Inducing labor naturally at 38 weeks - Mothering Forums

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#1 of 7 Old 12-27-2007, 08:41 PM - Thread Starter
 
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Hi, I am at 36 weeks as of tomorrow. I had my midwife visit today and asked how the baby was measuring. She said that she was a little big and at around 38 weeks they would decide whether to induce or not That being said, this practice is so kind and nice and are known for being gentle and not doing any unnecessary interventions.

I have read a lot about VBAC and talked about it until I exhaust myself with many doctors and the midwives. Except for this midwife, all have said that VBAC mamas cannot have induction with synthetic hormones. This, I am told, leads to another c-section because of the risk of too strong contractions and possible uterine rupture. I have been told by everyone else that I must go into labor naturally and progress naturally. Is this true?

My main question is this, would it be safe to do all the natural "get labor started" ideas at 38 weeks myself so that I will not be in the position to have to accept or reject medical advice? I know that many large babies are born naturally and at home and in birth centers. I really know this. I also know I will have a hard time saying "No" to these midwives and OB's because I am not confident with myself knowing all there is to know and am not assertive enough when "questioning authority." Please keep in mind that this practice is wonderful. I am treated with kindness and respect and their c-section rate is the lowest in my state, 2%

SAHM to Ivan 6/10/05 who says  signcirc1.gifand Matilda 1/31/08 who says saynovax.gif:::

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#2 of 7 Old 12-27-2007, 10:31 PM
 
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Oh mama.

First - size estimates this late in pregnancy are notoriously inaccurate.

second - natural methods of labor inducing don't usually work unless your body is ready. For a vbac, I would not do anything agressive however natural...that is just me (especially when there was no medical indication). I don't know anything about your past history...how many weeks along were you when you had your last baby?

third - you say this place is great about not doing unnecessary interventions but isn't inducing early because of a suspected big baby unnecessary? That is not evidence based.

from ACOG (The American College of Obstetricians and Gynecologists):

"Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes."

btw "The term fetal macrosomia implies fetal growth beyond a specific weight, usually 4,000 g (8 lb, 13 oz) or 4,500 g (9 lb, 4 oz), regardless of the fetal gestational age."

http://www.aafp.org/afp/20010701/practice.html

and a blurb from a more recent article from ACOG:

"Although post-term infants are larger than term infants and have an increased incidence of fetal macrosomia, there is no evidence to support induction of labor as a preventive measure in these cases."

http://www.aafp.org/afp/20041201/practice.html

"Suspecting a large or very large baby is not a medical reason for induction. In a November 2002 press release, ACOG reported that induction of labor for macrosomia (large baby) almost doubled the cesarean rate without improving perinatal outcomes (the health of the baby).2 This statement was based on a study published in Obstetrics & Gynecology.3 Several earlier studies also showed that induction for macrosomia increases, rather than decreases, cesarean section rates without improving the health of the baby.4,5,6 In the professional publication Evaluation of Cesarean Delivery, published by the American College of Obstetricians and Gynecologists, the authors recommend against induction for large babies in healthy women, concluding that ?Induction of labor for suspected macrosomia [large baby] does not improve outcome, expends considerable resources and may increase the cesarean delivery rate.?7"

http://www.lamaze.org/institute/care...aborBegins.asp


Do they think natural induction will produce different results?

I have no idea what the reason was for your c-section but I still think this is a good video to watch regardless - http://www.youtube.com/watch?v=roFVkDV45MM
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#3 of 7 Old 12-28-2007, 12:31 AM - Thread Starter
 
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Thanks Erin. Yes, I felt really weird when she said this. To give her the benefit of the doubt, she said this when Ivan was standing there crying because he wanted to leave and had hurt himself. I will clarify next week at my appt. Nobody there has ever given any indication that they would ever induce me, quite the opposite. There are 6 midwives and 4 OB's there. This is the first time I have met her and maybe I misunderstood, due to the noise of Ivan crying. Also, maybe she was referring to something "natural" that I did not have her clarify. I have read on these boards about all kinds of different things that I have never heard of.

My previous c-section was due to a very medically oriented practice that insisted that Ivan was close to 11 lbs. He was only 8 lb. 13oz. I was never really "upset" about his having a c-section birth until this pregnancy and reading about VBAC. Now, I feel guilty. Thanks for all the links and taking time to respond. I am so confused by all the different things I hear and read. My main goal it to get in and out of the hospital as safely and quickly as possible with my baby.

SAHM to Ivan 6/10/05 who says  signcirc1.gifand Matilda 1/31/08 who says saynovax.gif:::

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#4 of 7 Old 12-28-2007, 01:25 AM
 
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I was induced at 38 weeks naturally ( just a tiny bit of doctors help) and my baby was 6 lbs 15 oz. I have been induced two other times before this also, one at 38 weeks again, and one at 38.5 weeks, for a total of 3 times. Speaking from lots of experience in this area, I WOULD NOT recomend inducing at 38 weeks unless the baby is in distress, or something else life threatening. The reasons they wanted to induce me were very unecessary, and I hope to go to 40 weeks should I ever get pregnant again. My doctor said it was more "safe" to induce. Yeah right! My son had so many problems, and I think early induction was the cause and/or at least made them worse. My babies were all fine and I was fine in all my pregnancies. Everybody would have probably been better off in the long run if I would have went to 40 weeks.

You have the right to refuse to be induced if that is what you want. If they give you too much slack, you could find another caregiver. I totally believe that the "big baby" thing that doctors are so scared about is blown way out of proportion.

Size estimates tend to be WAY off , and I have had a ton of experience in this area also. I have had an average of 10-15 ultrasounds between my 3 pregnancies. The first baby they said was 9 1/2 lbs, we better induce. Uh, that "9 1/2 lb baby" turned out to be only 8 lbs 3 oz when he was born!!!

They said my daughter was larger too? and she was only 8 lbs 6 oz. My last son was even tinier at only 6 lb 15 oz. Those size estimates can be quite off.

I encourage you to know all your options!
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#5 of 7 Old 12-28-2007, 12:26 PM - Thread Starter
 
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Thanks. I called the one midwife in the practice who specializes in maternal depression last night. She has helped me previously as well with my many issues. She assured me that I would never be pressured to induce. I did misunderstand the other midwife. She also assured me that all the midwives there "hate" induction. When I asked her why anyone would mention induction for a suspected large baby, she let me know that the risk is head getting out and shoulders being stuck and damaging the baby's arm.

She told me my best bet was to "go with the flow" and make my own heart-felt decisions as they arrive to be made.

SAHM to Ivan 6/10/05 who says  signcirc1.gifand Matilda 1/31/08 who says saynovax.gif:::

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#6 of 7 Old 12-28-2007, 12:31 PM
 
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No natural way to make a baby come before she's ready. I would NOT induce for big baby, not in a million years. Some VBAC-friendly docs do low-dose Pit inductions. IMO if there is no medical problem, induction is best avoided.

I've known a lot of women IRL who've had 10, 11 and almost-12 pound babies.

Laura, CBE and mom to Maddiewaterbirth.jpg ( 06/03/04) & Graceuc.jpg (  09/10/06)
 
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#7 of 7 Old 12-28-2007, 12:40 PM
 
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I'm glad you talked to the midwife about this. Hopefully she'll talk to the other midwives and they won't mention induction again.

Honestly, there's no harm in natural "induction" methods- lots of sex, walking, spicy food, red raspberry leaf tea, evening primrose. Those things will not ever send a woman into labor who isn't just on the verge anyway but they will help move things along if the baby and your cervix are ready to go any day.

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