What happens if i refuse to be induced? - Mothering Forums

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#1 of 68 Old 06-09-2009, 01:25 PM - Thread Starter
 
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I'm 31 weeks pregnant, second baby. My doctor recently told me that if I go past 41 weeks they'll induce labour. I couldn't believe it. I know already should that circumstance arise, I will refuse medical treatment, my question, what happens then? Do I just wait until I go into labour and then go to the hospital? Has anyone on this forum refused medical intervention and what happened? I looked into getting a midwife but it's basically too late.
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#2 of 68 Old 06-09-2009, 01:28 PM
 
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I would respond with something like "let's not cross that bridge until we come to it", and then drag my feet if we got there.

At 31 weeks, your OB can "fire" you, but at 40+ weeks, it's patient abandonment, so I'd definitely hold off on starting the fight.
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#3 of 68 Old 06-09-2009, 01:29 PM
 
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Moving to the Pregnancy forum

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#4 of 68 Old 06-09-2009, 01:40 PM
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It's never too late to transfer to a midwife...unless it just so happens ALL the midwives in your area are booked, and even then, sometimes they will squeeze you in or suggest someone else to go to.
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#5 of 68 Old 06-09-2009, 02:17 PM
 
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the pregnancy police come and get you and take you to the hospital and make you submit to the induction. (my doula uses that analogy and I think it's funny - slightly disturbing, but funny)

You are smart to avoid induction simply b/c of the date. you're not late till 42w anyway. Women who are induced are 50% more likely to end up with a c/s. (just a nice little detail my first ob didn't bother to tell me.)

I would not answer the dr about this at this time as the PP is correct that they can drop you from care. At 41w however, it's too late for them to drop you, however, you can fire your dr at any time - including while in labor. I would keep looking for another practice. You may have luck searching through your local ICAN chapter for someone that's more natural birth/less intervention friendly

If you do not want induction then do not do the following w/o serious consideration of the risks:
  • late term u/s to est. size (these can be up to 2# off in either direction); inductions or c/s for suspected fetal macrosomnia are against ACOG guidelines.
  • allow any cervix checks before 40w;
  • no membrane stripping during checks- if you think dr will want to strip membranes w/o your consent then refuse the check; You can also make it clear when you get your gbs test that you do not consent to a cervix check (there's no reason for it anyway other than your pants are off, so why not?);
  • show up when it's scheduled. It's a little passive aggressive, but then so is manipulating and bullying a mother into an unnecessary induction.
DO consider having NST to determine baby's condition, optimal fetal positioning (spinningbabies.com), chiropractic and maybe acupuncture.

If you have a really good bishop's score (which requires a cervix check to determine), say above 6 or 7 or so, then induction might be warranted if the baby is in some distress. with the score at least that high there is a good chance of successful vaginal birth. If they are telling you that you need an induction NOW, and are not picking up the phone to call an ambulance then you have time to think it over. Ask about foley catheter induction rather than pit, and low level management of pit v. active management of labor. (I've had both and the low level with a good bishop's score resulted in my successful VBA2C.) If they mention cytotec, RUN - do not walk - out the door. (there's recent threads on MDC about it. )

good luck and go with your gut!!

Stinkerton 12/10/01 9lbs8oz, induced to c/s; Little Man 5/20/03 7lbs11oz, r c/s, fear of another labor; Jillybean 11/18/07 10lbs8oz 37cm head, induced VBA2C; and the Wee Beastie, 9lbs8oz, 35cm head, rpt VBA2C
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#6 of 68 Old 06-09-2009, 02:57 PM
 
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I have had three children in three different states and hospitals (MT,CA,MA) and all of them were past 41 weeks. All of my midwives scheduled inductions, but all three of them came naturally in there own time. The day before they were suppose to be induced. Actually with my second son, I called the day before and canceled his induction and he came the following night.

I was very passive aggressive in that sense. I went along with them up to the point when I decided against medical advice what was right for me and my baby. I had the fluid checked and NST, but all was fine and my second son was 9.1# posterior and from start to finish was less than 4 hours. If I had been induced it could have been a day or more of intervention and labor and because he was posterior they would have taken him c-section, but we had no problems.

My advice to you is too push it back as far as possible and if the time comes just call and cancel, tell them that yes you will be in for a NST the next day, because at that point they will be "worried". The bottom line, trust yourself and your baby. Birth is an extremely empowering experience.

Blessed Be!
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#7 of 68 Old 06-09-2009, 02:58 PM
 
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HappyMom38, have you posted in Finding Your Tribe? If midwifery care is not an option, I would be looking for a doula.

FWIW, I had an OB during my first pg. I started seeing him at about 6 months (family doc before then). He mentioned induction, episiotomy, and c-section at every single appointment, due to my small size. I had my appointments at the hospital, and I guess I just assumed that when I showed up in labour, they would let him know. He wasn't called, wasn't there for the birth, and his office called to remind me of a prenatal appointment 3 days after I gave birth. I don't even remember if I was preregistered at the hospital. So, yes, you can ignore your OB and just show up in labour.

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Originally Posted by Talula Fairie View Post
It's never too late to transfer to a midwife...unless it just so happens ALL the midwives in your area are booked, and even then, sometimes they will squeeze you in or suggest someone else to go to.
OP's location is listed as Toronto; chances are, all the midwives for her edd are booked up. They probably were when she was 10 weeks, unless there are many more now than when I lived there. And they can do a little bit of juggling, but legally they can only take so many patients due in any given month (IIRC). It's still worth a shot to give them a call, but unfortunately, demand exceeds supply when it comes to midwives in most parts of Ontario. And with a midwife, if she hit 42 weeks, her primary care would be transfered to an OB, as midwives cannot be the primary care giver for a woman who has reached 42 weeks.

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#8 of 68 Old 06-09-2009, 03:00 PM
 
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Check your state's laws to see if there is anything on the books about unborn baby's rights. Some states, including the one I live in, have these laws that doctors can use (abuse) to legally force pregnant moms into c-sections and inductions. There is a youtube video that explains it (link below). Beware that some of the stories they talk about are really, really sad.

http://www.youtube.com/watch?v=-3X4_p3yAC8

I would be thinking about ways to compromise/negotiate (for example, agreeing to have extra NSTs after week 41) with your OB if and when the time comes. OBs are mostly concerned about you suing them for malpractice if something goes wrong between week 41 and 42. So you might want to start another thread later on about how to talk to your OB about this subject. I'm sure someone on here has some wisdom about that.
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#9 of 68 Old 06-09-2009, 03:13 PM
 
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Just put your foot down and say no.
Also, if you show up in labor they can't exactly tell you to go elsewhere.
Even though I know all of the MWs in the area are probably full it certainly won't hurt to try.

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#10 of 68 Old 06-09-2009, 03:21 PM
 
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Good for you for wanting to wait until your baby is ready before evicting him or her. A blanket policy of inducing at 41 weeks is not medically justified and you and your pregnancy deserve to be treated individually. I agree with what MamatoLevi said in her post. I think arming yourself with as much information about being post-dated is to your advantage as well. If you haven't read "A Thinking Woman's Guide to a Better Birth" by Henci Goer, I would highly suggest it. It is also interesting to watch the homebirthing thread, because many of those mamas go after their due dates, into their 41 and 42nd week. And amazingly, there are little to no incidents of fetal macrosomia, placental deterioration or any of the other "scare tactics" OBs routinely use for pushing induction. Stick to your guns, Mama, and let that baby cook until they are ready!

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#11 of 68 Old 06-09-2009, 05:26 PM
 
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Quote:
Originally Posted by mamatolevi View Post
If they mention cytotec, RUN - do not walk - out the door. (there's recent threads on MDC about it. )
Sorry to crash here but I am scheduled for this tomorrow evening, can anyone point me to these threads?

Sewin earthlovin : Mama to my 8 yr old, 6 yr old and lil' baby : born 6/11/09.
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Sorry to crash here but I am scheduled for this tomorrow evening, can anyone point me to these threads?
I think I just saw it on the thread about having a natural hospital birth, today. I'll try to find the link.

Here it is:

http://www.mothering.com/discussions....php?t=1094669

Don't know how to add links really, but cut and pasting this into browser might work.
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#13 of 68 Old 06-09-2009, 06:03 PM
 
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Originally Posted by mynameisMom View Post
Sorry to crash here but I am scheduled for this tomorrow evening, can anyone point me to these threads?
some of them!

http://www.mothering.com/discussions...rchid=10213991

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#14 of 68 Old 06-09-2009, 06:06 PM
 
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Thank you, off to read.

Sewin earthlovin : Mama to my 8 yr old, 6 yr old and lil' baby : born 6/11/09.
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#15 of 68 Old 06-09-2009, 06:06 PM
 
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Originally Posted by mynameisMom View Post
Sorry to crash here but I am scheduled for this tomorrow evening, can anyone point me to these threads?
I just PM'ed you with some info... you can find a lot too if you google cytotec induction fda or similar phrases.

HTH!

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#16 of 68 Old 06-09-2009, 06:46 PM
 
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I had to switch OB's and I got a recommendation from a friend. She said "I love him, he's great. And he will induce you whenever you want". UMMM...I don't want an OB with that attitude. BUT I think at this point in time, the majority of women do want to be induced and so I think dr.s assume that offering it is doing you a great favor. I would just say "no, thank you"
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#17 of 68 Old 06-09-2009, 07:01 PM
 
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If you do not want induction then do not do the following w/o serious consideration of the risks:
  • late term u/s to est. size (these can be up to 2# off in either direction); inductions or c/s for suspected fetal macrosomnia are against ACOG guidelines.
  • allow any cervix checks before 40w;
  • no membrane stripping during checks- if you think dr will want to strip membranes w/o your consent then refuse the check; You can also make it clear when you get your gbs test that you do not consent to a cervix check (there's no reason for it anyway other than your pants are off, so why not?);
  • show up when it's scheduled. It's a little passive aggressive, but then so is manipulating and bullying a mother into an unnecessary induction.
DO consider having NST to determine baby's condition, optimal fetal positioning (spinningbabies.com), chiropractic and maybe acupuncture.
Is there any other valid reason for a late term ultrasound other than determining the size? I know my OB wants to do one. I also know that my brother and I were big babies, DH and his brother were big babies, and my brother and brother-in-law's kids were all big babies. We are looking at a 8-11pounder here, and I don't need an ultrasound to assure me of that... although I wouldn't be disappointed if heredity is wrong and we end up with a smaller babe, lol!

Happily married mom to DS (Aug 09) and two furry troublemakers.

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#18 of 68 Old 06-09-2009, 07:47 PM
 
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With my first, my doctor wanted to induce at 40 weeks exactly. I said no and he scheduled my next appointment for 40 weeks, 5 days and said we could induce then. I said that we would wait and see. DS was born on 40 weeks, 4 days.
Just say no.

ETA: Another reason for late u/s is to check amniotic fluid levels, or so I'm told.

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#19 of 68 Old 06-09-2009, 07:56 PM
 
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I'm looking at a 41-week limit and induction as well - and I'm with a group of midwives! Not all are equal that's for sure.

I'm planning on telling them AT 41 WEEKS that I'll be happy to do a NST and u/s - schedule it for a few days AFTER the 41 point, and then keep stalling as long as I have to when it comes down to being told I "have to" induce. That includes not showing up. And telling them that I think I'm going into labor on my own right now, thank you, and we should just wait and see - I'll call in a few hours. Stuff like that.

Can you hire a doula? It might make you feel a lot better about being with this OB if you aren't. I'm not super happy with my midwives but knowing I have a doula with me who's looking out for my best interests and knows EXACTLY what my vision is, really helps.

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#20 of 68 Old 06-09-2009, 08:38 PM
 
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Originally Posted by sunshynbaby View Post
Is there any other valid reason for a late term ultrasound other than determining the size? I know my OB wants to do one. I also know that my brother and I were big babies, DH and his brother were big babies, and my brother and brother-in-law's kids were all big babies. We are looking at a 8-11pounder here, and I don't need an ultrasound to assure me of that... although I wouldn't be disappointed if heredity is wrong and we end up with a smaller babe, lol!
yes, to check amniotic fluid levels. I have heard, someone who knows better please confirm!!, that a proper diagnosis for "low fluid" needs to be done over two u/s. So if the one comes up "low" get into bed, drink a ton of water, rest and see if it doesn't go up in a day or two. Most folks I know have had their levels go right up after that.

the other reason is to check the condition of the placenta - however from stories I'm hearing on line there are a lot of "your placenta is calcifying horribly" comments and when the baby is born, the placenta is fine. so I dn't really know what to make of u/s for checking placental condition.


BTW: 8# is not a big baby by any means. 10# might be, though not in my book. (my vba2c was 10.5#, a full pound larger than my first c/s baby, so my view of big and little are a wee skewed!)

Stinkerton 12/10/01 9lbs8oz, induced to c/s; Little Man 5/20/03 7lbs11oz, r c/s, fear of another labor; Jillybean 11/18/07 10lbs8oz 37cm head, induced VBA2C; and the Wee Beastie, 9lbs8oz, 35cm head, rpt VBA2C
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#21 of 68 Old 06-10-2009, 12:43 AM
 
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yes, to check amniotic fluid levels. I have heard, someone who knows better please confirm!!, that a proper diagnosis for "low fluid" needs to be done over two u/s. So if the one comes up "low" get into bed, drink a ton of water, rest and see if it doesn't go up in a day or two. Most folks I know have had their levels go right up after that.

the other reason is to check the condition of the placenta - however from stories I'm hearing on line there are a lot of "your placenta is calcifying horribly" comments and when the baby is born, the placenta is fine. so I dn't really know what to make of u/s for checking placental condition.


BTW: 8# is not a big baby by any means. 10# might be, though not in my book. (my vba2c was 10.5#, a full pound larger than my first c/s baby, so my view of big and little are a wee skewed!)
Thanks for the info. 8 pounds is being optimistic, lol. I was over 10 and my nephews on either side were 9-11 pounders.

Happily married mom to DS (Aug 09) and two furry troublemakers.

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#22 of 68 Old 06-10-2009, 02:54 AM
 
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Thanks for the info. 8 pounds is being optimistic, lol. I was over 10 and my nephews on either side were 9-11 pounders.
How big is your dad and the father or your nephews compared to your DH? The dad's size has a lot to do with how big the baby will be.

I personally don't think that the baby's weight is a big deal.
Mine were all 9lb babies exacept for one, yet my 8lb baby was the hardest to push because he had a big head.
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#23 of 68 Old 06-10-2009, 12:53 PM
 
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How big is your dad and the father or your nephews compared to your DH? The dad's size has a lot to do with how big the baby will be.

I personally don't think that the baby's weight is a big deal.
Mine were all 9lb babies exacept for one, yet my 8lb baby was the hardest to push because he had a big head.

DH was on the smaller side of the scale around 8 pounds. I don't know about my dad's weight at birth. He was born at home on a farm during a blizzard 76 years ago, and there aren't any records, lol. I don't think a big baby will be an issue for me either, which is why I wondered why else the OB would want a late term u/s. I have what they call "birthing hips."

Happily married mom to DS (Aug 09) and two furry troublemakers.

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#24 of 68 Old 06-10-2009, 12:53 PM
 
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about size - fat squishes and heads mold. the only real worry is SD and that can be managed by a competent provider that doesn't just yank on the baby. and though a real worry, it's still rather rare.

Stinkerton 12/10/01 9lbs8oz, induced to c/s; Little Man 5/20/03 7lbs11oz, r c/s, fear of another labor; Jillybean 11/18/07 10lbs8oz 37cm head, induced VBA2C; and the Wee Beastie, 9lbs8oz, 35cm head, rpt VBA2C
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#25 of 68 Old 06-12-2009, 10:56 AM - Thread Starter
 
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Thank you. All these answers are wonderful. I think if the baby isn't born by 41 weeks, I just won't show to the following appointment, wait until I go into labour and have myself taken to the hospital then.

We had midwives last time, and it didn't really work out, somehow (without me understanding the nature of the procedure) I had a stretch and sweep done at 40 + 3 days, went into labour 2 days later, lots of medical intervention. My husband has been wonderfully supportive and was really great about navigating our way through the last birth.

I mean it did work out in the end, in the sense that it was the very best day of my life and we have a wonderful, sweet & healthy, 18 month old baby.
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#26 of 68 Old 06-12-2009, 12:03 PM
 
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Holy freak, you're only 31 weeks and the OB is already talking induction? How about he let you go a wee bit post-due before bringing it up! Yikes.

I'm thankful my m/w says 42 weeks before she starts talking induction (and also thankful my babies come around the 40-week mark regardless). I saw an OB with my DS, he wanted to induce me before 40-weeks! I was like 39-weeks 5 days and he wanted to schedule it. I said no, he kept pushing so I finally scheduled it for around 41-ish weeks...well my DS came that weekend following his induction push. I'm thinking he just wanted to avoid coming in early bird on a Sunday like he had to.

Renae wife to J :, Mama to 4.5y/o J-bird and 2y/o A : and E coming in late Dec/Early Jan. My husband had a living donor kidney transplant! :
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#27 of 68 Old 06-25-2009, 11:12 AM - Thread Starter
 
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thank you, this is very helpful information. i have my next appointment on mon june 29th and i've been reading up about hypnobirthing, which has some good relaxation suggestions. both my brother and my husband were 3 weeks late and were healthy babies.
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#28 of 68 Old 06-25-2009, 11:14 AM - Thread Starter
 
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oh, i'm happy that the dr mentioned this policy early so i have lots of time to mentally prepare in case i'm late and have to refuse medical treatment from them...
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#29 of 68 Old 06-25-2009, 12:49 PM
 
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I didn't read all of the responses, but wanted to mention that my OB personally told me that inducing for suspected "big" baby is not supported with medical evidence.

Also, If I were in your shoes, I just wouldn't show up for any scheduled induction. I was induced with my 1st and it was HELL! Agreed with pp who said to run away from cytotec. My doctor with #1 pushed that crap on me, but luckily even 7 year ago, I knew the risks and requested cervidil.

It might be worth it to have a midwife that you can talk into being a consultant for you. I KNOW if my doctor was talking induction for any reason, I would run my entire pregnancy with my midwife for #2 to see if she felt it was medically necessary.

Automatically inducing for being 41 weeks pregnant is just irresponsible. I'd have serious concerns about any doctor doing that as standard procedure. Clearly they're more concerned about liability than mother and baby's health and well being.

~Sarah

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#30 of 68 Old 07-07-2009, 12:51 PM - Thread Starter
 
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i agree with you sarah, any doctor who talks about induction at 41 weeks is clearly irresponsible and cares more about liability than mother and baby.
wow that's something to chew on.

i'm now at 36 weeks and have been reading up on hypnobirthing (which discouraging pretty much any medical intervention). and visualizing a natural and pleasant birth. hope it goes well.

due august 8th 2009. i'll keep you guys posted. thx.
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