This is a pretty good "problem" to have in a twin pregnancy!
post #16 of 25
I was told that it would be a good idea to have the boys out at 37 weeks, but that was only because of the TTTS. Barring that, I have never heard an OB say that all twins must be induced at 37 weeks. I have heard plenty of them say that they consider twins to be "term" at 37 weeks and therefore won't stop labor that begins after that time.

But times are a-changing. I heard that even in my relatively progressive area now the "latest" recommendation is that ALL MZ twins that share a placenta be delivered by c-section because they might develop TTTS during delivery!

My god, that's like 75 percent of all MZ twins that are advised to have a c-section now. I call BS. :/ It makes me livid that people are being told that. It's like being told that all babies everywhere should be delivered via c-section because of the possibility of a cord accident during birth or the placenta prematurely separating from the uterine wall--both of which happen more often than TTTS happening during delivery with no signs or symptoms or markers up unto that point. :P
post #17 of 25
nak, i haven't read all the posts yet but my twins were 39w 5d and u/s showed one of my placentas as being "stage 3"at 33w... if they are worried about the placenta/s - bpp's and nst's should be sufficient monitoring
post #18 of 25
I would feel uncomfortable inducing at 38 weeks. Many twins do go longer . . . just look around this board.

My OB wouldn't do anything to stop delivery after 36 weeks, but said she wouldn't induce till 40 weeks, or even 41 depending how things were looking.

As it was, I had a c-section at 39 weeks to to the risk of cord prolapse if my water broke (both were breech, with all the cord dangling at the bottom).
post #19 of 25
Thread Starter 
Thanks for the additional thread. Very helpful.

Thanks in general for the advice. This is what I suspected and the track my friend is on as well. It's good even to hear from the other thread that folks have skipped appointments and other things to get the care they want. We're all very smart Mamas and we need each other to trust ourselves and our bodies...especially with first time pregnancies in our crazy country. BTW does anyone have a link or something to the one bad study about how risky it is to carry twins past 38 weeks? It would be great just to know what it says etc.
post #20 of 25
chiming in late here...
i went to 40 weeks, very healthy pregnancy, skipped many appts, dr said we could go to 42 weeks before induction.
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