When to induce?

[ArgyleEnigma]

Hi ladies. What are your thoughts on when to induce? I know neonatal mortality and morbidity increases after 41 weeks, by not by a lot in absolute terms. My ob would let me go until 42 weeks, which makes me nervous--also, not that it really matters, but their LMP due date is 2 days after my charting/ovulation due date. But, I have an unfavorable cervix--no dilation whatsoever. Naturally, this increases the risks of induction.

What would June do? Would you ask for an induction at 41 weeks, or wait until 42?

[carolinaheart]

FTM so no advice but following.

When we first found out I was pregnant, I was prepared to go to 42 weeks if need be. But now that I've heard and read about the risks after 41 weeks, I am very nervous about going past that and my OB is ready to induce Sunday at 41 even.

I'm also incredibly nervous about being induced because I'm in the same boat as you. No dilation at all.

[amiet79]

Normally the practice I go to induces at 10 days overdue unless there are other medical concerns and they would do it earlier. My doctor and I discussed it and I won't be induced until close to 42 weeks.

I had both of my babies at 42 weeks and everything was fine. I didn't have a great induction with DS, my first, and I really wanted to avoid that when I had DD, which I barely avoided and I had a better labor experience.

It's up to you and everyone has a different experience. Some women respond really well to induction while others don't.

[microworm]

I guess if it were me, I would base my decision off how favorable my cervix is looking. The risk of needing a C-section after a long, failed induction scares me. Lucky for me, my doctor has already said he would expect an induction to go very well for me based on how favorable my cervix is looking. So I would entertain the idea of an induction at 40.5 weeks. With DS, my cervix was looking favorable for weeks before I went into labor at 40+3d. So I would be willing to give it a couple days after 40 but I don't want to get to 41 and my Ob practice doesn't like you going past 41 weeks anyway.

[pdxlaurens]

I have an induction scheduled at 41w2d in case I need it. I was induced with my first at 41w1d.
Apparently the placenta *can* start to fail around 41 weeks, one of my midwives described it as the only organ with an expiration date. It doesn't mean that it will, plenty remain totally healthy and functional until 42 or more weeks. If you decide to wait until 42 weeks you might get extra monitoring but otherwise there is no harm in waiting. The only reason I'm not waiting longer is because my first induction ended in a c section and odds of a successful VBAC decrease after about 41 weeks.

[packerfan4life]

So I just had a discussion with my midwife about this a couple weeks ago. Initially I was leaning toward waiting to 42 weeks bevause I really don't want to be induced. But after talking with her not only is neonatal risk increased but she said they actually found an increased risk of c-section for those who delay to 41 weeks. That combined with my measly 6 weeks of mat lwave that starts at 41 weeks and if I end up going the induction route I'm planning to do 41 weeks.

[greysonsmom]

I have an induction scheduled for 40+1 if I don't go into labor first. I had an easy fast labor with my first and I'm already 4cm dilated so if I need to be induced my OB seems to think my body would just need a little push. She would let me go longer if I wanted but I'm pretty over it.

[nymama917]

I had GD with my first so they said if I did not have her by my due date then they were inducing. I had her 4 days early. I was terrified of an induction ending in a C-section and I also wanted a med-free labor and knew that wasn't going to happen if I was induced. This time because GD seems to be mild and I'm having absolutely no side effects and baby is average size she said she would let me go past my due date. We haven't talked induction yet mainly because I went on my own with the first. I would hesitate to induce much before 42 weeks just because again I'm terrified of a C-section but if the doctor was a hard no to waiting that long I would take her advice and do as she suggests.

[sandandsea]

My doctor will induce at 41 weeks based on the later of the ultrasound or lmp dates. Last time I was induced for pre e at 40+3 and had chosen the latest of three dates to do it. This time there is no pre e and I'm 3cm again at this point and would induce as soon as she recommend. I'm 39'weeks now and the latest she will let me go is the 22nd which would be exactly 6 months from DSs bday

[Stringy]

I'm right there with you. Mine won't induce until 41 but but also seems to not do it on a weekend which will likely put me at 41+2 by the time it would happen. I'm just hoping something happens on its own.

[manybellsdown]

In addition to what everyone else has said, I'd also consider how well you respond to medication, in general. If you know.

I had a highly unfavorable cervix (nada happening, high and posterior) and chose induction at 41+1. I wanted to go longer, but I too was concerned about the placenta and the risks after talking to my doctor. I REALLY feared a long induction ending in c-section. I delayed the epidural sooo long because of this (which was difficult given my absence of pain tolerance and the hard pitocin contractions). But overall my body responded really quickly and really easily to the induction meds, particularly considering the lack of action beforehand. And baby was 9 lbs, 7 oz, so she was cooked.

A family member of mine, by contrast, refused all intervention and meds, including the epidural, because she knew meds often did not work as planned for her. As an example, she said she is one of x small percent that get hyper and hallucinate on Benadryl. For me, Benadryl makes me sleepy and less itchy.

Anyway, I'm rambling but possibly something to think about.

[mladerri]

I want an induction sooner than later. With ds I was induced at 40+4 and this time around my doctor says she won't induce until 41 weeks. I have an appt Thursday and I'm going to discuss why things have changed from 2 1/2 years ago. @aryleenigma I would talk about the risks and benefits with your doctor and see what you and your doctor think is best for the baby and yourself.

[happyday]

Mine doesn't require induction until 42 weeks. She will schedule one for after 41 weeks.
I likely would have requested an induction by 41w4d. It's kinda arbitrary, I guess, but 42 weeks makes me nervous.

[ArgyleEnigma]

My doc is taking a fairly one-size-fits-all approach to this. He is against induction before 42 weeks for anybody, and wouldn't really talk about the relative risks, just said that he "knew the data." He will let me insist on scheduling an induction at 41 weeks, though. It's frustrating because I feel very on my own here, since he just gives his opinion without really elaborating or supporting it. He just keeps repeating that induction is not without risks and doubles the chances of a c-section.

I will be picking a different OB after all this, our communication is just not good, but it's way too late for that now.

[Stringy]

Has anyone heard anything about acupuncture for inducing or helping get labor started? I just realized someone gave me a card but can't remember if that's one of the things it helped with.

[packerfan4life]

Jun 8, 2016 1:21:30 GMT -5 ArgyleEnigma said:

My doc is taking a fairly one-size-fits-all approach to this. He is against induction before 42 weeks for anybody, and wouldn't really talk about the relative risks, just said that he "knew the data." He will let me insist on scheduling an induction at 41 weeks, though. It's frustrating because I feel very on my own here, since he just gives his opinion without really elaborating or supporting it. He just keeps repeating that induction is not without risks and doubles the chances of a c-section.

I will be picking a different OB after all this, our communication is just not good, but it's way too late for that now.

That is super frustrating. I switched to a midwife practice at 35 weeks and even they have found data that shows your c-section rates with indiction are higher with induction at 42 weeks than 41. She didn't tell me I had to choose 41 or 42 weeks, just presented the data. I think nationwide 41 weeks is becoming the standard so it seems strange that he's making you feel like you have to push/beg for it.

[manybellsdown]

Jun 8, 2016 3:35:12 GMT -5 Stringy said:

Has anyone heard anything about acupuncture for inducing or helping get labor started? I just realized someone gave me a card but can't remember if that's one of the things it helped with.

I have heard/read a lot of success stories re: acupuncture and labor. I alllllmost did it but couldn't get in.

[manybellsdown]

Jun 8, 2016 1:21:30 GMT -5 ArgyleEnigma said:

My doc is taking a fairly one-size-fits-all approach to this. He is against induction before 42 weeks for anybody, and wouldn't really talk about the relative risks, just said that he "knew the data." He will let me insist on scheduling an induction at 41 weeks, though. It's frustrating because I feel very on my own here, since he just gives his opinion without really elaborating or supporting it. He just keeps repeating that induction is not without risks and doubles the chances of a c-section.

I will be picking a different OB after all this, our communication is just not good, but it's way too late for that now.

That is highly frustrating. Let you insist? Did he actually phrase it like that? I would roll my eyes so hard if it weren't such an important decision. Definitely a sign of poor communication on his part. Is there another OB in the practice that you can talk to? Asking because I had to meet all of them in case one delivered my last baby.

[ArgyleEnigma]

manybellsdown No, he didn't phrase it like that, I just found out he was willing to do it when I started insisting. Well, he said he'd "try" to get me inn the schedule. I'm going to call today to make sure he actually did.

I haven't gotten a second opinion from someone else in the practice, but I was able to ping someone I have a personal connection to who is an OB/RE. She was more helpful.

[happyday]

Jun 8, 2016 3:35:12 GMT -5 Stringy said:

Has anyone heard anything about acupuncture for inducing or helping get labor started? I just realized someone gave me a card but can't remember if that's one of the things it helped with.

I did Accupuncture through my entire pregnancy and would highly recommend it!

[manybellsdown]

ArgyleEnigma, that's great about the OB advice. Good luck with scheduling!

[regal]

In regards to acupuncture I had it done when labour was starting and stopping for a couple of days. Every needle have me a contraction and I went into labour a couple of good later.

As for induction, my midwife will monitor the placenta and fluid around 40+5 via ultrasound. As long as everything is safe for baby, I'll bake as long as I need to.

[GOmamab15]

Thanks for starting this thread ArgyleEnigma, I didn't know that there were increased risks before 41 weeks. In my L&D class the doula who taught it said risks increase at 42w. I had no idea that more practices won't go past 41w.
I'm only 38w right now but I definitely want to ask about it at my OB appointment tomorrow.

[ArgyleEnigma]

I went ahead and scheduled for the 16th, which would be about 41-1. Thanks everyone for your input. I hope I'm doing the right thing.

Now, baby, come on your own instead, please!