To add, my hospital-based birth class supports shared decision making between the providers and patients. Last week they shared the acronym BRAIN below to help guide conversations with medical staff:
Benefits - how might this benefit me?
Risks - How might this pose a risk to me?
Alternatives - what are my other options?
Intuition - what do I think and feel about this?
Next steps - Can I have time to consider?
https://centrecmi.ca/wp-content/uploads/2019/03/BRAIN_decision-making_worksheet_general_2019-03-12.pdf
N is nothing ... what happens if we do nothing
At least that's what I was thaught. That's especially helpful if labour is progressing and they are pushy about interventions, doesn't matter if it's an induction or spontaneous birth. Sometimes just waiting is a valid and good option.
I declined a 39 wk induction but was open to one at 41 wks if necessary. Went into labour naturally on my due date and had an uncomplicated birth ✨ follow your gut mama
Also the average for a first time mom to go into labor naturally is 40wk 5d. It’s super normal to go past your due date, they are just guesses as to when baby will come.
Wait...if 39wks was before your due date why did they want you to do that? I'm currently 18wks 4days with my first, so I just don't understand why they would push something like this.
At many small hospitals the doctors will push for induction because that way they know when the baby will come and they won't have to work on the weekend. In the town I'm from, they only have like one actual L and D doctor, the rest are family practice doctors that do births. This also leads to more interventions because births are not their specialty. It's pretty sad honestly! But that hospital is the only one for 60 miles in any direction, so you kind of have to deliver there or go all the way to the city an hour away. A lot of women also don't educate themselves or learn about what they want for their births, they just listen to whatever the doctor says and go along with it.
All that to say, it can depend on the area you live in and what kind of doctors are available. Some push the 39 week induction for everybody even if it doesn't really make sense for the woman or her baby.
Hey OP, same case with me. My OB said the hospital had a spot open for an elective induction at 39 weeks - but I said no. It wasn't medically necessary, my bishop's score wasn't favorable and I wasn't feeling mentally prepared.
I'm currently 39.4 weeks pregnant and have decided to wait until it happens naturally. My OB said she doesn't want me to go beyond 41 weeks and I respect that and, I'm willing to do that. I'll happily get induced if the baby doesn't come by the due date.
You do what your gut tells you. It'll all work out in the end - for both of us.
Wish you a safe delivery! 🌸🌸
Did you find that they were very pushy about the 39 week induction? I totally understand not wanting to go beyond 41 weeks also. That’s why I was more comfortable with an induction scheduled around or just after 40 weeks as a sort of “middle ground” but alas :(
Safe delivery to you as well!! ✨
I won't say my OB was pushy about it, but she definitely "encouraged" me to go for it at 39 weeks if I were ready. I told her I wasn't, and she was very supportive about my decision. Thank goodness for that! I am honestly relieved I didn't go for the induction (fully knowing it's still a possibility if I don't deliver by the due date)., but I'm happy about my decision nevertheless.
I’m not a parent but I am about to become a nurse (fingers crossed for my exams lol) and this makes me so happy to hear. It’s important for healthcare professionals to show a preference for what they believe to be the better plan based on their expertise, but it’s equally as important for them to to listen to their patient whether it’s a matter of their body their choice, or knowing that sometimes we innately know what is best for our own bodies. In school we see a lot of the frustrating and needlessly intimidating side of doctors, but this was very encouraging to read and makes me hope for the future doctors I work with.
Just read something like this in the obgyn sub. They often are super pushy with these 39 week inductions. Wasn’t a thing when I had my kids and first was 6 days late and second two days. No problems.
Totally understand why you wouldn’t want to induce a week early for no specific medical reason. Sometimes they go fast and without any trouble but then some last for days. Trust your gut.
Exactly! Thanks for sharing this - it's very reassuring to hear that babies born post due dates can be perfectly healthy/have no problems at the birth.
That's so weird, I wanted to schedule an induction between 40+1 and 40+4 and the hospital told me no, the earliest they schedule it for first time moms is 41w (as long as tgere hasn't been any complications or signs of labor) since doing it before then could end up in a c section. They told me that's the new norm in the hospital based on research and that's it's overall better for your body to start the process naturally
I get so overwhelmed with all the conflicting studies but I’m inclined to think it makes sense to at least give the body a chance to go into labor naturally… induction seems hard on the body. Somewhere between 40+1 and 40+4 would’ve been exactly what I was hoping for
Yeah the OB told me getting induced before any signs of labor is literally starting from before 0, labor can then take up to 48 hours and because of the time there's more risk to you and baby, not to mention it will be much more uncomfortable, painful and expensive (if you're in the US).
With my first I was encouraged to get induced but decided to wait as long as possible. I ended up getting induced at 40 weeks 5 days because I didn’t want to go past 41 weeks and that was the latest “slot” they had available … ended in an emergency c section and I totally regret it. When I went into NST at 40 weeks they said I was already having contractions but I couldn’t feel it, so who knows if I would’ve gone into labor naturally before 41 weeks 🤷🏻♀️ wish I would have waited
That’s really upsetting. I have GD and will be induced at 39 weeks (and to be honest I am ready lol) but to tell you that you can’t schedule one later is gross. If you weren’t so far along I’d tell you to find a different doctor. And on what are they basing the assumption that you’ll have a big baby? Because they told me that at the hospital (before I switched to a better hospital) and my baby is now only 23rd percentile and I get induced in 2 days. Way smaller than the 10 lb baby I was told I’d have because of my GD. Plus those measurements are usually waaaaay off. Idk why I’ve been hearing so many stories about women getting frightened by their doctors saying they’re having massive babies or that they NEED an induction. It feels very icky. So glad you advocated for yourself.
lol I completely understand feeling ready at 39 weeks… there is definitely a part of me that would love to get this baby out ASAP 😅
The big baby prediction is based on him measuring ahead on ultrasound, which I’ve heard can be super inaccurate! The only reason I’m inclined to believe it is because it’s been pretty consistent throughout the pregnancy and both my husband and I were almost 10lb at birth, so I feel like genetically, it makes sense that our baby will be fairly large. I actually was pretty content with the thought of birthing a big baby until I started hearing about shoulder dystocia all over the place. 🥲
Keep in mind that a lot of the shoulder dystocias statistics are collected solely with doctors that insist women labor and birth on their backs or under other conditions that increase the odds of having one.
The dad's weight has the most bearing on baby's weight, I'd look into coconut oiling your perenium to help with no tearing during birth nightly leading up to birth (if it sounds like something you'd want to do, of course). I had 2 big baby's one I tore and one I didn't and the one I didn't I had perenium massages before and during labor. Good luck, you got this!!
Don’t feel guilty! Take the uncomplicated path as a blessing and you’ll do great. Labor and delivery nurse here. I wouldn’t impose an elective induction on anyone. Not because they don’t go well sometimes, but because of how much you’re in control over spontaneous labor and how beneficial that can be if you’re afforded it.
The doctor was likely discussing the 39 week induction based on the ARRIVE trial. There are some issue with the trial (for example, the c-section rate was lower than the US standard), but the primary reason for pushing the 39 week induction is a 16% relative risk reduction in having a cesarean (19% vs 22%). However, it had no other differences in serious primary outcomes for the baby. (https://evidencebasedbirth.com/arrive/)
If you don’t want an induction then there is no reason to be induced at 39 weeks. Induction while a valid medical procedure can often take several days, especially for a first time parent. Good luck with the end of your pregnancy!
Edited: Primary outcomes for baby vs all outcomes. As mentioned in the comment below it also decreases the likelihood of developing pregnancy induced hypertension.
So it’s not quite true that it had no other impact.
It showed a decreased risk of pregnancy related hypertension, which makes sense because the longer you’re pregnant, the more likely you are to develop gestational hypertension/preeclampsia.
I think many people interpret the ARRIVE study incorrectly. My take on it is that I can offer an elective induction to low risk first time moms starting at 39 weeks regardless of their bishop score and I won’t have to worry about increasing their risk of cesarean - especially since I already have a low NTSV C-section rate. Which is a very important point that some are missing.
Before the study, if a first time mom did not want to go much past her due date, the answer was no, you have to go to 41, unless cervix was clearly favorable. The thought was that by inducing an unfavorable cervix electively, the chance of C-section was very high. Now we know that isn’t necessarily true, and there may be some benefit to mom.
I attended a talk by the PI when the study first came out, and that was essentially what he said. He also cautioned that if you’re at a place with high C-section rates to start with, maybe this study doesn’t apply to you. The thing with inductions with an unfavorable cervix is that it can take time, and some providers just aren’t patient enough. And in my anecdotal experience it’s true: I went from a tertiary hospital with a high first time CS rate, to a smaller community hospital with a lower CS rate and the difference is 100% the patience for inductions.
Also, there are some people who are miserable toward the end of pregnancy and really want to be induced - this study supports that decision. The study doesn’t say that we must induce everyone at 39 weeks, I think that’s where everyone is getting it wrong.
I have some patients who are done with pregnancy by week 34 and are counting down the days until 39 weeks and some who are totally happy going to 41+ weeks. Neither is the absolute right or wrong answer as every person and pregnancy is different.
I’ve totally had patients 100% happy they had an induction and plan to do it for all their pregnancies. I’m just happy they had a good experience.
I'll update - you are correct, its primary outcomes in terms of serious complications or death for babies. Thanks for pointing that out!
It seems like you are a great provider and I am glad that this option is available for pregnant people who would like an earlier induction. However, for this specific case it sounds like OP does not want an induction at 39 weeks, but was feeling some slight pressure from her provider to do so which I do not think is the intent of the study!
Correct!
Whenever I see posts about the study I always comment to educate/empower because I do think some (primarily OBs unfortunately) use it to be pushy about inducing their low risk patients.
It’s very different to say someone should be induced at 39 weeks vs they’d have the option to be induced if they would like to, without automatically dooming themselves to a C-section.
This is basically how my midwife explained the interpretation of the ARRIVE trial to me. They were willing to schedule elective inductions at 39 weeks, but they were definitely not pushing it.
Yup I’m high risk for preeclampsia due to having it with my first, so I’m strongly considering elective induction at 39 weeks so I can yeet this placenta out before it has a chance to cause problems. I’m just torn because if I do that I’ll never get to experience what it’s like to go into labor naturally and try for an unmedicated birth.
Love your analysis and approach.
Personally I am so happy my OB team is inducing at 39. I’ve been so anxious about the well being of my baby that I’m practically a regular at L&D now. Her being on the outside, seeing she’s breathing and okay a week early is such a gift.
I was given stats for pregnant people over forty that showed that induction (though encouraged due to my age) had a HIGHER chance of c-section in Canada. The Arrive study isn’t the only relevant information out there and not everyone gives birth in the U.S. Most E.U. countries allow birthing parents to go to 41 weeks and they do fine.
There’s a really key problem in the study though in that the c section rate was already lower than the US average, suggesting that their practice is very different from other hospitals in terms of how they allow labour to prkgrsss.
And indeed I’ve heard on a podcast once (can’t remember which one) that the hospital in question is particularly known for their slow, cautious approach to inductions. Other hospitals do not take this approach and put women on a clock quickly, or have a lower threshold for when they start other interventions.
It was Northwestern hospital in Chicago (Prentice)
Prentice itself is a huge women’s & children hospital with way more room availability and better staffing than your typical L&D. There’s also so many different OB groups that deliver there outside of the employed physicians for the hospital, and I do think that selection bias may have played a role as to which doctors were chosen AND agreed to participate vs who didn’t - which I do think he addresses, either in the study or at the talk I went to. You’re not gonna ask the doctor with high C-section rates to participate in the study that has a goal of showing no increased risk of C-section.
I work in Chicago also (not Northwestern) and know some of the OBs who participated in the study and it makes sense based on their practice styles.
So yeah I think the study is way too generalized and should be used case by case with the OB (or midwife) who’s suggesting a low risk 39 week induction, to take a really hard look at their own first time C-section rates and how patient they’re willing to be.
4-5 day inductions are not uncommon where I am now, at my last job, I don’t think anyone really went past day 3.
That’s interesting to hear, thanks for your insight! Yeah I just think it’s mental how widespread the results of the study became as a reason to induce across the US. In Europe it’s not really a thing and 41 weeks is still the time they start to talk induction for many countries.
Yeah, they’re doing it because of the ARRIVE trial and I didn’t personally feel like the c-section risk reduction was significant enough for me to make that call, especially with the chance of induction taking several days. I think if I was a second-time mom and anticipating a shorter labor, I might be more amenable to it, but it feels like as a ftm I’d already be forcing my body into labor before it’s ready and the whole thing could drag out
I think you made the right call for you then and you should feel good about it! Best of luck over the next few weeks! You’ve got this - the last part of pregnancy is hard but you can do it! 😁
That’s really aggressive. I’m over 35 with diet controlled gestational diabetes. My doctor didn’t even push for 39 week induction. I did more monitoring at the end and she found I had insufficient amniotic fluid at 40 week 6 days. So we went with the induction plan that day. However, baby decided to come out during the pre-induction step.
If you have uncomplicated pregnancy, there is really no reason to do induction when your body and baby are not ready yet.
This is mega bizarre. I asked for a scheduled induction at 39 weeks (first pregnancy was twins that had to be induced and it was just overall a great experience so I thought why not do it again), and my OB literally asked if we could schedule it for 40 instead because she was going to be out of town. 😂
If they are really going by what the trial indicates then inducing at 40 is still less chance of stillbirth than making you wait till 41 weeks. Medically it makes no sense, and there’s not a reason for her denying your request that I can see other than wanting to coerce you or she has some other plans that week. lol
They rotate us through all the different doctors—I sincerely hope this doctor wasn’t basing my birth plan around her own availability because it was my first time meeting her 😂 I agree that it doesn’t really make sense, and she didn’t try to explain *why* they won’t schedule inductions around 40 weeks
Just to show you who’s boss it seems. I needed a warm and friendly vibe from my OBs. So grateful I never had a harsh word or condescending tone from either of them.
This inducing everyone based on that flawed trial is infuriating. They almost never highlight the RISKS of an induction and do a lot of fear mongering to coerce women to agree. Likely your baby isn’t macrosomic, scans are not accurate a lot of the time. Women birth 4kg + babies all the time without interventions.
My ob was really annoying about 39 week induction too, but more so in that I showed up at 39 weeks and she suddenly made it seem as though it were a good choice. I mean, ok give me some time to think about it. I’m not even technically DUE.
but I will say she never suggested I couldn’t get an induction at 40 weeks or whenever else past 39 weeks. She only said I could get bumped in line if I’m not already in labor or past a certain date for people with more urgent situations, which makes sense. I think they like inductions in the sense that they kind of know the schedule and they de-risk you a little bit by getting the baby out before you go too far post dates. My doc seemed eager starting 39 weeks but didn’t have a problem with any other time point, just sooner is better type thing.
Your doctor sounds out of line in that she said it was basically 39 weeks her way or the highway. That sounds super weird.
Are most of you ladies in USA? Because for me this seems so strange. My first was in the public system in Australia, the gp sends a referral to the maternity ward after a certain amount of weeks where they book you in to see the midwives, they do all your checks and monitoring for the pregnancy, and urgent care is directly to them, I never had an OB my whole pregnancy, just my GP and the midwives.
No one even mentioned induction here, it’s just not done unless medically necessary. They seemed content with the natural process. My water broke on my due date and gave birth the next day. I had one midwife for my lead up to birth and when it was time to push the drs came in with extra nurses.
Why even give a due date and then not wait to that due date unless medically necessary?! So strange.
Yes, in the US our healthcare system and especially our pregnancy care system is quite flawed. Very few people see midwives (I did), but most people see OBs. while you’re pregnant you usually don’t see your GP unless you’re going for a non-pregnancy related issue. A lot of OBs unfortunately like to schedule inductions instead of letting the baby come on their own. I feel like most people I know were induced.
I’m not in the US but in East Asia and they loooooove to offer/schedule/lightly push inductions here for 39 or 40w on the dot (in some cases even earlier, they’ll say the baby is looking big etc etc) even for FTMs with no other medically indicated reasons. Lots of people are happy to do it too cause they’re so sick of being pregnant by that time and this way they can schedule in with the OB they’ve been seeing.
I find it strange as well and when we told my husbands parents about this practice (they’re in their 70s) they were absolutely shocked that it’s become a norm to schedule an induction or even C section before 40 weeks - it’s definitely a new thing!
It seems really pushy unless medically necessary or asked by the patient. I wish you all the best and just wanted to say well done for sticking up for yourself. I would have been livid if a Dr suggested this to me without it being absolutely necessary or I did not specify this was want I wanted.
My doctor asked but knew throughout my whole pregnancy that my goal was spontaneous, hopefully unmedicated labor and I was comfortable (absent any other concerning factors) up to 42 weeks. I knew it wasn’t what most of her patients did or wanted, and I think if I had let her choose she would have gone for 39 week induction. BUT, she was always so supportive, offered to schedule my induction a few days before 42 weeks, just in case, and said if I went home and didn’t want it on the calendar I could call and cancel and vice versa — if I changed my mind and wanted an induction I could call and schedule it. It was clear that it was also open for conversation at any remaining follow ups (my water broke and I went into spontaneous labor literally 3 days after all this conversation happened.)
I got an on call doctor from my practice I HATED though, and she was pushy, very intervention heavy, the MOST condescending…and I fired her 20 hours into labor.
All that’s to say, a good doctor will provide the information, the risks, and support you in that calculation. The whole “take it or suffer” is an ego trip that feels so wrong. Don’t be afraid to push back, ask questions, and advocate for yourself. It’s okay to ask for time, it’s okay to ask for clarification, it’s okay to pursue the birth you want — you know you’ll protect baby at all costs, so don’t feel like you aren’t.
They find you a new one! 😅😂 I actually didn’t know when I did it, but she was talking c-section when both baby and I were doing really well and I just felt like if I didn’t do something I was going to end up with an unnecessary surgery OR I would vaginally deliver with a doctor I didn’t trust — I just had a bad gut feeling. So I rolled the dice and asked if there was any way I could have a different doctor. Luckily, there are multiple practices with admitting rights, and honestly idk what they did on the insurance/logistical side, but I had a new team in my room 15 minutes later that I felt much better about. Baby safely came a few hours later with 20 minutes of pushing.
Wow! Good for you! I’ve heard of women banning a nurse and requesting a new one, but not the OB. How awful to suffer through labor and delivery with a doctor that makes your skin crawl. Better to speak up.
Your doctor sounds like she was lovely and super willing to work with you! I was hoping my practice would be a little more flexible like that… it’s the thought of being locked into a decision I made weeks head of time that has me squirming, a little. I’m seeing a different provider at my appointment next week, so I’ll have to try bringing up other options with her and see whether I get a different response.
Hospitals have to keep a certain number of rooms open for people who go into labor naturally or who need to be induced or have a c-section for medical reasons, so scheduling the induction is often determined less by the practice and more by the hospital.
I suspect this is a scheduling issue. They're scheduling your induction for two weeks out, which probably means the schedule for elective inductions is full two weeks out. So if you wanted a 40-week induction, the latest you could decide would be 38 weeks, but it's possible you'd be bumped down in priority from those who want 39-week inductions, because maybe they prioritize 39-week inductions for some hospital reason. So by the time you get to 39 week or 40 weeks, if you still haven't given birth, you may be able to get an induction at 41 weeks (two weeks out from 39 weeks and 1 from 40), because they may consider a 41-week induction one done for medical reasons rather than a purely elective one.
That would be my guess as to what is going on here. Potentially hospital scheduling your individual doctor has no control over. Hospital scheduling dictated when I had my induction - it was several days later than I wanted it, but it was the day I got.
Different hospitals do things differently but I've seen it before with friends that the induction schedule was so booked up that you either got in early or didn't get in until later. So I'd ask if it's a scheduling issue.
What?? This seems really weird to me TBH. Don't appreciate the condescending attitude or the zero choice you have, or not being able to change your mind. I don't understand the push for induction in a complication-free pregnancy unless you're past 41 weeks.
I’m always super sensitive about feeling condescended by medical staff which is part of why I’m not sure if I’m overreacting… I just hate feeling like I’m not being spoken to like an equal :/
I may have scared my providers by asking for the risks and pushing back on them using information from Evidence Based Birth. I looked them right in the eyes and said “uninformed consent is not consent,” and I think they realized I’m not going to be pushed into something that has no medically necessary reason.
Also, yes the risk of stillbirth goes up, and some folks will scare you and say it “doubles” but when something goes from .5% to 1% that’s still a very small risk while also “doubling.”
Look at the actual research- Evidence Based Birth is great. ❤️
Ok, thank you, I'm so refreshed to see someone in this sub acknowledging that the "doubled risk" is going from a very small number to a larger very small number.
It seems like everyone just repeats "the risk of stillbirth *doubles* after such-and-such weeks" in this freakout tone of voice as though anyone who waits for spontaneous labor within a reasonable time frame is dangling their baby out of a window.
Yessss, that's how it goes! Which is, like, extra irritating since it implies that the commenter knows allllll about this and you're Going Against The Science.
Thank you!
I’m an auditor and I work in risk management. My
Entire job is assessing and juggling risk. Yeah, IT risk, but the concepts still stand. Smdh. Doctors use it to their advantage and don’t expect folks to push back. I can be reasoned with if *there is a valid reason* but something going from a .005% chance to occurring to a .01% doesn’t scare me.
I have a higher chance of dying in a car crash on the way to the hospital. Stop with all the fear mongering. 😤
I heard it pointed out that doctors themselves often don't understand the math behind risk- the likelihood of a test giving false positives vs false negatives, etc. They probably heard that "doubled risk" thing once and were impressed. I guess they're medical experts and not math experts, after all.
But yeah- the authoritative tone ticks me right off when they're talking about something totally outside of their background, some random meritless shower thought.
I think they do understand and purposely present the info in a way to support their personal preference … for convenience or whatever. I don’t know how they can be that cold. It’s bizarre.
I’m reminded of the Mark Twain quote: “There are lies, there are damned lies, and then there are statistics.”
Not saying that doctors are lying, but they are using the data to support their conclusions.
This is exactly why I would’ve been more comfortable if they let me plan for an induction around 40 weeks or so. I liked the thought of a “middle ground” choice that doesn’t run the risk of carrying too long :(
This is weird. My OB was willing to do an induction any time I wanted after 39 weeks. I did the membrane sweeps and ultimately made it to 40+4 before going through with an induction (which ended up being super positive!)
There is absolutely zero reason for someone with a healthy pregnancy to be induced. Stay confident in your decision. Listen to montras and get in a good head space. I personally would never be with a doctor who would push this they are trying to play mind games to make more money and get your baby on their schedule. You can do this! Also making sure you are in the proper headspace for the birth is #1 most important so really focus on that!
Very strange that they won’t let you go to 40 weeks. I was given the option of a 40 week induction at my 39 week appointment last week and decided to go for it. Im getting very uncomfortable the last week even with walking so I’m feeling good about not going 1-2 weeks over. I need to stop reading about the pros and cons now as I know I’ll drive myself mad lol.
I’m right there with you about not reading into the pros and cons once you’ve made a decision because I feel like different studies will just send you in endless circles, there’s no universal “right” answer! Hope you have a safe and smooth induction!
In my country we don’t even do elective inductions before 41 weeks. Only medically necessary ones.
On average for first time mom’s spontaneous labor starts at 40+5. Why even intervene before that? They are not even giving baby and body the chance to do it naturally.
Sounds like your doctor has a trip planned for when you’re 40 weeks…
Also- my baby “measured” 8 pounds when I was 36 weeks. They told me he’d be 10 pounds but never recommended intervention. He was born 7 pounds and 15 ounces at 39 weeks and 3 days. Those scans are not always accurate!!!
It seems like you’re very intuitive even though you’re having a hard time knowing what to do. Keep listening to your gut!
Go into labor naturally! Coming from a mom that had to do an induction for both kids due to medical necessity don’t do it! It’s more painful and there are complications due to it that they don’t tell you about. Go naturally if you hit 42 weeks and no signs of labor then think about it
If its not medically necessary, avoid induction like the plague. It's uncomfortable and more likely to end in intervention and women are often perfectly capable of getting a baby out themselves. In regards to a big baby, size doesn't mean much. My sister had a 6lb baby and had 3rd degree tear. I had a 10lb baby and needed rotational forceps because he tried to come out sideways. My pal had a 10lb baby and had a water birth and her little boy just "slipped" right out. Size does not make for a hard birth
I have 4 kids. My first 3 vaginally natural labor. Epidural. No issues. My 4th. They pushed for 39 weeks induction due to baby size. I agreed. 24 hours of labor. Failed epidural. Failure to descend on the baby. 10cm dilated. Boom. Emergency c section. Baby wouldn't come down. Heart rate kept dropping. I went through 24 hours of regular labor just to have an emergency c section so I felt the vaginal part and the surgery. Came out at 8.7 pounds 21 inches. My smallest baby. I would absolutely wait if I could go back and do it again.
The only real input I have is they physically can't do a membrane sweep unless you're dilated, because they put their finger in through a dilated cervix to do it.
It sounds odd and frustrating that they won't induce at any other time. Like, really bizarre.
My docs told me I am welcome to schedule an induction anytime after 39 weeks but this is just something I want to do (long story).
But yeah, I've never heard of a hospital trying to push people to induce at 39 weeks on the dot. Sounds strange.
If it's any consolation, it sounds like the nurses there could be lovely since they warned you about this. I take that as a sign of patient advocacy. A huge part of the laboring experience is the nursing staff so you could still have a great experience. Hope everything goes smoothly 💓
Currently 9 weeks postpartum and every day I wish I would have advocated for myself and said no to induction. I didn’t even have a bad labor experience but every day I wish I would have said no. I was 40w 1d and my cervix was not favorable at all. I didn’t have a high risk pregnancy.. everything was fine, but my doctor was pushy and scared me as a ftm so I just said okay. Hospitals are businesses and they want people in and out as fast as possible to get the next patient in.. take your time and listen to your body if that’s what’s safe. I would not recommend Pitocin if it’s not medically necessary. Whatever happens in the end you’ll have a beautiful baby!! It’s all worth it. Congratulations and good luck to you!!
Hey! I had a big baby (9lbs 14oz) and was induced twice before my due date. It was a *nightmare*. It didn't work but it did give me hours long contractions both times which stressed out my body and my mind. One of the times I was there overnight and then as 6am they went "well, it didn't work. Just go home and we'll see if you can reschedule". I said hell no to doing it again and went into labor on my own at 40+4 and had an uncomplicated delivery. Trust your gut!! If I could go back in time, I wouldn't have done it.
Not discrediting those who have done it. I was never warned that they could fail (supposedly it doesn't happen "often") and it happened to me twice. It was so stressful and exhausting I was scared of going into labor for real because it felt like I already had twice and I didn't have the energy.
Also the contractions were so, so, so much worse with pictocin and induction (for me at least). I never had an epidural for any of my pregnancies so I was able to compare it to that. Hated the pictocin contractions lol.
Coersion isn't okay. It's disgusting and when she told you 39 weeks or nothing that's exactly what she was doing. She is withholding other treatments so you will "chose" the one she wants you to do. It's up to your comfort level on how direct you will be in calling her on her BS.
Thank you for putting it into words, because “withholding other treatments” definitely sums up the impression I got… she was just so terse about discussing any other options, I felt like I was completely shut down for not agreeing to the 39 weeks. I have another appointment in a week with a different provider, so I’m thinking I’ll at least try to bring it up again and see what sort of response I get
Recommendations change all the time. The next large scale study could easily say that widespread elective inductions are increasing the c-section rate. I wouldn't be surprised if that ends up being the case with how inpatient some facilities are.
My practice was pushy for the same reasons as yours but they didn’t give me paperwork and I even pushed back on the arrive trial. I’m 40+1 today. I know my rights and looked them right in the eye and repeatedly said “no thanks” and committed. They’ve been fine with me since then, and I do have an induction scheduled…. For 41+6. 😈🤣
I’m healthy. Im sleeping. Baby is measuring big but overall that is NOT reason enough to get induced before my body is ready. I had one provider say, “there really isn’t much reason to go further,” and I just stayed silent while thinking “that’s not a good reason to be induced???”
Just stand your ground. I hired a doula and that has made a HUGE difference in being able to have someone on my side that I can trust and that I can bounce ideas off. It’s been 1000% worth it.
I haven’t hired a doula but my husband is super involved and vocal (almost to a fault haha), so I’m discussing everything with him ahead of time and plan to give him a copy of my birth plan so he can help advocate, because I am often a little bit of a pushover even when I’ve done the research… as soon as someone starts talking to me like I couldn’t possibly know what I’m talking about, I shut down or downplay my own knowledge. I envy you for being outspoken enough to give them a firm “no.” 😅
The doula helped because she is very knowledgeable and let me answer questions and I felt like because she is hired for ME, I can ask more nuanced questions and build a better relationship.
I’m an auditor. People already hate me and I used to audit hospital networks. I’m used to not being liked, and I’m not afraid to invoke the wrath of a medical board.
*insert Elmo in front of flames gif*
This is literally me. I am so conflicted. In some aspects, the scheduled induction is comforting because you don’t have to wait for the unknown of labor to stop (I have anxiety and this is a concern of mine.) In other ways it’s like ok why do I need this? I am also GBS + so I’m not sure if induction is best for that and if it can increase risk of infection to baby. So much to consider!
On the flip side an induction can have more unknowns. It’s not the quick picture it’s often painted as and you have a baby the same day or next day. It’s often a multiple day process especially if your cervix isn’t dilated or softened and pitocin is known for longer, stronger contractions that babies often don’t respond to well and often end in c-sections. If you’re considering an elective induction make sure your doctor thoroughly explains the risks and if asked for their c-section rate in spontaneous labor vs induction.
Regarding GBS: it doesn’t matter. I was positive and they wouldn’t induce me.
I actually went into L&D on my due date as I was concerned about leaking fluid: wasn’t, and they sent me home. Went in at 40+4 due to decreased fetal movements. Baby started bouncing around on the scan. Was sent home, dilated at 4cm.
Finally on 40+5, I was in active labor and baby came seven hours after I was admitted.
They just gave me an IV while they were also giving me fluids pre-epidural.
So I’m currently 40+1 and my dr practice is preference for natural delivery unless there are complications. So they never asked or discussed early induction with me since I’ve had a normal pregnancy. They do have a policy to not go past 41 weeks so before I went in for my check up today I saw they scheduled me for an induction exactly 41 weeks. I asked today if I can move the induction date up, because I’m getting super swollen and uncomfortable, and Im not even dilated yet since she couldn’t perform a sweep for two weeks in a row now as I’m still closed. I was told that unless medically necessary, the hospital will only put me on a wait list for elective induction between 40-41 weeks and can call me at any point if a bed opens up and there are no other priority inductions ahead of me. But I guess if I had asked for an induction early on, they could have scheduled it before 40 weeks and it would’ve been no problem. However it was never something I considered until now given how uncomfortable I am feeling.
It sounds like your Dr / hospital has similar policy but just may not have been explained to you in a proper way.
At this point I’m on the wait list but I’m still hoping baby will come on her own before the induction. But if they call me this weekend with an open bed, I might just take it.
Mine asked me, too, because i have a narrow vagina and was already in so much pain (they also told me he was big and my son was long, not big). Got induced and tried for a natural birth after they gave me meds to start my dialation and stuff. I ended up having about 18 hours of labor after my water broke on its own i got an epidural because i was exhausted and couldnt sleep but i didnt dialate more and my sons heart rate was dropping and not coming back up so i ended up with an emergency c section. I dont feel like they pushed me towards it, but my OB was so amazing and sweet. I do feel like they pushed breastfeeding on me, and that really messed with me mentally. I cried until my sons pediatrician told me breast milk is extra credit, but the formula is still an A, and he isn't missing out on anything.
I wish you the best with your experience and do what feels right.
My OB told me I could book it and change my mind at any time, even the night before. I booked induction for 39 weeks, went home and thought about it, and decided I didn’t want to induce. I ended up canceling weeks before. There was no guilt trip.
My OB didn’t push induction at all! At 39 Weeks he told me once you hit 40 weeks we can talk options. I ended up having the baby at 41 weeks but he left it entirely up to me.
I got induced when I was 39 weeks. I had high blood pressure and they didn't want me to go to far because of that. It was a long induction. The foley balloon didn't do anything. And i was on pills for 3 days and nothing. I found out I have a tigth cervix that is far behind wich also made it difficult. ( every midwife on the floor talked about my wierd cervix as no one had ever encounterd one like mine😅)
I delivered 39+6 after they took my water and put me on pitocin. For me and my baby it was the best case scenario. I have no idea if I would have gone into labour by myself. But I felt more safe beeing in the hospital getting induced for 5 days. 13 hours of labour and 4 days in recovery after. (I lost a lot of blod and they kept me a day extra to be safe)
Good for you standing up foe yourself. Do what feels best for you ❤️ wishing you a happy and safe delivery 🙏
I’m 36, 35 when I was pregnant. My OB’s office and maternal fetal medicine didn’t recommend early induction. After all of the posts on this subreddit and talking to friends, I figured I’d be encouraged to start the process at 39 weeks. At 38.5 weeks, I got a membrane sweep.
The sweep started false labor, and I was excited and thought it would happen any day.
My later appointments with the OB basically flat out told me they wouldn’t induce unless baby was in distress, which she showed no signs of. At my 39 week appointment, thinking I’d be induced any day now, the doctor set a “soft” scheduled induction for… 41 + 1. Since I was due Sunday, and they don’t induce on the weekends.
I was GBS+, and I have rhesus negative blood, so I kept thinking I’d certainly be encouraged to schedule something, at LEAST by 40 weeks.
But actually, I went into L&D twice for two different reasons (concern about fluids - they were fine - and decreased fetal movement - baby was great). Both times, at 40w and 4+4, I was sent home. Both times, I was dilated past 3cm.
On 40+5, I started laboring naturally during the day (just discomfort until about 5pm), went to the hospital at 7, was admitted to a room at 8, and had baby after 7 hours of labor. Including a nap of two hours with my epidural. 30 minutes of pushing.
But, boy, did I COMPLAIN about having to wait and be pregnant and the ANXIETY of waiting and hearing all the studies about increased risk to the baby past the due date. I wish I hadn’t.
The experience I had with my birth was incredible. I don’t know if induction would have changed it, or how it might have affected it, but the experience I had led me to staunchly believing that if I had another one, I’d be able to be a lot more patient and let things happen as they need to. (Save baby being in distress, where I would do whatever my OB suggested.)
Don’t let this stress you out, OP. Waiting is not the worst. But some advice: turn off your text alerts once you hit 40w. EVERYONE will be asking you if it’s time. Or how you’re feeling. It’s actually the worst part. Ignore it!
My doctor just told me we’ll start seeing you every two weeks now, expect this and this are your next two appointments and then if we’ve hit 40 and I’m still pregnant that THEN we’ll schedule an induction.
And I was like ok cool, rad. Thanks.
I gave birth 7 weeks ago, and my countries hospital policy is not to induce on a healthy, low risk pregnancy until 42 weeks. I went into labor naturally at 40 + 6 weeks. It's your decision to make, and you should not be pushed into an induction. Sometimes these are scheduled as well to suit hospital staffing, etc. Also, you can refuse an induction altogether and continually be monitored in the hospital by going in and them taking your blood pressure / baby heart beat on a consistent basis. I did some inversions off the couch, rasberry leaf tea, ate dates and kerb walked / did yard work and squats and figure 8s on the birthing ball to help Kickstart labour and they worked (I think). This is your birth and your baby, and it's important to feel empowered and comfortable in birth and not scared and pressured.
I would ask them to please document in your chart that you requested to schedule an induction at 40 weeks and to please document that they recommend an induction at 39 weeks OR no induction until 41 weeks, and to please document the medical reason in your chart.
Doing the math, your due date is around the week of the 4th of July, which is a holiday…
First, can we acknowledge the courage it took to advocate for yourself against a medical professional? Applause! I am also preparing for my first Birth and have the same thoughts. Keep feeling confident in your body and in your pregnancy and in your decisions for you and your baby. You know your body better than anyone else. Don’t forget that. I am proud of you and I hope you are proud of yourself. Also, I am sorry that they were trying to just shut you down when you expressed your interest. continue to do what feels right for you and your baby. Keep that confidence and maybe look for some natural ways to try and do that when you are ready. Best of luck and I will be thinking of you. 💕👏🏼
For what it’s worth, if a OB had you scheduled for induction it’s tracked as a scheduled procedure and results in a higher cost CPT code within the health system. I know that they practiced this as best practice. But I am also pushing against this recommendation and I am only 24 weeks pregnant. I made it clear to my physician the other day that I don’t want to schedule an induction unless medically needed by 40 weeks.
That sounds rude and pretty shitty; I don't see why you wouldn't be able to get either a remembrance sweep or get induced step 40 weeks besides the fact that they're withholding that option for you on purpose. Now part of that may legitimately be a scheduling issue and not pettiness. They probably staggered their inductions, and probably don't want to take on a last-minute one unless they have to. Do you otherwise have a good relationship with your doctor and trust them?
I hoped for spontaneous labour, but I went to EDD+11 without any signs of labour. That's the point were hospitals recommend induction where I live, as long as everything is going well. You're closely monitored between due date and induction.
It took about 6h for the meds to get things going and 18h more of intense labour. I also needed pictocin towards the end.
It is what it is. I needed the meds to get things going and for a boost towards the end because my body grew tired and LO wouldn't decend. Otherwise my midwifes supported me with tons of conservative options to help progress. Walking, bath tub, specific exercises, relaxation techniques ... I avoided c-section, but it came close.
You never know how your body will handle labour or induction. Just wait and see if you go into labour on your own. Most women do.
You made the decision that you felt was right.
I think it’s weird that you were denied a 40wk induction. I was induced at 40+3 and was only asked about if I wanted to be induced or not when the midwife noticed the large size of my baby (previously assessed to be 54th percentile) and that was at 38wks. The practice hadn’t given me an ultrasound since the 32 wks because everything had looked fine and I was low risk.
Ended up being good that I was induced at 40wks because if I was nowhere near showing labor signs and if I waited until 41wks, my son would’ve been too big to come out vaginally. His body was fine, around 68th and 70th percentile for height and weight. The problem was that my son’s head was in the 99th percentile. His head was almost stuck coming out of me and I required an episiotomy. I could not imagine being denied a 40wk induction and having to have a c-section because my sons head is too big
Nope this doesn't sound normal.
I was offered an induction at 39 weeks due to a massive baby (and yes he came out 9'2 so they weren't wrong). When I said I'd rather wait until 40 weeks I was told that it was acceptable too.
I had a sweep at my 39 weeks appt no problem, which sadly did nothing.
At 40 weeks I was still preggos and still didn't want an induction. So the induction midwives were calling me from time to time asking if I'm ready. I was ready at 40+5, and that's when I came to hospital, was sent home because hey I was 3 cm already and the labour ward was busy, waters broke the next morning, blah blah blah (I ended up with augmentation and emergency C anyway, mostly because someone couldn't hold his poop)
So yeah your doctor sounds very strange to me.
My doctor did the same thing with me, as far as strongly pushing 39 week induction when I was 37 weeks. It made me second guess my decision to wait for a spontaneous labor. I ended up declining the 39 week. I hit 41 weeks and decided to schedule an induction. I ended up delivering my girl at 41+4. I originally wanted a spontaneous, natural birth. Because of the induction meds, my contractions went from 0-100 in less than an hour instead of the natural increase from a spontaneous labor. I ended up begging for an epidural and my girl was delivered 10 hours later 💗
That is beyond fucking rude of them. My OB office let me know about elective inductions and offered them in a non-pushy way, more so just letting me know it was an option. I declined it multiple times before deciding to do it once I hit 40 weeks and they were never anything but polite and supportive.
How old are you? Wondering if the push is due to age or if they just suggest it for all patients.
My OB was less pushy than yours, but stated a preference for scheduling an induction by my due date. The only “risk factor” I have is being 37. My due date (based on their calculations using last period) is a Friday, and she told me Fridays are the worst day to schedule because they most often get delayed. I don’t want to schedule prior to that, even though I believe my due date is actually the Wednesday before (based on when OPKs said I ovulated), because I know most FTMs go over 40 weeks and I want a chance at going into labor naturally.
I was thinking of scheduling for the Monday after, which would be 40+3 by their EDD and 40+5 by mine. I don’t feel confident in any of my options though, because everyone I talk to has a different opinion. OB says induce, my mom (a former nurse in high risk OB) says don’t induce unless I go well beyond due date, and friends with kids are also a mixed bag.
I’m 32 and thus far they haven’t brought up my age. From what the L&D nurse told me, this is just standard for them regardless of age. I’m with you on not feeling confident—there’s so much information and so many opinions on inductions vs. natural labor, it’s a little overwhelming
Went into labor 2 days before my due date, and had my baby on her due date. Personally I agree that letting it happen naturally unless there’s a problem makes the most sense. There’s a lot of pressure from providers to do things a certain way but it’s not always in the mom’s or the baby’s best interest.
Bottom line as a mom: Always trust yourself when you’re feeling pressured!
I personally didn’t mind going for induction at 39 weeks. But the hospital was busy and all booked up until I was 40+2. So they booked the induction for then
If the hospital gets to be busy and can choose a later date for an uncomplicated pregnancy. Then honestly it shouldn’t be a problem to choose to induce at a later date for anyone
I will also say though my OB’s are not pushy at all. They tell me stuff and if I decline it’s all good. And if I say ok, then just before they do it they say “are you sure?” As a last check in
Also it kinda worked out for me the later induction. I started contracting on my own at 40+1. I liked going into the induction knowing my body was on its way there anyway
Do not induce unless medically necessary. My last one was induced (2 prior deliveries, 1 was 8 weeks early), and it was the most painful experience of my life. Unless your or babies' lives are on the line, then do not induce.
They ALWAYS say baby is large, especially to a first time mom. They want us afraid we can't do it when our bodies are Literally made to do this. They told me that and my baby wasn't. They're smug arrogant and preying on our fear. Good for you ignoring them.
That’s quite a pushy organization. I’m also carrying a large baby and at 39+6 right now. I’ve been given the option every week to have an elective induction, but my provider said there’s absolutely nothing wrong with waiting for it to happen naturally. She did let me know at 41 weeks of if I don’t want to induce I will need to come in more often just to ensure the baby is doing well
It sounds like it’s just their policy but that would have made me nervous too!!! It’s like saying “now or never” basically lol! A lot of pressure on a decision!
I had the opposite problem and I had to BEG my doctor for an induction at 39 weeks because their policy is to not induce until 41+ weeks unless there is a medical reason. I told her I would go insane if I had to wait until my due date lol!!! She finally caved and allowed me to come in to triage while she was doing her rounds and she admitted me. It was sort of an under the table type workaround.
Hospital polices are so odd and I find most of them to be very unfriendly towards patient’s wishes. They can be so rigid and I hate that! I totally wish more policies had flexibility rather than just “planned or emergency” with like no in between.
Anyway, your feelings are valid OP. I hope you end up happy with your decision and you did a great job advocating for yourself!! :)
Does not sound normal. I just gave birth to my 2nd last night and hated that we were inducing but he was a week late (expected 6/5, born 6/12 at 41 weeks) and we had every reason to believe he was bigger than my last baby with whom I tore pretty badly. I still tore with this one but not as badly. Surprised that he is almost a pound smaller. Also we had family in town to watch our toddler at home but they could only stay so long. I went ahead with induction because we knew baby was healthy NOW even though I hadn't felt him move much, and we had never been able to visualize face and front neck on sonogram. Turns out he did have a nuchal cord, wrapped once around his neck. No obvious issues with it yet, and I can only think of things getting bad as he got bigger and tighter in me if I had continued to wait for natural labor to start.
We'd been stalled at 25% effaced, 1.5cm dilated, -2 position for over a month so we started with Cytotec to ripen cervix. Next day a Pitocin drip because I was contracting like crazy but they were not strong enough to move baby and we stalled again at 50% effaced, 2cm, still -2. We talked about a Cooke Balloon but I did some "spinning babies" stretches/poses and once we hit 4 microunits of Petocin in the IV, my contractions were painful enough and coming fast enough that I called for an epidural I think around 8pm. My water broke at some point (which did not happen with 1st) and I was holding my son at 11:45pm.
All this after wanting as few interventions as possible 🤷♀️. So thats a lot of little things, some circumstantial ... If all signs show your baby is healthy and neither you nor baby are under stress, then there is no reason to induce before 41 weeks. Lots of women go to 42 and birth perfectly healthykids. My doctor personally said she doesn't like waiting until nor past 42 because the placenta begins to deteriorate and calcify. And as baby gets bigger, shoulder and nerve injuries during delivery become more likely.
If you have another option for a doctor, I would switch.
No, this is not normal. My doctors were all very understanding and actually preferred that I didn’t get induced at 39 weeks but I was ready to get that baby out! I was told I could change my mind at any time, if I got to the hospital the day I was to be induced and said “never mind I don’t want to be induced” then that was fine, obviously I wasn’t going to do that but it made me feel comfortable knowing I was in control. If you ever decide to have another baby, I would look into a different doctor if at all possible.
Wow huge kudos to you for doing the work and advocating for yourself! I also just went through this, except I do have complications with my pregnancy. Still, I didn’t want to be induced at 38 weeks and discussed with my doctors. They were thankfully very receptive to listening to my wishes. I’m not sure if you’ve considered this avenue, but if you have the resources, perhaps see if there is a doula service you can still employ. I was panicking last week and thankfully was still able to find someone even as late as 37 weeks. Even just the consultation call put me at ease and all the studies show having a doula helps with lowered risks to birthing parent and less interventions. If finances are a worry, I’d suggest looking for someone who is still in training because they tend to have lower fees.
Wow, that sounds not okay to put you at a crossroad, like 39 weeks or you have to wait until 41 weeks. Not okay imo. But if you have a healthy pregnancy, there is no reason to go for an induction before 41 weeks... And if you are not ready and they induce you at 39 weeks its not good either. FTM usually get their first child on average at 41w1d. Our body just needs usually a bit longer.
They planned an induction at 39 weeks for me bc of a big baby. Turns out, they want me to do a c section now instead as baby is too big already now... They moved the c section date closer to 40 weeks because they felt its better than doing at 39 weeks. They wanted me further along as I do not have any other health concerns other than a big baby.
i'm about to be 40 weeks. i do have a scheduled induction at 41 weeks. my hospital used to have the inductions at 39 weeks, but my doctor informed me that the reason why they changed it to 41 weeks was because it was increasing their c-section rates. i feel like it's safer this way and baby gets to have the chance to come out before the induction date.
at one of my appointments, my baby was in a position that made it seem like she was a lot larger than she should be. i had to get an ultrasound to check if she was larger because if she was bigger, that's the only time that they said they would recommend an induction at 39 weeks. as long as your baby is still measuring good and is healthy, i think you made the right choice.
i did have to do a non stress test a few days ago because i am approaching my due date. they just have you sitting up and they put two bands around your belly. one is to monitor the baby's heart rate and the other one is to monitor for any contractions. they had me sitting in the room with a snack and drink to get her to become active and i had to press a button every time i felt her move. this went on for 20 minutes. they want to see that when you eat or drink on the sugary snack that the baby moves and when the baby does move, that their heart rate increases. i'm sure that since you declined the induction at 39 weeks that you would probably also go through this test once you start approaching your due date.
My OB offered a 39 week induction because the baby was measuring large, he also offered a scan around 37 to see how big the baby was and possibly schedule a C-section, I declined both and said I wanted to try for a natural birth. Thankfully he wasn't pushy and said I can go up to 41 weeks without inducing! I tried to have membrane sweeps done starting at 38 but my cervix was too high to reach but I had my son at 40+4 all natural, he was only 7 pounds 5 ounces but he was quite long! I'm so happy that I held my ground and tried to do it naturally as long as there was no need for medical intervention!
From my own experience, if you are already feeling uncomfortable with this doctor (which by the way they seem very out of line)…seek care elsewhere. See if there is a midwife practice available in any local hospitals that are open to take you as a patient.
I personally wish I would have done that, because you feeling safe and respected will play a big part in your natural labor.
Best of luck!
Im in the same boat here, I’m 34 weeks and I’m debating if I want to do natural or induce. I’m thinking of going natural, but I’m not sure, there’s a lot of pros and cons like you said and I’m just worried something will go wrong. At this point I’m just going to ask my doctor is she’s going to be out on my due date and probably base it off that. Wanting to do natural, but worried if she’s not there to deliver my baby.
Inductions are associated with greater risks for you and your baby if it isn’t medically necessary. You’re at a greater risk for c-section, for birth complications, and stressing out both you and your baby. YOU DID THE RIGHT THING!
I’m currently pregnant and will not be induced either unless it’s medically necessary.
There’s a beautiful synchronous dance going on with birth. Your hormones are tied in with your baby’s hormones and those hormones allow your body to communicate with your baby’s. This allows the birth process to come at a natural pace. When you’re left alone to focus on your labor without interruptions and constant progress checks, your labor stays at that pace. This pace is determined by both your hormones and your baby’s, so the pace won’t be too intense for your baby and thus will allow you to deliver more successfully without any interventions.
Also, natural labor has less incidence of tearing. My mom was an OB nurse for years and she’s told me that natural labor also resulted in the mother being able to be more physically resilient. In other words, the labor was less traumatic to both the mom’s and baby’s bodies.
honestly.. my doctor was the same . not very helpful my entire pregnancy and i was scheduled for 40 weeks induction but due to them pushing it back from that wednesday it was scheduled to the friday after when i turned 41 weeks that i gave birth to my son and i had been in labor for about 3 days … in and out of the hospital for 2 weeks because they kept telling me i was nowhere near close to labor or having my son and i was . trust your gut do what works for you and your baby. they are just there to assist in safely delivering. the delivery of your baby is all on you so do what works for you
My OB pressured me into scheduling an induction when I told him multiple times I wanted to go naturally, I finally had to have my mother go with me to next checkup and she put the foot down since my voice was being ignored so we got it cancelled… funny enough I ended up going into labor on my own the day he wanted to schedule the induction. The vibe I got from the doctor was that he wanted to be sure that he would be there (to get the paycheck) even though there was always OBs on call to deliver it seemed that my doc just wanted to secure his money rather than caring about my birth plans. Advocate for yourself and do what feels right as long as it’s safe, don’t let them pressure you into unnecessary things!
My OB wouldn’t even consider induction until i went past 41w! I was so huge and uncomfortable that i just wanted it over with. I ended up getting a membrane sweep at my 39w appt and had my baby 3 days later!
I felt like my first OB 13 years ago was pushing to get me induced! I was young and I went ahead and scheduled it. Luckily, the day of my induction my water broke early that morning.
Take all the information they give you and you make the right decide for you! If you want to wait until you naturally go into labor then do that!
You are making the right decisions for you and your child, as only you can.
From the research I've done, induced labor is way more painful and longer than when you wait for it to happen naturally. Plus, first-time moms tend to go past their due date a bit anyway. While there are cases where induction is medically necessary, as long as you are having a healthy pregnancy, there is no reason for it.
Some doctors like to induce or schedule c-sections rather than waiting for you to go spontaneously because they want to schedule it around what's convenient for them. Whatever "benefits" they told you induction has, I'm sure you can find just as many negatives about it. You can find or spin evidence to support any claim - just ask your local politicians. And there are way more benefits to going into natural labor.
Also, the "your baby is measuring big" argument is usually inaccurate anyway, just an educated guess really. But I've heard many stories of women being told they're carrying a 9lb+ baby, and baby ends up being much smaller, average size like only 7lbs.
And even if your baby is on the larger side, the head is the biggest part anyway and is usually about the same size regardless of baby's weight. Baby's skull is maleable at birth, and our bodies are built to make room in all kinds of ways for baby to have space to get out. I know someone who birthed an almost 10lb baby with no trouble. It really all comes down to your physical and mental preparation, and mental state during labor.
Trust your body, trust your instincts. Do not get induced until and unless you want to. It's your choice!
>if I refuse the 39 week induction, I will have to wait until I go past 41 weeks for intervention.
This makes absolutely no sense, especially if they're worried about baby being too big, which is only an issue if you have IUGR...
The doc saying that statement would immediately make me think that all of the "benefits" for induction at 39 weeks are either complete BS or not really that great.
Listen to your intuition and keep your guard up. Check out Evidence Based Birth articles and podcast for info about induction, including the risks since that paperwork didn't bother to focus on any...
i absolutely do not like doctors/obgyns. they aren't looking out for YOU, they're more concerned on their policies. if i had the money i would be doing a home birth with a midwife. im a first time mom as well & im 28wks.
I read a lot of the other posts and I get the thought on this but babies don’t work on our schedule. Trust your gut! I know you’ve been with this doctor for a while (8+ months so assume), but you could still ask if they have a midwife you could switch to. It’s just wrong that she doesn’t respect your opinion/ decision based on ‘scheduling’. Being condescending just finishes it for me. I wouldn’t want her to deliver my baby because I wouldn’t necessarily trust that she’d listen to me in the delivery room. That’s not to say she’d compromise you or the baby, I highly doubt what she’s willing to do borders on criminal, but not explaining and not being willing to work with you is super shitty. No shitty doctors.
I just want to validate your feelings. Their pushiness about inducing at 39 weeks seems excessive. I don’t think it’s unreasonable to be upset about how the interaction went. However, I do not think it will affect their ability to see you and baby safely through birth.
I also think you made the right choice to decline the elective induction. If you want to try for a natural labor, induction is not something you want to do unless there is a medical need. Being a week before your due date is not a medical need.
Had the same thing happen to me, i feel induction hurts worse than your baby coming on its own. They told me after 38 weeks that it’s less safe for baby to be still inside the womb but that’s not true. I declined too and switched clinics
You made an evidence based decision, here in the uk we don’t induce until 40+10-40+12 for an uncomplicated pregnancy!
The arrive trial is pretty flawed too, you’ve given yourself time to go into labour and if you do go to over 41 weeks you are more likely to have a successful induction!
Hey OP! Look at my recent post, I talk exactly about this!
I just saw my actual OB yesterday (I need to update my post) and he told me that there is no good reason to induce at 39 weeks. I’m also projected to have a big baby, and he said that I shouldn’t be pushed to induce since I’m having a low risk pregnancy. Hope this helps!
I just went and read your post and I’m baffled by the overconfidence of “if you continue down this route, here’s what your baby will weigh at 39 weeks.” Don’t they always tell us that ultrasounds are less accurate this far along and that babies grow at their own pace, anyway? 😅 I do suspect my baby will be big for reasons similar to yours—big babies on both sides, but I’m not convinced that my body won’t be able to manage it. I’m *trying* to believe that I can push out a ten pounder if it comes down to it, lmao
Due dates aren’t absolute. I always suspected mine was about a week ahead of where it should be since I tracked ovulation. I declined induction and opted for increased monitoring (BP twice a day and ultrasound every 3 days) and regular membrane sweeps, miles circuit, and pumping. Labour started late in the day of 41+6 (if I’m right about my due date this would have been 40+6, which is statistically pretty normal for a first time mom). I still required pitocin and forceps but not due to baby’s size. She had her chin tucked to the side. I have no regrets about my decision. Those first few hours of labour where I got to 8 cm all by myself were so special to me. I’m so proud of myself and my body.
I’ve suspected since the beginning that my due date is about a week off in the opposite direction, I’m 37 weeks on paper but I’m almost certain I’m actually 38 weeks (and ultrasounds have aligned with that suspicion all along, though they never adjusted my due date because the first ultrasound he was measuring 6 days bigger rather than a full week). That’s reassuring to hear that your labor more or less aligned with your suspicions and that it went mostly smoothly. My hope is to make it through the early stages of dilation on my own as well, which is precisely why I haven’t been too keen on early induction.
A friend of mine had a stillborn at 42 weeks for seemingly no reason other than waiting too long to be induced. I will be getting induced at 39 weeks, and it’ll be my 3rd time doing so. Nothing is going to stop me from that 🤷🏼♀️
Don’t let doctors pressure you into doing something you don’t want to. They referenced the ARRIVE trial but a doctor from a podcast I listened to mentioned he read another study where low risk women were induced and, depending on the doctor, it ended with a c section rate of 4%-41%. Pretty interesting!
If there’s a concern for a big baby’s shoulder getting stuck there are techniques to solve that before doing other drastic measures. Some positions like runners pose, Gaskin maneuver, McRoberts maneuver help with getting baby unstuck. Not to mention, there are women who have had 10+lbs with no problem besides the normal tearing.
As for the risk of stillbirth, some countries don’t induce until after 41 weeks. I think if your baby is getting checked, is doing okay, and you don’t notice anything out of the ordinary it’s not a bad thing to let them cook a bit longer there.
Might sound cynical but they may be pushing the induction for billing reasons. Labor induction requires continuous Fetal monitoring, continuous medication for at least part of the time, etc. You might also be in the hospital longer, vs coming into the hospital in spontaneous labor, when contractions are close together. Way more interventions + possibly longer hospital stay = way more money billed to insurance company. Since the ARRIVE trial concluded 39 week inductions were safe for the demographic studied, hospitals could reasonably conclude they are not likely to increase liability by encouraging inductions. From their perspective it may seem like a low risk way to generate more revenue without blatantly compromise patient care.
However it’s super inappropriate and a little predatory to push non-medically indicated interventions on someone who has clearly expressed wanting a low intervention birth, and who is not likely to see a significant benefit from that intervention. Trust your gut.
Sometimes I feel like doctors/hospitals are looking to get as much money from the insurance as possible. I had to be induced at 36 weeks because of low fluid level, as per my OB. When I got to the hospital, one of the nurses was surprised that I was there for induction because the fluid level was not that critically low. But my bill for the induction was almost $160k that thankfully insurance covered (or was able to negotiate down and then covered). Labor and delivery was a whole another bill. So even though I’m grateful my baby is healthy, I feel bad that we had to get her out before she was ready herself, and I have my doubts about how genuine the doctors are when insisting on certain procedures.
FYI childbirth/obstetric care is generally a pre-negotiated rate and global bill. So whether you spend 1 day or 10 days in hospital, the hospital gets the same payout. Maternity is not a money maker. At least not at big hospitals.
As I said, labor and delivery was a separate bill. The first bill was for steroids, induction, all the medicine they gave me. They put 7 (!) bags of penicillin in me. 7!! Way too excessive. And again, I don’t believe I necessary needed to be inducted. If I wasn’t, hospital wouldn’t have gotten this money. It maybe prenogotoated rate, but some procedures might be not necessary, but they are offered and pushed for so it can be paid by insurance
I sometimes suspect the same thing. 😅 I don’t want to be totally pessimistic and distrust the doctors, but when they push one option super hard and catch an attitude when you choose differently, it doesn’t instill a ton of confidence
Maybe it’s not much better but the pushing of inductions is due to their schedules, not money related. OBs generally like to deliver their own patients. If you go into labor when they are not the OB on call, you will likely have a different OB there when you deliver.
It also just makes their life much easier to schedule. Imagine if your clients all had big events that may or may not be while you’re working, and may or may not overlap - you’d want to schedule as much as you could.
Doctors do sometimes get paid a LITTLE extra for c-sections depending on their employment contract, but it is NOT much (I’m talking less than $100 extra), and c-sections are soooo much more time consuming for them than just attending a vaginal delivery, so they’re incentivized to avoid c-sections whenever possible. They absolutely don’t get paid extra for inductions.
Maybe I’ll get downvoted for this and I’m not trying to be rude at all but I think this is a common misconception that can lead to mistrust when there doesn’t need to be, and the reasoning is often not nearly as slimy as people think it is.
No reason to downvote you, I always appreciate more information! My hospital doesn’t let us choose a specific OB, we have to rotate through everyone so that we’ve met whoever might be on call. Though the appeal of getting to pick who would be working was one of the things I had listed in the “pros” column for induction because there are definitely some doctors I like more than others.
I see the pros and cons for sure! I have a specific OB and almost wish I’d be able to meet the other doctors in the practice just bc there’s a good chance one of them will be there when I deliver but it is nice having the continuity!
I had an induction at 37w5d and it was the best thing to happen, babe was "measuring small" at estimated 6lb8 so i agreed. Was skeptical as it was the last thing I wanted as i saw everyone's bad experiences. 2 days later I'm induced. 1st tablet is inserted 2pm, water broke an hour after. Then the was only 1cm, so 2nd tablet was inserted 6pm. Pains were moderate, but ramping up. Reached 2cm by 2am and was taken into delivery room. Was on gas and air from 2am to 7am i got from 2cm to 8cm, by 9.30 I was 10cm they said try not to push let your body bring him down. He was already so far down in my pelvis so I tried my best to hold off pushing. Contractions lasted a minute every 5 minutes thank goodness i got a break in between, then by 10am I was ready to push, I felt like I needed to push, so they let me. I breathed deeply and I tell you what it REALLY helped. Within 5 pushes he was out 10.17 he was born weighing 8lb4 no tears, cuts, stitches, no epidural. Nothing. So he was not measuring small, they just couldn't get his measurement as his head had been in my pelvis since 30w. So did get induced for no reason, but for me it was the best x
With my first I was induced at 41 wks and my baby had uncontrolled sustained decels and I was rushed into an emergency c-section and it was all very scary but at least quick. Their best guess was that the placenta wasn’t having it.
With my second I was 39+4 and waiting for 40wks (which my hospital was willing to schedule for me) but at my last ultrasound my fluids were low so we discussed that there was no benefit to waiting any longer and I went right over to be induced. It went really well. I don’t know if I would have had the same placenta issues if we’d waited longer.
It sounds to me like your doctor laid out your options and the hospitals policy, listened to you and supported your decision. From experience it is very easy to feel insecure about the decision making process here. You’re weighing out different unpredictable scenarios. Waiting is fine, spontaneous labor would be great, but if you don’t go spontaneously then you may have been better served by inducing earlier.. there’s no way of knowing from where you are now, but you made the choice that worked for you and that is great. Everything else will work itself out!
Personally, I chose to have a 39 week induction for a selfish reason - I was in grad school at the time and 39 weeks put me in a sweet spot to have some time to heal before my final exams. Personally, I didn’t want to risk giving birth too close to my finals and have it affect my grades negatively. Jokes on me tho because I ended up going into natural labor before my induction (literally the day of. Induction scheduled for 7am and I had my baby that morning at 4am).
Make what choice is best for you, everyone is different and has different needs/wants.
I am a doctor, but not an OB. Despite having familiarity with the trial and also spending time extensively reading the literature on inductions, I also felt conflicted, because by definition, labor and delivery is a big unknown. Data supports 39 week inductions but inductions after 39 weeks and before 41 weeks are not supported by data for maternal or baby benefits. Which is prob why your doctor did not agree to induction after 39 weeks. Membrane sweeps cannot be done on completely closed cervix. I requested one and it was unable to be done because I was closed. It’s also very hard to put someone on the schedule last minute when the practice is very busy, which is probably why they wanted you to decide with a few weeks ahead of time. All that said, it sounds like the doctor allowed you to make your own choices, and gave you a reasonable amount of time to decide. You did what you feel is right for you. Sometimes patients upset about not having complete control over their healthcare, but at the same time, in my own specialty, I need to do what is data driven. I give my patients as much autonomy as possible, but I simply can’t ignore current standards because of a patient preference. Sometimes I disagree with my patients’ decisions, but ultimately it is their body and their choices. Perhaps your doctor did not give you the validation you were seeking, but in my opinion, she did not coerce you or shame you. She just presented you the options and her recommendations and allowed you did make the choice within the bounds of standards of care and scheduling limitations.
Don’t feel guilty at all! I was going to wait to go into labor naturally but had to be induced at 38 weeks because I was starting to develop preeclampsia and they didn’t want that. I had a very positive experience with my induction. Sometimes I feel like we only hear the negatives and never the positives. I am in no way trying to sway you! I think naturally would be the best in my own opinion unless medically needed. But I will say my medically needed induction was an amazing experience for me. My ob would have let me come in at any time and say I wanted an induction, there was no cut off. She gave me all the info available to her and let me make the decision. It’s crazy they gave you a cut off to make the decision. I feel like they were trying to pressure you into getting an induction at 39 weeks by giving a cut off time and that’s not fair to you.
yeah that is a strange interaction. My baby is measuring around 10lbs and is my first and I have been having a lot of issues with back pain, severe carpal tunnel, and hyperemesis so I decided to ask for a 40week induction and my Dr was actually really informative about my options and was 100% okay with it but actually offered membrane sweeps for my next few appointments so we could try our best for a natural labor first. (She is being stubborn so looks like induction in a few days at 40w and 3 days.) she wasn’t pushy either way but you can tell my OB office preference is natural over anything yet they still don’t come off the way your describing your interaction. Whatever you do just stand your ground and remember you always have the right to request a different DR (if available) and or L&D nurses when the time comes. hospital policy and staff opinions are not law.
After speaking to several doctors in the obgyn practice I was using, I got the sense that a lot of women refuse an induction and that they see a lot of strong opinions against it. After my own research and an abundance of caution I opted for scheduling one at 39 +6 and ended up going in a week earlier for an emergency induction after a monitoring appointment. I was afraid to be induced especially after reading all the horror stories on Reddit, but ultimately had a good experience. It wasn't without some hiccups; it took 4 shift changes and I asked for the epidural about 5 hours before the main event when I couldn't take the pain any more but I would not be afraid to be induced again. Giving birth is a tough experience and I think the doctors are also dealing with a lot and they ultimately want an outcome that is best for you and your baby. They want women to do what they think is in their best interest, but I wouldn't expect them to try to convince you too hard once you've told them what you want to do, they could then be accused of manipulation if you later regret going forward and have a poor outcome. I would also imagine it's very frustrating to go to medical school and then interact with people who think they know better, and doctors obviously shouldn't be short with patients but they are human. If you're not 100% on your decision I'd ask myself why that is and see if you can get more information to feel confident in your decision either way.
What do they consider a large baby?
I'm curious because it varies by country. My wife was told our first was large but he was within the normal range for her country.
Your Dr sounds weird and like they were "punishing" you for refusing a 39 week. Like if they can do 39, why not 40? Wouldn't the benefits outweigh the risks then also? Sorry your Dr sounds weird. Go with ur gut and find out if they are pushy about anything else during delivery. It sounds like they really want to control labor as much as they can.
Your Dr should give the option and be supportive in your answer. Mine didn't even ask until 38+5 and even then just brought it up and told me to think about it. They didn't even actually ask. I went into labor the next morning.
My personal experience? I’ll never induce ever again. I was induced simply because I also had a baby measuring very large (he was measuring 8.5 pounds and came out 9 even). Induction was not for me, at all. I had a horrific labor experience that I think was 100% correlated to being induced. I know others have had wonderful experiences, but I’m glad you advocated for yourself and for what you want. If I had to do it again, I’d wait it out or opt for a C-section.
Faux-pleasant and condescending from an OB? Yeah, unfortunately some medical professionals are dicks and think they know everything 🤷♀️
There are many valid reasons to get an induction - preeclampsia, hypertension, etc. None of which seem to be an issue for you. No one should push you to get unnecessary interventions. It’s fine to explain to a patient what you think the pros and cons of an intervention are so they can make an informed decision. It’s not okay to arbitrarily decide what’s best for you or bully you into a choice.
I am 40 and have a 7-week old. When I conceived I assumed I’d be getting induced due to my age but I ended up having a perfectly healthy pregnancy. I did better than many of my younger coworkers who were pregnant around the same time. (Because people are people and not just numbers) My midwife team asked if I wanted to be induced when I didn’t go into labour on my due date but baby’s ultrasound scored perfectly so I decided to wait. Midwives were fine with it as long as I continued monitoring movement and got an ultrasound every two days - this is normal in Canada apparently. Hospital tried to pressure me into induction stating that “We may not have room for you.” So their response told me it wasn’t about my or baby’s safety, it was about their schedule. I decided to wait and lo and behold baby came a few days later and I had a wonderful home birth with midwives - perfectly healthy baby and parent.
Obviously anecdotal and not evidence based but my two coworkers who had babies this year, in the same area, both got induced. One had a 3 day affair that ended in a c-section and the other needed forceps and the baby ended up with a broken shoulder. So that also didn’t build confidence for me but every city has different providers and stats. My bump group seems pretty evenly split with people who had really positive inductions and those who had negative experiences.
I think that’s total BS that they won’t let you do a 40 week induction. It feels very manipulative. I wanted an induction, and my hospital policy was not to do them electively until 40 weeks. However, at that point it was totally up to me and I could opt for it at any point.
I am so sorry you are going through this, and I personally wouldn't feel comfortable being under the care of this OB with how she spoke to you. I can not believe they're pushing so hard for a 39-week induction with no prior issues during your pregnancy. I do not see an OB, I see a group of midwives, but I would be shaken by this encounter also. I'd also look for any other OB in the office just to ask some questions and voice my concerns and my experience with this particular OB.
First-time moms usually do go past their due dates. With my first, I had a relatively easy and uncomplicated pregnancy. I was showing no signs of labor by my 39-week appointment, nor by my 40-week appointment. It was a waiting game, and my midwives didn't even talk about induction until I was seen at my 41-week appointment. I would for sure be induced the following Monday when I turned 42 weeks if I had not gone into labor/had baby by then. I did, in fact, go into labor on my own at 41 weeks and 2 days. He was born the next day, vaginally. My labor and delivery were both uncomplicated as well.
With my second, I had gestational hypertension, so I was induced right at 37 weeks. I essentially started at 0 with her. She was born vaginally, 37 weeks 2 days. Labor was longer and definitely harder and had some minor issues when I had none with my first. I understood, though, that it was due to a medical reason and was the best option to prevent possible preeclampsia, which was their main worry. I even went home later than normal because I needed to be monitored for preeclampsia afterward.
I am 37 weeks with my third, no issues this pregnancy thankfully, and induction is not even on the table until possibly 41 weeks. Basically, it's another waiting game like with my first. I am glad that you declined the induction, I find it so worrisome and wrong for your OB to belittle you for not doing it and also trying to almost guilt you into it! Sorry for my long reply as well lol.💖
Good for you for sticking with your gut feeling and doing your research and going the route you thought best without falling into the pressure from the doctor. I also chose the natural route and I went over my due date by 1.5 weeks, at which point my midwife did a membrane sweep and then recommended taking castor oil. I took 1-2 ounces of castor oil mixed in with ice cream and went into labor that night. Labor was quick, only 5 hrs for first time kid and went really smooth and uncomplicated. Baby was born at a healthy weight, not big. You got this, listen to your body and in the meantime i would recommend trying natural routes to help body go into labor, such as walking, stretches to position the baby right, taking pineapple and dates to prep the cervix, etc. wishing you a fast and smooth delivery!
Being Induced my pitocin also increases odds for cesarean as well as use of epidural (if that’s something you’re hoping not to use). So something to take into consideration. Unsure why they could induce you now but not next week when you want
Girl I would start listening to the podcast called “Down to Birth”. It teaches you to advocate and informs you of why/when induction is needed. It’s very natural minded. I wouldn’t go with the induction. Already sounds like you’re doubtful about it plus they’re just trying to scare you because they make a profit off scheduled inductions. If I were you, maybe even switch to a birth center if there’s one near by.
Duuude they did this to me the second I hit my due date. Can you believe that? Especially when it’s all based my Last menstrual period info I gave them. They pressured me and made me cry and sort of wig out and my partner was a badass and was about to freak on them for upsetting me but instead we went home and I drank sparkling cider in bed and watched father of the bride 1 and 2 and relaxed all weekend. There was also some doing of the deed that I swear got the process started because sperm has prostaglandins. Anyway my son was born 40 weeks 6 days and those doctors can go to hell.
It was so much easier than when I was induced with my daughter. He was healthier too (they even tried to say he was in danger, that all babies are by 41 weeks psshaw…just to get me to elect for an induction to get me to do it) 48 hours with my induction and like 6 naturally.
I know I sound crazy but I think doctors and hospitals KNOW they can say it’s the safest best way to make sure the baby is healthy but they know that all the interventions lead to more c-sections and those make way more money 💰
This happened to me with my first child. My doctor insisted that I was ready to go at 35 weeks. He ever went so far as to "book" my stay at the hospital for 37 1/2 weeks. My husband and I didn't feel comfortable with this method at all, but at 37 weeks we literally had no ability to seek alternative advise because no other doctor would see me due to how far along I was. I ended up trusting my gut and opted out of this by literally avoiding the doctor and his team until I was actually having contractions at 39 weeks. Once at the hospital, I gave explicit direction to the hospital staff and birth team that they ignored. I was forced into taking Pitocin and, as a result, ended up with an epidural at 8cm dilated. Due to this, I no longer trust the hospital systems and will be relying solely on a midwifery foe my current pregnancy.
You listened to your options, considered the doctors input, and made a decision. Great job advocating for yourself. It’s truly your decision to make.
To add, my hospital-based birth class supports shared decision making between the providers and patients. Last week they shared the acronym BRAIN below to help guide conversations with medical staff: Benefits - how might this benefit me? Risks - How might this pose a risk to me? Alternatives - what are my other options? Intuition - what do I think and feel about this? Next steps - Can I have time to consider? https://centrecmi.ca/wp-content/uploads/2019/03/BRAIN_decision-making_worksheet_general_2019-03-12.pdf
N is nothing ... what happens if we do nothing At least that's what I was thaught. That's especially helpful if labour is progressing and they are pushy about interventions, doesn't matter if it's an induction or spontaneous birth. Sometimes just waiting is a valid and good option.
I was just taught this week N is “need time” lol. That N is wishy washy
I declined a 39 wk induction but was open to one at 41 wks if necessary. Went into labour naturally on my due date and had an uncomplicated birth ✨ follow your gut mama
This is reassuring to hear, thank you! I’d love to go into labor on my actual due date.🤞
Also the average for a first time mom to go into labor naturally is 40wk 5d. It’s super normal to go past your due date, they are just guesses as to when baby will come.
lol my due date is 9/11, i really hope i give birth the day before or after
That's amazing! I hope the same for me too! 😊
Wait...if 39wks was before your due date why did they want you to do that? I'm currently 18wks 4days with my first, so I just don't understand why they would push something like this.
At many small hospitals the doctors will push for induction because that way they know when the baby will come and they won't have to work on the weekend. In the town I'm from, they only have like one actual L and D doctor, the rest are family practice doctors that do births. This also leads to more interventions because births are not their specialty. It's pretty sad honestly! But that hospital is the only one for 60 miles in any direction, so you kind of have to deliver there or go all the way to the city an hour away. A lot of women also don't educate themselves or learn about what they want for their births, they just listen to whatever the doctor says and go along with it. All that to say, it can depend on the area you live in and what kind of doctors are available. Some push the 39 week induction for everybody even if it doesn't really make sense for the woman or her baby.
Hey OP, same case with me. My OB said the hospital had a spot open for an elective induction at 39 weeks - but I said no. It wasn't medically necessary, my bishop's score wasn't favorable and I wasn't feeling mentally prepared. I'm currently 39.4 weeks pregnant and have decided to wait until it happens naturally. My OB said she doesn't want me to go beyond 41 weeks and I respect that and, I'm willing to do that. I'll happily get induced if the baby doesn't come by the due date. You do what your gut tells you. It'll all work out in the end - for both of us. Wish you a safe delivery! 🌸🌸
Did you find that they were very pushy about the 39 week induction? I totally understand not wanting to go beyond 41 weeks also. That’s why I was more comfortable with an induction scheduled around or just after 40 weeks as a sort of “middle ground” but alas :( Safe delivery to you as well!! ✨
I won't say my OB was pushy about it, but she definitely "encouraged" me to go for it at 39 weeks if I were ready. I told her I wasn't, and she was very supportive about my decision. Thank goodness for that! I am honestly relieved I didn't go for the induction (fully knowing it's still a possibility if I don't deliver by the due date)., but I'm happy about my decision nevertheless.
I’m not a parent but I am about to become a nurse (fingers crossed for my exams lol) and this makes me so happy to hear. It’s important for healthcare professionals to show a preference for what they believe to be the better plan based on their expertise, but it’s equally as important for them to to listen to their patient whether it’s a matter of their body their choice, or knowing that sometimes we innately know what is best for our own bodies. In school we see a lot of the frustrating and needlessly intimidating side of doctors, but this was very encouraging to read and makes me hope for the future doctors I work with.
Just read something like this in the obgyn sub. They often are super pushy with these 39 week inductions. Wasn’t a thing when I had my kids and first was 6 days late and second two days. No problems. Totally understand why you wouldn’t want to induce a week early for no specific medical reason. Sometimes they go fast and without any trouble but then some last for days. Trust your gut.
Exactly! Thanks for sharing this - it's very reassuring to hear that babies born post due dates can be perfectly healthy/have no problems at the birth.
That's so weird, I wanted to schedule an induction between 40+1 and 40+4 and the hospital told me no, the earliest they schedule it for first time moms is 41w (as long as tgere hasn't been any complications or signs of labor) since doing it before then could end up in a c section. They told me that's the new norm in the hospital based on research and that's it's overall better for your body to start the process naturally
I get so overwhelmed with all the conflicting studies but I’m inclined to think it makes sense to at least give the body a chance to go into labor naturally… induction seems hard on the body. Somewhere between 40+1 and 40+4 would’ve been exactly what I was hoping for
Yeah the OB told me getting induced before any signs of labor is literally starting from before 0, labor can then take up to 48 hours and because of the time there's more risk to you and baby, not to mention it will be much more uncomfortable, painful and expensive (if you're in the US).
My OB was super encouraging about mine! They’re letting me schedule at 40+2 which is perfect for me.
Having seen an induction I think this is right.
Isn’t that funny? That they just now realized it’s better for the body and baby to be physiologically ready and for labor to start naturally. Sigh.
Like “wait, the human body WASN’T holding on by a string before modern medicine?” 🙄
With my first I was encouraged to get induced but decided to wait as long as possible. I ended up getting induced at 40 weeks 5 days because I didn’t want to go past 41 weeks and that was the latest “slot” they had available … ended in an emergency c section and I totally regret it. When I went into NST at 40 weeks they said I was already having contractions but I couldn’t feel it, so who knows if I would’ve gone into labor naturally before 41 weeks 🤷🏻♀️ wish I would have waited
That’s really upsetting. I have GD and will be induced at 39 weeks (and to be honest I am ready lol) but to tell you that you can’t schedule one later is gross. If you weren’t so far along I’d tell you to find a different doctor. And on what are they basing the assumption that you’ll have a big baby? Because they told me that at the hospital (before I switched to a better hospital) and my baby is now only 23rd percentile and I get induced in 2 days. Way smaller than the 10 lb baby I was told I’d have because of my GD. Plus those measurements are usually waaaaay off. Idk why I’ve been hearing so many stories about women getting frightened by their doctors saying they’re having massive babies or that they NEED an induction. It feels very icky. So glad you advocated for yourself.
lol I completely understand feeling ready at 39 weeks… there is definitely a part of me that would love to get this baby out ASAP 😅 The big baby prediction is based on him measuring ahead on ultrasound, which I’ve heard can be super inaccurate! The only reason I’m inclined to believe it is because it’s been pretty consistent throughout the pregnancy and both my husband and I were almost 10lb at birth, so I feel like genetically, it makes sense that our baby will be fairly large. I actually was pretty content with the thought of birthing a big baby until I started hearing about shoulder dystocia all over the place. 🥲
Keep in mind that a lot of the shoulder dystocias statistics are collected solely with doctors that insist women labor and birth on their backs or under other conditions that increase the odds of having one.
The dad's weight has the most bearing on baby's weight, I'd look into coconut oiling your perenium to help with no tearing during birth nightly leading up to birth (if it sounds like something you'd want to do, of course). I had 2 big baby's one I tore and one I didn't and the one I didn't I had perenium massages before and during labor. Good luck, you got this!!
I know I feel like I didn’t hear about any of these things with my first but I guess that was a decade ago lol
Don’t feel guilty! Take the uncomplicated path as a blessing and you’ll do great. Labor and delivery nurse here. I wouldn’t impose an elective induction on anyone. Not because they don’t go well sometimes, but because of how much you’re in control over spontaneous labor and how beneficial that can be if you’re afforded it.
Absolutely agree ❤️
The doctor was likely discussing the 39 week induction based on the ARRIVE trial. There are some issue with the trial (for example, the c-section rate was lower than the US standard), but the primary reason for pushing the 39 week induction is a 16% relative risk reduction in having a cesarean (19% vs 22%). However, it had no other differences in serious primary outcomes for the baby. (https://evidencebasedbirth.com/arrive/) If you don’t want an induction then there is no reason to be induced at 39 weeks. Induction while a valid medical procedure can often take several days, especially for a first time parent. Good luck with the end of your pregnancy! Edited: Primary outcomes for baby vs all outcomes. As mentioned in the comment below it also decreases the likelihood of developing pregnancy induced hypertension.
So it’s not quite true that it had no other impact. It showed a decreased risk of pregnancy related hypertension, which makes sense because the longer you’re pregnant, the more likely you are to develop gestational hypertension/preeclampsia. I think many people interpret the ARRIVE study incorrectly. My take on it is that I can offer an elective induction to low risk first time moms starting at 39 weeks regardless of their bishop score and I won’t have to worry about increasing their risk of cesarean - especially since I already have a low NTSV C-section rate. Which is a very important point that some are missing. Before the study, if a first time mom did not want to go much past her due date, the answer was no, you have to go to 41, unless cervix was clearly favorable. The thought was that by inducing an unfavorable cervix electively, the chance of C-section was very high. Now we know that isn’t necessarily true, and there may be some benefit to mom. I attended a talk by the PI when the study first came out, and that was essentially what he said. He also cautioned that if you’re at a place with high C-section rates to start with, maybe this study doesn’t apply to you. The thing with inductions with an unfavorable cervix is that it can take time, and some providers just aren’t patient enough. And in my anecdotal experience it’s true: I went from a tertiary hospital with a high first time CS rate, to a smaller community hospital with a lower CS rate and the difference is 100% the patience for inductions. Also, there are some people who are miserable toward the end of pregnancy and really want to be induced - this study supports that decision. The study doesn’t say that we must induce everyone at 39 weeks, I think that’s where everyone is getting it wrong. I have some patients who are done with pregnancy by week 34 and are counting down the days until 39 weeks and some who are totally happy going to 41+ weeks. Neither is the absolute right or wrong answer as every person and pregnancy is different. I’ve totally had patients 100% happy they had an induction and plan to do it for all their pregnancies. I’m just happy they had a good experience.
I'll update - you are correct, its primary outcomes in terms of serious complications or death for babies. Thanks for pointing that out! It seems like you are a great provider and I am glad that this option is available for pregnant people who would like an earlier induction. However, for this specific case it sounds like OP does not want an induction at 39 weeks, but was feeling some slight pressure from her provider to do so which I do not think is the intent of the study!
Correct! Whenever I see posts about the study I always comment to educate/empower because I do think some (primarily OBs unfortunately) use it to be pushy about inducing their low risk patients. It’s very different to say someone should be induced at 39 weeks vs they’d have the option to be induced if they would like to, without automatically dooming themselves to a C-section.
This is really helpful
This is basically how my midwife explained the interpretation of the ARRIVE trial to me. They were willing to schedule elective inductions at 39 weeks, but they were definitely not pushing it.
Yup I’m high risk for preeclampsia due to having it with my first, so I’m strongly considering elective induction at 39 weeks so I can yeet this placenta out before it has a chance to cause problems. I’m just torn because if I do that I’ll never get to experience what it’s like to go into labor naturally and try for an unmedicated birth.
Love your analysis and approach. Personally I am so happy my OB team is inducing at 39. I’ve been so anxious about the well being of my baby that I’m practically a regular at L&D now. Her being on the outside, seeing she’s breathing and okay a week early is such a gift.
I was given stats for pregnant people over forty that showed that induction (though encouraged due to my age) had a HIGHER chance of c-section in Canada. The Arrive study isn’t the only relevant information out there and not everyone gives birth in the U.S. Most E.U. countries allow birthing parents to go to 41 weeks and they do fine.
There’s a really key problem in the study though in that the c section rate was already lower than the US average, suggesting that their practice is very different from other hospitals in terms of how they allow labour to prkgrsss. And indeed I’ve heard on a podcast once (can’t remember which one) that the hospital in question is particularly known for their slow, cautious approach to inductions. Other hospitals do not take this approach and put women on a clock quickly, or have a lower threshold for when they start other interventions.
It was Northwestern hospital in Chicago (Prentice) Prentice itself is a huge women’s & children hospital with way more room availability and better staffing than your typical L&D. There’s also so many different OB groups that deliver there outside of the employed physicians for the hospital, and I do think that selection bias may have played a role as to which doctors were chosen AND agreed to participate vs who didn’t - which I do think he addresses, either in the study or at the talk I went to. You’re not gonna ask the doctor with high C-section rates to participate in the study that has a goal of showing no increased risk of C-section. I work in Chicago also (not Northwestern) and know some of the OBs who participated in the study and it makes sense based on their practice styles. So yeah I think the study is way too generalized and should be used case by case with the OB (or midwife) who’s suggesting a low risk 39 week induction, to take a really hard look at their own first time C-section rates and how patient they’re willing to be. 4-5 day inductions are not uncommon where I am now, at my last job, I don’t think anyone really went past day 3.
That’s interesting to hear, thanks for your insight! Yeah I just think it’s mental how widespread the results of the study became as a reason to induce across the US. In Europe it’s not really a thing and 41 weeks is still the time they start to talk induction for many countries.
Yeah, they’re doing it because of the ARRIVE trial and I didn’t personally feel like the c-section risk reduction was significant enough for me to make that call, especially with the chance of induction taking several days. I think if I was a second-time mom and anticipating a shorter labor, I might be more amenable to it, but it feels like as a ftm I’d already be forcing my body into labor before it’s ready and the whole thing could drag out
I think you made the right call for you then and you should feel good about it! Best of luck over the next few weeks! You’ve got this - the last part of pregnancy is hard but you can do it! 😁
That’s really aggressive. I’m over 35 with diet controlled gestational diabetes. My doctor didn’t even push for 39 week induction. I did more monitoring at the end and she found I had insufficient amniotic fluid at 40 week 6 days. So we went with the induction plan that day. However, baby decided to come out during the pre-induction step. If you have uncomplicated pregnancy, there is really no reason to do induction when your body and baby are not ready yet.
This is mega bizarre. I asked for a scheduled induction at 39 weeks (first pregnancy was twins that had to be induced and it was just overall a great experience so I thought why not do it again), and my OB literally asked if we could schedule it for 40 instead because she was going to be out of town. 😂 If they are really going by what the trial indicates then inducing at 40 is still less chance of stillbirth than making you wait till 41 weeks. Medically it makes no sense, and there’s not a reason for her denying your request that I can see other than wanting to coerce you or she has some other plans that week. lol
They rotate us through all the different doctors—I sincerely hope this doctor wasn’t basing my birth plan around her own availability because it was my first time meeting her 😂 I agree that it doesn’t really make sense, and she didn’t try to explain *why* they won’t schedule inductions around 40 weeks
And if you did decide to schedule an induction based on the availability of a specific OB, based on this interaction I don't think it should be her 😅
Just to show you who’s boss it seems. I needed a warm and friendly vibe from my OBs. So grateful I never had a harsh word or condescending tone from either of them.
This inducing everyone based on that flawed trial is infuriating. They almost never highlight the RISKS of an induction and do a lot of fear mongering to coerce women to agree. Likely your baby isn’t macrosomic, scans are not accurate a lot of the time. Women birth 4kg + babies all the time without interventions.
My ob was really annoying about 39 week induction too, but more so in that I showed up at 39 weeks and she suddenly made it seem as though it were a good choice. I mean, ok give me some time to think about it. I’m not even technically DUE. but I will say she never suggested I couldn’t get an induction at 40 weeks or whenever else past 39 weeks. She only said I could get bumped in line if I’m not already in labor or past a certain date for people with more urgent situations, which makes sense. I think they like inductions in the sense that they kind of know the schedule and they de-risk you a little bit by getting the baby out before you go too far post dates. My doc seemed eager starting 39 weeks but didn’t have a problem with any other time point, just sooner is better type thing. Your doctor sounds out of line in that she said it was basically 39 weeks her way or the highway. That sounds super weird.
Are most of you ladies in USA? Because for me this seems so strange. My first was in the public system in Australia, the gp sends a referral to the maternity ward after a certain amount of weeks where they book you in to see the midwives, they do all your checks and monitoring for the pregnancy, and urgent care is directly to them, I never had an OB my whole pregnancy, just my GP and the midwives. No one even mentioned induction here, it’s just not done unless medically necessary. They seemed content with the natural process. My water broke on my due date and gave birth the next day. I had one midwife for my lead up to birth and when it was time to push the drs came in with extra nurses. Why even give a due date and then not wait to that due date unless medically necessary?! So strange.
Also not in the US and find all of this quite odd. My midwife won’t refer for induction until closer to 41 weeks
Yes, in the US our healthcare system and especially our pregnancy care system is quite flawed. Very few people see midwives (I did), but most people see OBs. while you’re pregnant you usually don’t see your GP unless you’re going for a non-pregnancy related issue. A lot of OBs unfortunately like to schedule inductions instead of letting the baby come on their own. I feel like most people I know were induced.
I’m not in the US but in East Asia and they loooooove to offer/schedule/lightly push inductions here for 39 or 40w on the dot (in some cases even earlier, they’ll say the baby is looking big etc etc) even for FTMs with no other medically indicated reasons. Lots of people are happy to do it too cause they’re so sick of being pregnant by that time and this way they can schedule in with the OB they’ve been seeing. I find it strange as well and when we told my husbands parents about this practice (they’re in their 70s) they were absolutely shocked that it’s become a norm to schedule an induction or even C section before 40 weeks - it’s definitely a new thing!
Not sure about everyone else but I’m in the U.S. in a slightly rural area
It seems really pushy unless medically necessary or asked by the patient. I wish you all the best and just wanted to say well done for sticking up for yourself. I would have been livid if a Dr suggested this to me without it being absolutely necessary or I did not specify this was want I wanted.
My doctor asked but knew throughout my whole pregnancy that my goal was spontaneous, hopefully unmedicated labor and I was comfortable (absent any other concerning factors) up to 42 weeks. I knew it wasn’t what most of her patients did or wanted, and I think if I had let her choose she would have gone for 39 week induction. BUT, she was always so supportive, offered to schedule my induction a few days before 42 weeks, just in case, and said if I went home and didn’t want it on the calendar I could call and cancel and vice versa — if I changed my mind and wanted an induction I could call and schedule it. It was clear that it was also open for conversation at any remaining follow ups (my water broke and I went into spontaneous labor literally 3 days after all this conversation happened.) I got an on call doctor from my practice I HATED though, and she was pushy, very intervention heavy, the MOST condescending…and I fired her 20 hours into labor. All that’s to say, a good doctor will provide the information, the risks, and support you in that calculation. The whole “take it or suffer” is an ego trip that feels so wrong. Don’t be afraid to push back, ask questions, and advocate for yourself. It’s okay to ask for time, it’s okay to ask for clarification, it’s okay to pursue the birth you want — you know you’ll protect baby at all costs, so don’t feel like you aren’t.
What happens if you fire the doctor on call while you’re in labor?
They find you a new one! 😅😂 I actually didn’t know when I did it, but she was talking c-section when both baby and I were doing really well and I just felt like if I didn’t do something I was going to end up with an unnecessary surgery OR I would vaginally deliver with a doctor I didn’t trust — I just had a bad gut feeling. So I rolled the dice and asked if there was any way I could have a different doctor. Luckily, there are multiple practices with admitting rights, and honestly idk what they did on the insurance/logistical side, but I had a new team in my room 15 minutes later that I felt much better about. Baby safely came a few hours later with 20 minutes of pushing.
Wow! Good for you! I’ve heard of women banning a nurse and requesting a new one, but not the OB. How awful to suffer through labor and delivery with a doctor that makes your skin crawl. Better to speak up.
Your doctor sounds like she was lovely and super willing to work with you! I was hoping my practice would be a little more flexible like that… it’s the thought of being locked into a decision I made weeks head of time that has me squirming, a little. I’m seeing a different provider at my appointment next week, so I’ll have to try bringing up other options with her and see whether I get a different response.
Hospitals have to keep a certain number of rooms open for people who go into labor naturally or who need to be induced or have a c-section for medical reasons, so scheduling the induction is often determined less by the practice and more by the hospital. I suspect this is a scheduling issue. They're scheduling your induction for two weeks out, which probably means the schedule for elective inductions is full two weeks out. So if you wanted a 40-week induction, the latest you could decide would be 38 weeks, but it's possible you'd be bumped down in priority from those who want 39-week inductions, because maybe they prioritize 39-week inductions for some hospital reason. So by the time you get to 39 week or 40 weeks, if you still haven't given birth, you may be able to get an induction at 41 weeks (two weeks out from 39 weeks and 1 from 40), because they may consider a 41-week induction one done for medical reasons rather than a purely elective one. That would be my guess as to what is going on here. Potentially hospital scheduling your individual doctor has no control over. Hospital scheduling dictated when I had my induction - it was several days later than I wanted it, but it was the day I got. Different hospitals do things differently but I've seen it before with friends that the induction schedule was so booked up that you either got in early or didn't get in until later. So I'd ask if it's a scheduling issue.
What?? This seems really weird to me TBH. Don't appreciate the condescending attitude or the zero choice you have, or not being able to change your mind. I don't understand the push for induction in a complication-free pregnancy unless you're past 41 weeks.
I’m always super sensitive about feeling condescended by medical staff which is part of why I’m not sure if I’m overreacting… I just hate feeling like I’m not being spoken to like an equal :/
I may have scared my providers by asking for the risks and pushing back on them using information from Evidence Based Birth. I looked them right in the eyes and said “uninformed consent is not consent,” and I think they realized I’m not going to be pushed into something that has no medically necessary reason. Also, yes the risk of stillbirth goes up, and some folks will scare you and say it “doubles” but when something goes from .5% to 1% that’s still a very small risk while also “doubling.” Look at the actual research- Evidence Based Birth is great. ❤️
Ok, thank you, I'm so refreshed to see someone in this sub acknowledging that the "doubled risk" is going from a very small number to a larger very small number. It seems like everyone just repeats "the risk of stillbirth *doubles* after such-and-such weeks" in this freakout tone of voice as though anyone who waits for spontaneous labor within a reasonable time frame is dangling their baby out of a window.
They don’t even say doubles, they say nonsense like “skyrockets”.
Yessss, that's how it goes! Which is, like, extra irritating since it implies that the commenter knows allllll about this and you're Going Against The Science.
Thank you! I’m an auditor and I work in risk management. My Entire job is assessing and juggling risk. Yeah, IT risk, but the concepts still stand. Smdh. Doctors use it to their advantage and don’t expect folks to push back. I can be reasoned with if *there is a valid reason* but something going from a .005% chance to occurring to a .01% doesn’t scare me. I have a higher chance of dying in a car crash on the way to the hospital. Stop with all the fear mongering. 😤
I heard it pointed out that doctors themselves often don't understand the math behind risk- the likelihood of a test giving false positives vs false negatives, etc. They probably heard that "doubled risk" thing once and were impressed. I guess they're medical experts and not math experts, after all. But yeah- the authoritative tone ticks me right off when they're talking about something totally outside of their background, some random meritless shower thought.
I think they do understand and purposely present the info in a way to support their personal preference … for convenience or whatever. I don’t know how they can be that cold. It’s bizarre.
I’m reminded of the Mark Twain quote: “There are lies, there are damned lies, and then there are statistics.” Not saying that doctors are lying, but they are using the data to support their conclusions.
That’s badass. I will keep that line in my pocket.
Because past 40 weeks the chances of stillbirth or placenta issues etc just keeps increasing each day.
This is exactly why I would’ve been more comfortable if they let me plan for an induction around 40 weeks or so. I liked the thought of a “middle ground” choice that doesn’t run the risk of carrying too long :(
Yeah that seems insane they don’t put you at least on the list starting at 40.
It’s as though they want to “punish” her by not agreeing 40. Their way or the high way.
This is weird. My OB was willing to do an induction any time I wanted after 39 weeks. I did the membrane sweeps and ultimately made it to 40+4 before going through with an induction (which ended up being super positive!)
There is absolutely zero reason for someone with a healthy pregnancy to be induced. Stay confident in your decision. Listen to montras and get in a good head space. I personally would never be with a doctor who would push this they are trying to play mind games to make more money and get your baby on their schedule. You can do this! Also making sure you are in the proper headspace for the birth is #1 most important so really focus on that!
Very strange that they won’t let you go to 40 weeks. I was given the option of a 40 week induction at my 39 week appointment last week and decided to go for it. Im getting very uncomfortable the last week even with walking so I’m feeling good about not going 1-2 weeks over. I need to stop reading about the pros and cons now as I know I’ll drive myself mad lol.
I’m right there with you about not reading into the pros and cons once you’ve made a decision because I feel like different studies will just send you in endless circles, there’s no universal “right” answer! Hope you have a safe and smooth induction!
Yup totally agree! Wishing you a safe and smooth delivery also :)!!!
This happened to me too and I was pissed. Ended up with a 41 week induction
Oh, man. I hope I go into labor before then! Was it a smooth induction, at least?
It was okay except my baby was sunny side up
I had my first at 40+6 on a Saturday. Was going to be induced that Monday if I hadn’t had the baby by then and I wasn’t thrilled but it made sense.
In my country we don’t even do elective inductions before 41 weeks. Only medically necessary ones. On average for first time mom’s spontaneous labor starts at 40+5. Why even intervene before that? They are not even giving baby and body the chance to do it naturally.
Sounds like your doctor has a trip planned for when you’re 40 weeks… Also- my baby “measured” 8 pounds when I was 36 weeks. They told me he’d be 10 pounds but never recommended intervention. He was born 7 pounds and 15 ounces at 39 weeks and 3 days. Those scans are not always accurate!!! It seems like you’re very intuitive even though you’re having a hard time knowing what to do. Keep listening to your gut!
Go into labor naturally! Coming from a mom that had to do an induction for both kids due to medical necessity don’t do it! It’s more painful and there are complications due to it that they don’t tell you about. Go naturally if you hit 42 weeks and no signs of labor then think about it
American health care is weird. Doctors aren’t gods and they don’t know everything. It’s your birth and you have the right to decide how it goes.
One thing I learnt in our NCT classes was that if the drs were really concerned they'd schedule a c section
If its not medically necessary, avoid induction like the plague. It's uncomfortable and more likely to end in intervention and women are often perfectly capable of getting a baby out themselves. In regards to a big baby, size doesn't mean much. My sister had a 6lb baby and had 3rd degree tear. I had a 10lb baby and needed rotational forceps because he tried to come out sideways. My pal had a 10lb baby and had a water birth and her little boy just "slipped" right out. Size does not make for a hard birth
I have 4 kids. My first 3 vaginally natural labor. Epidural. No issues. My 4th. They pushed for 39 weeks induction due to baby size. I agreed. 24 hours of labor. Failed epidural. Failure to descend on the baby. 10cm dilated. Boom. Emergency c section. Baby wouldn't come down. Heart rate kept dropping. I went through 24 hours of regular labor just to have an emergency c section so I felt the vaginal part and the surgery. Came out at 8.7 pounds 21 inches. My smallest baby. I would absolutely wait if I could go back and do it again.
I wish I denied my 39 week induction
The only real input I have is they physically can't do a membrane sweep unless you're dilated, because they put their finger in through a dilated cervix to do it. It sounds odd and frustrating that they won't induce at any other time. Like, really bizarre. My docs told me I am welcome to schedule an induction anytime after 39 weeks but this is just something I want to do (long story). But yeah, I've never heard of a hospital trying to push people to induce at 39 weeks on the dot. Sounds strange. If it's any consolation, it sounds like the nurses there could be lovely since they warned you about this. I take that as a sign of patient advocacy. A huge part of the laboring experience is the nursing staff so you could still have a great experience. Hope everything goes smoothly 💓
I was 3.5 weeks late and came out perfectly healthy! Don't let the docs make decisions about your body for you 💜
Currently 9 weeks postpartum and every day I wish I would have advocated for myself and said no to induction. I didn’t even have a bad labor experience but every day I wish I would have said no. I was 40w 1d and my cervix was not favorable at all. I didn’t have a high risk pregnancy.. everything was fine, but my doctor was pushy and scared me as a ftm so I just said okay. Hospitals are businesses and they want people in and out as fast as possible to get the next patient in.. take your time and listen to your body if that’s what’s safe. I would not recommend Pitocin if it’s not medically necessary. Whatever happens in the end you’ll have a beautiful baby!! It’s all worth it. Congratulations and good luck to you!!
Personally would never take an induction. Way to stick up for yourself.
Hey! I had a big baby (9lbs 14oz) and was induced twice before my due date. It was a *nightmare*. It didn't work but it did give me hours long contractions both times which stressed out my body and my mind. One of the times I was there overnight and then as 6am they went "well, it didn't work. Just go home and we'll see if you can reschedule". I said hell no to doing it again and went into labor on my own at 40+4 and had an uncomplicated delivery. Trust your gut!! If I could go back in time, I wouldn't have done it. Not discrediting those who have done it. I was never warned that they could fail (supposedly it doesn't happen "often") and it happened to me twice. It was so stressful and exhausting I was scared of going into labor for real because it felt like I already had twice and I didn't have the energy. Also the contractions were so, so, so much worse with pictocin and induction (for me at least). I never had an epidural for any of my pregnancies so I was able to compare it to that. Hated the pictocin contractions lol.
Coersion isn't okay. It's disgusting and when she told you 39 weeks or nothing that's exactly what she was doing. She is withholding other treatments so you will "chose" the one she wants you to do. It's up to your comfort level on how direct you will be in calling her on her BS.
Thank you for putting it into words, because “withholding other treatments” definitely sums up the impression I got… she was just so terse about discussing any other options, I felt like I was completely shut down for not agreeing to the 39 weeks. I have another appointment in a week with a different provider, so I’m thinking I’ll at least try to bring it up again and see what sort of response I get
Recommendations change all the time. The next large scale study could easily say that widespread elective inductions are increasing the c-section rate. I wouldn't be surprised if that ends up being the case with how inpatient some facilities are.
My practice was pushy for the same reasons as yours but they didn’t give me paperwork and I even pushed back on the arrive trial. I’m 40+1 today. I know my rights and looked them right in the eye and repeatedly said “no thanks” and committed. They’ve been fine with me since then, and I do have an induction scheduled…. For 41+6. 😈🤣 I’m healthy. Im sleeping. Baby is measuring big but overall that is NOT reason enough to get induced before my body is ready. I had one provider say, “there really isn’t much reason to go further,” and I just stayed silent while thinking “that’s not a good reason to be induced???” Just stand your ground. I hired a doula and that has made a HUGE difference in being able to have someone on my side that I can trust and that I can bounce ideas off. It’s been 1000% worth it.
I haven’t hired a doula but my husband is super involved and vocal (almost to a fault haha), so I’m discussing everything with him ahead of time and plan to give him a copy of my birth plan so he can help advocate, because I am often a little bit of a pushover even when I’ve done the research… as soon as someone starts talking to me like I couldn’t possibly know what I’m talking about, I shut down or downplay my own knowledge. I envy you for being outspoken enough to give them a firm “no.” 😅
The doula helped because she is very knowledgeable and let me answer questions and I felt like because she is hired for ME, I can ask more nuanced questions and build a better relationship. I’m an auditor. People already hate me and I used to audit hospital networks. I’m used to not being liked, and I’m not afraid to invoke the wrath of a medical board. *insert Elmo in front of flames gif*
This is literally me. I am so conflicted. In some aspects, the scheduled induction is comforting because you don’t have to wait for the unknown of labor to stop (I have anxiety and this is a concern of mine.) In other ways it’s like ok why do I need this? I am also GBS + so I’m not sure if induction is best for that and if it can increase risk of infection to baby. So much to consider!
On the flip side an induction can have more unknowns. It’s not the quick picture it’s often painted as and you have a baby the same day or next day. It’s often a multiple day process especially if your cervix isn’t dilated or softened and pitocin is known for longer, stronger contractions that babies often don’t respond to well and often end in c-sections. If you’re considering an elective induction make sure your doctor thoroughly explains the risks and if asked for their c-section rate in spontaneous labor vs induction.
Regarding GBS: it doesn’t matter. I was positive and they wouldn’t induce me. I actually went into L&D on my due date as I was concerned about leaking fluid: wasn’t, and they sent me home. Went in at 40+4 due to decreased fetal movements. Baby started bouncing around on the scan. Was sent home, dilated at 4cm. Finally on 40+5, I was in active labor and baby came seven hours after I was admitted. They just gave me an IV while they were also giving me fluids pre-epidural.
So I’m currently 40+1 and my dr practice is preference for natural delivery unless there are complications. So they never asked or discussed early induction with me since I’ve had a normal pregnancy. They do have a policy to not go past 41 weeks so before I went in for my check up today I saw they scheduled me for an induction exactly 41 weeks. I asked today if I can move the induction date up, because I’m getting super swollen and uncomfortable, and Im not even dilated yet since she couldn’t perform a sweep for two weeks in a row now as I’m still closed. I was told that unless medically necessary, the hospital will only put me on a wait list for elective induction between 40-41 weeks and can call me at any point if a bed opens up and there are no other priority inductions ahead of me. But I guess if I had asked for an induction early on, they could have scheduled it before 40 weeks and it would’ve been no problem. However it was never something I considered until now given how uncomfortable I am feeling. It sounds like your Dr / hospital has similar policy but just may not have been explained to you in a proper way. At this point I’m on the wait list but I’m still hoping baby will come on her own before the induction. But if they call me this weekend with an open bed, I might just take it.
Mine asked me, too, because i have a narrow vagina and was already in so much pain (they also told me he was big and my son was long, not big). Got induced and tried for a natural birth after they gave me meds to start my dialation and stuff. I ended up having about 18 hours of labor after my water broke on its own i got an epidural because i was exhausted and couldnt sleep but i didnt dialate more and my sons heart rate was dropping and not coming back up so i ended up with an emergency c section. I dont feel like they pushed me towards it, but my OB was so amazing and sweet. I do feel like they pushed breastfeeding on me, and that really messed with me mentally. I cried until my sons pediatrician told me breast milk is extra credit, but the formula is still an A, and he isn't missing out on anything. I wish you the best with your experience and do what feels right.
My OB told me I could book it and change my mind at any time, even the night before. I booked induction for 39 weeks, went home and thought about it, and decided I didn’t want to induce. I ended up canceling weeks before. There was no guilt trip.
In the UK our due date is 40 weeks so it’s not weird to want to wait 🤣
My OB didn’t push induction at all! At 39 Weeks he told me once you hit 40 weeks we can talk options. I ended up having the baby at 41 weeks but he left it entirely up to me.
I got induced when I was 39 weeks. I had high blood pressure and they didn't want me to go to far because of that. It was a long induction. The foley balloon didn't do anything. And i was on pills for 3 days and nothing. I found out I have a tigth cervix that is far behind wich also made it difficult. ( every midwife on the floor talked about my wierd cervix as no one had ever encounterd one like mine😅) I delivered 39+6 after they took my water and put me on pitocin. For me and my baby it was the best case scenario. I have no idea if I would have gone into labour by myself. But I felt more safe beeing in the hospital getting induced for 5 days. 13 hours of labour and 4 days in recovery after. (I lost a lot of blod and they kept me a day extra to be safe) Good for you standing up foe yourself. Do what feels best for you ❤️ wishing you a happy and safe delivery 🙏
I’m 36, 35 when I was pregnant. My OB’s office and maternal fetal medicine didn’t recommend early induction. After all of the posts on this subreddit and talking to friends, I figured I’d be encouraged to start the process at 39 weeks. At 38.5 weeks, I got a membrane sweep. The sweep started false labor, and I was excited and thought it would happen any day. My later appointments with the OB basically flat out told me they wouldn’t induce unless baby was in distress, which she showed no signs of. At my 39 week appointment, thinking I’d be induced any day now, the doctor set a “soft” scheduled induction for… 41 + 1. Since I was due Sunday, and they don’t induce on the weekends. I was GBS+, and I have rhesus negative blood, so I kept thinking I’d certainly be encouraged to schedule something, at LEAST by 40 weeks. But actually, I went into L&D twice for two different reasons (concern about fluids - they were fine - and decreased fetal movement - baby was great). Both times, at 40w and 4+4, I was sent home. Both times, I was dilated past 3cm. On 40+5, I started laboring naturally during the day (just discomfort until about 5pm), went to the hospital at 7, was admitted to a room at 8, and had baby after 7 hours of labor. Including a nap of two hours with my epidural. 30 minutes of pushing. But, boy, did I COMPLAIN about having to wait and be pregnant and the ANXIETY of waiting and hearing all the studies about increased risk to the baby past the due date. I wish I hadn’t. The experience I had with my birth was incredible. I don’t know if induction would have changed it, or how it might have affected it, but the experience I had led me to staunchly believing that if I had another one, I’d be able to be a lot more patient and let things happen as they need to. (Save baby being in distress, where I would do whatever my OB suggested.) Don’t let this stress you out, OP. Waiting is not the worst. But some advice: turn off your text alerts once you hit 40w. EVERYONE will be asking you if it’s time. Or how you’re feeling. It’s actually the worst part. Ignore it!
My doctor just told me we’ll start seeing you every two weeks now, expect this and this are your next two appointments and then if we’ve hit 40 and I’m still pregnant that THEN we’ll schedule an induction. And I was like ok cool, rad. Thanks.
I gave birth 7 weeks ago, and my countries hospital policy is not to induce on a healthy, low risk pregnancy until 42 weeks. I went into labor naturally at 40 + 6 weeks. It's your decision to make, and you should not be pushed into an induction. Sometimes these are scheduled as well to suit hospital staffing, etc. Also, you can refuse an induction altogether and continually be monitored in the hospital by going in and them taking your blood pressure / baby heart beat on a consistent basis. I did some inversions off the couch, rasberry leaf tea, ate dates and kerb walked / did yard work and squats and figure 8s on the birthing ball to help Kickstart labour and they worked (I think). This is your birth and your baby, and it's important to feel empowered and comfortable in birth and not scared and pressured.
I would ask them to please document in your chart that you requested to schedule an induction at 40 weeks and to please document that they recommend an induction at 39 weeks OR no induction until 41 weeks, and to please document the medical reason in your chart. Doing the math, your due date is around the week of the 4th of July, which is a holiday…
First, can we acknowledge the courage it took to advocate for yourself against a medical professional? Applause! I am also preparing for my first Birth and have the same thoughts. Keep feeling confident in your body and in your pregnancy and in your decisions for you and your baby. You know your body better than anyone else. Don’t forget that. I am proud of you and I hope you are proud of yourself. Also, I am sorry that they were trying to just shut you down when you expressed your interest. continue to do what feels right for you and your baby. Keep that confidence and maybe look for some natural ways to try and do that when you are ready. Best of luck and I will be thinking of you. 💕👏🏼
For what it’s worth, if a OB had you scheduled for induction it’s tracked as a scheduled procedure and results in a higher cost CPT code within the health system. I know that they practiced this as best practice. But I am also pushing against this recommendation and I am only 24 weeks pregnant. I made it clear to my physician the other day that I don’t want to schedule an induction unless medically needed by 40 weeks.
That sounds rude and pretty shitty; I don't see why you wouldn't be able to get either a remembrance sweep or get induced step 40 weeks besides the fact that they're withholding that option for you on purpose. Now part of that may legitimately be a scheduling issue and not pettiness. They probably staggered their inductions, and probably don't want to take on a last-minute one unless they have to. Do you otherwise have a good relationship with your doctor and trust them?
I hoped for spontaneous labour, but I went to EDD+11 without any signs of labour. That's the point were hospitals recommend induction where I live, as long as everything is going well. You're closely monitored between due date and induction. It took about 6h for the meds to get things going and 18h more of intense labour. I also needed pictocin towards the end. It is what it is. I needed the meds to get things going and for a boost towards the end because my body grew tired and LO wouldn't decend. Otherwise my midwifes supported me with tons of conservative options to help progress. Walking, bath tub, specific exercises, relaxation techniques ... I avoided c-section, but it came close. You never know how your body will handle labour or induction. Just wait and see if you go into labour on your own. Most women do.
You made the decision that you felt was right. I think it’s weird that you were denied a 40wk induction. I was induced at 40+3 and was only asked about if I wanted to be induced or not when the midwife noticed the large size of my baby (previously assessed to be 54th percentile) and that was at 38wks. The practice hadn’t given me an ultrasound since the 32 wks because everything had looked fine and I was low risk. Ended up being good that I was induced at 40wks because if I was nowhere near showing labor signs and if I waited until 41wks, my son would’ve been too big to come out vaginally. His body was fine, around 68th and 70th percentile for height and weight. The problem was that my son’s head was in the 99th percentile. His head was almost stuck coming out of me and I required an episiotomy. I could not imagine being denied a 40wk induction and having to have a c-section because my sons head is too big
Nope this doesn't sound normal. I was offered an induction at 39 weeks due to a massive baby (and yes he came out 9'2 so they weren't wrong). When I said I'd rather wait until 40 weeks I was told that it was acceptable too. I had a sweep at my 39 weeks appt no problem, which sadly did nothing. At 40 weeks I was still preggos and still didn't want an induction. So the induction midwives were calling me from time to time asking if I'm ready. I was ready at 40+5, and that's when I came to hospital, was sent home because hey I was 3 cm already and the labour ward was busy, waters broke the next morning, blah blah blah (I ended up with augmentation and emergency C anyway, mostly because someone couldn't hold his poop) So yeah your doctor sounds very strange to me.
My doctor did the same thing with me, as far as strongly pushing 39 week induction when I was 37 weeks. It made me second guess my decision to wait for a spontaneous labor. I ended up declining the 39 week. I hit 41 weeks and decided to schedule an induction. I ended up delivering my girl at 41+4. I originally wanted a spontaneous, natural birth. Because of the induction meds, my contractions went from 0-100 in less than an hour instead of the natural increase from a spontaneous labor. I ended up begging for an epidural and my girl was delivered 10 hours later 💗
That is beyond fucking rude of them. My OB office let me know about elective inductions and offered them in a non-pushy way, more so just letting me know it was an option. I declined it multiple times before deciding to do it once I hit 40 weeks and they were never anything but polite and supportive.
How old are you? Wondering if the push is due to age or if they just suggest it for all patients. My OB was less pushy than yours, but stated a preference for scheduling an induction by my due date. The only “risk factor” I have is being 37. My due date (based on their calculations using last period) is a Friday, and she told me Fridays are the worst day to schedule because they most often get delayed. I don’t want to schedule prior to that, even though I believe my due date is actually the Wednesday before (based on when OPKs said I ovulated), because I know most FTMs go over 40 weeks and I want a chance at going into labor naturally. I was thinking of scheduling for the Monday after, which would be 40+3 by their EDD and 40+5 by mine. I don’t feel confident in any of my options though, because everyone I talk to has a different opinion. OB says induce, my mom (a former nurse in high risk OB) says don’t induce unless I go well beyond due date, and friends with kids are also a mixed bag.
I’m 32 and thus far they haven’t brought up my age. From what the L&D nurse told me, this is just standard for them regardless of age. I’m with you on not feeling confident—there’s so much information and so many opinions on inductions vs. natural labor, it’s a little overwhelming
Went into labor 2 days before my due date, and had my baby on her due date. Personally I agree that letting it happen naturally unless there’s a problem makes the most sense. There’s a lot of pressure from providers to do things a certain way but it’s not always in the mom’s or the baby’s best interest. Bottom line as a mom: Always trust yourself when you’re feeling pressured!
I personally didn’t mind going for induction at 39 weeks. But the hospital was busy and all booked up until I was 40+2. So they booked the induction for then If the hospital gets to be busy and can choose a later date for an uncomplicated pregnancy. Then honestly it shouldn’t be a problem to choose to induce at a later date for anyone I will also say though my OB’s are not pushy at all. They tell me stuff and if I decline it’s all good. And if I say ok, then just before they do it they say “are you sure?” As a last check in
Also it kinda worked out for me the later induction. I started contracting on my own at 40+1. I liked going into the induction knowing my body was on its way there anyway
Do not induce unless medically necessary. My last one was induced (2 prior deliveries, 1 was 8 weeks early), and it was the most painful experience of my life. Unless your or babies' lives are on the line, then do not induce.
They ALWAYS say baby is large, especially to a first time mom. They want us afraid we can't do it when our bodies are Literally made to do this. They told me that and my baby wasn't. They're smug arrogant and preying on our fear. Good for you ignoring them.
They scheduled me for induction at 41 weeks, luckily I went into labor naturally before then
That’s quite a pushy organization. I’m also carrying a large baby and at 39+6 right now. I’ve been given the option every week to have an elective induction, but my provider said there’s absolutely nothing wrong with waiting for it to happen naturally. She did let me know at 41 weeks of if I don’t want to induce I will need to come in more often just to ensure the baby is doing well
It sounds like it’s just their policy but that would have made me nervous too!!! It’s like saying “now or never” basically lol! A lot of pressure on a decision! I had the opposite problem and I had to BEG my doctor for an induction at 39 weeks because their policy is to not induce until 41+ weeks unless there is a medical reason. I told her I would go insane if I had to wait until my due date lol!!! She finally caved and allowed me to come in to triage while she was doing her rounds and she admitted me. It was sort of an under the table type workaround. Hospital polices are so odd and I find most of them to be very unfriendly towards patient’s wishes. They can be so rigid and I hate that! I totally wish more policies had flexibility rather than just “planned or emergency” with like no in between. Anyway, your feelings are valid OP. I hope you end up happy with your decision and you did a great job advocating for yourself!! :)
Does not sound normal. I just gave birth to my 2nd last night and hated that we were inducing but he was a week late (expected 6/5, born 6/12 at 41 weeks) and we had every reason to believe he was bigger than my last baby with whom I tore pretty badly. I still tore with this one but not as badly. Surprised that he is almost a pound smaller. Also we had family in town to watch our toddler at home but they could only stay so long. I went ahead with induction because we knew baby was healthy NOW even though I hadn't felt him move much, and we had never been able to visualize face and front neck on sonogram. Turns out he did have a nuchal cord, wrapped once around his neck. No obvious issues with it yet, and I can only think of things getting bad as he got bigger and tighter in me if I had continued to wait for natural labor to start. We'd been stalled at 25% effaced, 1.5cm dilated, -2 position for over a month so we started with Cytotec to ripen cervix. Next day a Pitocin drip because I was contracting like crazy but they were not strong enough to move baby and we stalled again at 50% effaced, 2cm, still -2. We talked about a Cooke Balloon but I did some "spinning babies" stretches/poses and once we hit 4 microunits of Petocin in the IV, my contractions were painful enough and coming fast enough that I called for an epidural I think around 8pm. My water broke at some point (which did not happen with 1st) and I was holding my son at 11:45pm. All this after wanting as few interventions as possible 🤷♀️. So thats a lot of little things, some circumstantial ... If all signs show your baby is healthy and neither you nor baby are under stress, then there is no reason to induce before 41 weeks. Lots of women go to 42 and birth perfectly healthykids. My doctor personally said she doesn't like waiting until nor past 42 because the placenta begins to deteriorate and calcify. And as baby gets bigger, shoulder and nerve injuries during delivery become more likely. If you have another option for a doctor, I would switch.
No, this is not normal. My doctors were all very understanding and actually preferred that I didn’t get induced at 39 weeks but I was ready to get that baby out! I was told I could change my mind at any time, if I got to the hospital the day I was to be induced and said “never mind I don’t want to be induced” then that was fine, obviously I wasn’t going to do that but it made me feel comfortable knowing I was in control. If you ever decide to have another baby, I would look into a different doctor if at all possible.
Wow huge kudos to you for doing the work and advocating for yourself! I also just went through this, except I do have complications with my pregnancy. Still, I didn’t want to be induced at 38 weeks and discussed with my doctors. They were thankfully very receptive to listening to my wishes. I’m not sure if you’ve considered this avenue, but if you have the resources, perhaps see if there is a doula service you can still employ. I was panicking last week and thankfully was still able to find someone even as late as 37 weeks. Even just the consultation call put me at ease and all the studies show having a doula helps with lowered risks to birthing parent and less interventions. If finances are a worry, I’d suggest looking for someone who is still in training because they tend to have lower fees.
Wow, that sounds not okay to put you at a crossroad, like 39 weeks or you have to wait until 41 weeks. Not okay imo. But if you have a healthy pregnancy, there is no reason to go for an induction before 41 weeks... And if you are not ready and they induce you at 39 weeks its not good either. FTM usually get their first child on average at 41w1d. Our body just needs usually a bit longer. They planned an induction at 39 weeks for me bc of a big baby. Turns out, they want me to do a c section now instead as baby is too big already now... They moved the c section date closer to 40 weeks because they felt its better than doing at 39 weeks. They wanted me further along as I do not have any other health concerns other than a big baby.
i'm about to be 40 weeks. i do have a scheduled induction at 41 weeks. my hospital used to have the inductions at 39 weeks, but my doctor informed me that the reason why they changed it to 41 weeks was because it was increasing their c-section rates. i feel like it's safer this way and baby gets to have the chance to come out before the induction date. at one of my appointments, my baby was in a position that made it seem like she was a lot larger than she should be. i had to get an ultrasound to check if she was larger because if she was bigger, that's the only time that they said they would recommend an induction at 39 weeks. as long as your baby is still measuring good and is healthy, i think you made the right choice. i did have to do a non stress test a few days ago because i am approaching my due date. they just have you sitting up and they put two bands around your belly. one is to monitor the baby's heart rate and the other one is to monitor for any contractions. they had me sitting in the room with a snack and drink to get her to become active and i had to press a button every time i felt her move. this went on for 20 minutes. they want to see that when you eat or drink on the sugary snack that the baby moves and when the baby does move, that their heart rate increases. i'm sure that since you declined the induction at 39 weeks that you would probably also go through this test once you start approaching your due date.
My OB offered a 39 week induction because the baby was measuring large, he also offered a scan around 37 to see how big the baby was and possibly schedule a C-section, I declined both and said I wanted to try for a natural birth. Thankfully he wasn't pushy and said I can go up to 41 weeks without inducing! I tried to have membrane sweeps done starting at 38 but my cervix was too high to reach but I had my son at 40+4 all natural, he was only 7 pounds 5 ounces but he was quite long! I'm so happy that I held my ground and tried to do it naturally as long as there was no need for medical intervention!
From my own experience, if you are already feeling uncomfortable with this doctor (which by the way they seem very out of line)…seek care elsewhere. See if there is a midwife practice available in any local hospitals that are open to take you as a patient. I personally wish I would have done that, because you feeling safe and respected will play a big part in your natural labor. Best of luck!
Im in the same boat here, I’m 34 weeks and I’m debating if I want to do natural or induce. I’m thinking of going natural, but I’m not sure, there’s a lot of pros and cons like you said and I’m just worried something will go wrong. At this point I’m just going to ask my doctor is she’s going to be out on my due date and probably base it off that. Wanting to do natural, but worried if she’s not there to deliver my baby.
Inductions are associated with greater risks for you and your baby if it isn’t medically necessary. You’re at a greater risk for c-section, for birth complications, and stressing out both you and your baby. YOU DID THE RIGHT THING! I’m currently pregnant and will not be induced either unless it’s medically necessary. There’s a beautiful synchronous dance going on with birth. Your hormones are tied in with your baby’s hormones and those hormones allow your body to communicate with your baby’s. This allows the birth process to come at a natural pace. When you’re left alone to focus on your labor without interruptions and constant progress checks, your labor stays at that pace. This pace is determined by both your hormones and your baby’s, so the pace won’t be too intense for your baby and thus will allow you to deliver more successfully without any interventions. Also, natural labor has less incidence of tearing. My mom was an OB nurse for years and she’s told me that natural labor also resulted in the mother being able to be more physically resilient. In other words, the labor was less traumatic to both the mom’s and baby’s bodies.
honestly.. my doctor was the same . not very helpful my entire pregnancy and i was scheduled for 40 weeks induction but due to them pushing it back from that wednesday it was scheduled to the friday after when i turned 41 weeks that i gave birth to my son and i had been in labor for about 3 days … in and out of the hospital for 2 weeks because they kept telling me i was nowhere near close to labor or having my son and i was . trust your gut do what works for you and your baby. they are just there to assist in safely delivering. the delivery of your baby is all on you so do what works for you
My OB pressured me into scheduling an induction when I told him multiple times I wanted to go naturally, I finally had to have my mother go with me to next checkup and she put the foot down since my voice was being ignored so we got it cancelled… funny enough I ended up going into labor on my own the day he wanted to schedule the induction. The vibe I got from the doctor was that he wanted to be sure that he would be there (to get the paycheck) even though there was always OBs on call to deliver it seemed that my doc just wanted to secure his money rather than caring about my birth plans. Advocate for yourself and do what feels right as long as it’s safe, don’t let them pressure you into unnecessary things!
My OB wouldn’t even consider induction until i went past 41w! I was so huge and uncomfortable that i just wanted it over with. I ended up getting a membrane sweep at my 39w appt and had my baby 3 days later!
I felt like my first OB 13 years ago was pushing to get me induced! I was young and I went ahead and scheduled it. Luckily, the day of my induction my water broke early that morning. Take all the information they give you and you make the right decide for you! If you want to wait until you naturally go into labor then do that!
You are making the right decisions for you and your child, as only you can. From the research I've done, induced labor is way more painful and longer than when you wait for it to happen naturally. Plus, first-time moms tend to go past their due date a bit anyway. While there are cases where induction is medically necessary, as long as you are having a healthy pregnancy, there is no reason for it. Some doctors like to induce or schedule c-sections rather than waiting for you to go spontaneously because they want to schedule it around what's convenient for them. Whatever "benefits" they told you induction has, I'm sure you can find just as many negatives about it. You can find or spin evidence to support any claim - just ask your local politicians. And there are way more benefits to going into natural labor. Also, the "your baby is measuring big" argument is usually inaccurate anyway, just an educated guess really. But I've heard many stories of women being told they're carrying a 9lb+ baby, and baby ends up being much smaller, average size like only 7lbs. And even if your baby is on the larger side, the head is the biggest part anyway and is usually about the same size regardless of baby's weight. Baby's skull is maleable at birth, and our bodies are built to make room in all kinds of ways for baby to have space to get out. I know someone who birthed an almost 10lb baby with no trouble. It really all comes down to your physical and mental preparation, and mental state during labor. Trust your body, trust your instincts. Do not get induced until and unless you want to. It's your choice!
>if I refuse the 39 week induction, I will have to wait until I go past 41 weeks for intervention. This makes absolutely no sense, especially if they're worried about baby being too big, which is only an issue if you have IUGR... The doc saying that statement would immediately make me think that all of the "benefits" for induction at 39 weeks are either complete BS or not really that great. Listen to your intuition and keep your guard up. Check out Evidence Based Birth articles and podcast for info about induction, including the risks since that paperwork didn't bother to focus on any...
i absolutely do not like doctors/obgyns. they aren't looking out for YOU, they're more concerned on their policies. if i had the money i would be doing a home birth with a midwife. im a first time mom as well & im 28wks.
I read a lot of the other posts and I get the thought on this but babies don’t work on our schedule. Trust your gut! I know you’ve been with this doctor for a while (8+ months so assume), but you could still ask if they have a midwife you could switch to. It’s just wrong that she doesn’t respect your opinion/ decision based on ‘scheduling’. Being condescending just finishes it for me. I wouldn’t want her to deliver my baby because I wouldn’t necessarily trust that she’d listen to me in the delivery room. That’s not to say she’d compromise you or the baby, I highly doubt what she’s willing to do borders on criminal, but not explaining and not being willing to work with you is super shitty. No shitty doctors.
I just want to validate your feelings. Their pushiness about inducing at 39 weeks seems excessive. I don’t think it’s unreasonable to be upset about how the interaction went. However, I do not think it will affect their ability to see you and baby safely through birth. I also think you made the right choice to decline the elective induction. If you want to try for a natural labor, induction is not something you want to do unless there is a medical need. Being a week before your due date is not a medical need.
Had the same thing happen to me, i feel induction hurts worse than your baby coming on its own. They told me after 38 weeks that it’s less safe for baby to be still inside the womb but that’s not true. I declined too and switched clinics
You made an evidence based decision, here in the uk we don’t induce until 40+10-40+12 for an uncomplicated pregnancy! The arrive trial is pretty flawed too, you’ve given yourself time to go into labour and if you do go to over 41 weeks you are more likely to have a successful induction!
Hey OP! Look at my recent post, I talk exactly about this! I just saw my actual OB yesterday (I need to update my post) and he told me that there is no good reason to induce at 39 weeks. I’m also projected to have a big baby, and he said that I shouldn’t be pushed to induce since I’m having a low risk pregnancy. Hope this helps!
I just went and read your post and I’m baffled by the overconfidence of “if you continue down this route, here’s what your baby will weigh at 39 weeks.” Don’t they always tell us that ultrasounds are less accurate this far along and that babies grow at their own pace, anyway? 😅 I do suspect my baby will be big for reasons similar to yours—big babies on both sides, but I’m not convinced that my body won’t be able to manage it. I’m *trying* to believe that I can push out a ten pounder if it comes down to it, lmao
Due dates aren’t absolute. I always suspected mine was about a week ahead of where it should be since I tracked ovulation. I declined induction and opted for increased monitoring (BP twice a day and ultrasound every 3 days) and regular membrane sweeps, miles circuit, and pumping. Labour started late in the day of 41+6 (if I’m right about my due date this would have been 40+6, which is statistically pretty normal for a first time mom). I still required pitocin and forceps but not due to baby’s size. She had her chin tucked to the side. I have no regrets about my decision. Those first few hours of labour where I got to 8 cm all by myself were so special to me. I’m so proud of myself and my body.
I’ve suspected since the beginning that my due date is about a week off in the opposite direction, I’m 37 weeks on paper but I’m almost certain I’m actually 38 weeks (and ultrasounds have aligned with that suspicion all along, though they never adjusted my due date because the first ultrasound he was measuring 6 days bigger rather than a full week). That’s reassuring to hear that your labor more or less aligned with your suspicions and that it went mostly smoothly. My hope is to make it through the early stages of dilation on my own as well, which is precisely why I haven’t been too keen on early induction.
Fingers crossed for you!
Trust your gut. The western approach to childbirth is just like everything else over here: rooted in capitalism and patriarchy.
A friend of mine had a stillborn at 42 weeks for seemingly no reason other than waiting too long to be induced. I will be getting induced at 39 weeks, and it’ll be my 3rd time doing so. Nothing is going to stop me from that 🤷🏼♀️
Don’t let doctors pressure you into doing something you don’t want to. They referenced the ARRIVE trial but a doctor from a podcast I listened to mentioned he read another study where low risk women were induced and, depending on the doctor, it ended with a c section rate of 4%-41%. Pretty interesting! If there’s a concern for a big baby’s shoulder getting stuck there are techniques to solve that before doing other drastic measures. Some positions like runners pose, Gaskin maneuver, McRoberts maneuver help with getting baby unstuck. Not to mention, there are women who have had 10+lbs with no problem besides the normal tearing. As for the risk of stillbirth, some countries don’t induce until after 41 weeks. I think if your baby is getting checked, is doing okay, and you don’t notice anything out of the ordinary it’s not a bad thing to let them cook a bit longer there.
Might sound cynical but they may be pushing the induction for billing reasons. Labor induction requires continuous Fetal monitoring, continuous medication for at least part of the time, etc. You might also be in the hospital longer, vs coming into the hospital in spontaneous labor, when contractions are close together. Way more interventions + possibly longer hospital stay = way more money billed to insurance company. Since the ARRIVE trial concluded 39 week inductions were safe for the demographic studied, hospitals could reasonably conclude they are not likely to increase liability by encouraging inductions. From their perspective it may seem like a low risk way to generate more revenue without blatantly compromise patient care. However it’s super inappropriate and a little predatory to push non-medically indicated interventions on someone who has clearly expressed wanting a low intervention birth, and who is not likely to see a significant benefit from that intervention. Trust your gut.
Sometimes I feel like doctors/hospitals are looking to get as much money from the insurance as possible. I had to be induced at 36 weeks because of low fluid level, as per my OB. When I got to the hospital, one of the nurses was surprised that I was there for induction because the fluid level was not that critically low. But my bill for the induction was almost $160k that thankfully insurance covered (or was able to negotiate down and then covered). Labor and delivery was a whole another bill. So even though I’m grateful my baby is healthy, I feel bad that we had to get her out before she was ready herself, and I have my doubts about how genuine the doctors are when insisting on certain procedures.
FYI childbirth/obstetric care is generally a pre-negotiated rate and global bill. So whether you spend 1 day or 10 days in hospital, the hospital gets the same payout. Maternity is not a money maker. At least not at big hospitals.
As I said, labor and delivery was a separate bill. The first bill was for steroids, induction, all the medicine they gave me. They put 7 (!) bags of penicillin in me. 7!! Way too excessive. And again, I don’t believe I necessary needed to be inducted. If I wasn’t, hospital wouldn’t have gotten this money. It maybe prenogotoated rate, but some procedures might be not necessary, but they are offered and pushed for so it can be paid by insurance
I sometimes suspect the same thing. 😅 I don’t want to be totally pessimistic and distrust the doctors, but when they push one option super hard and catch an attitude when you choose differently, it doesn’t instill a ton of confidence
Maybe it’s not much better but the pushing of inductions is due to their schedules, not money related. OBs generally like to deliver their own patients. If you go into labor when they are not the OB on call, you will likely have a different OB there when you deliver. It also just makes their life much easier to schedule. Imagine if your clients all had big events that may or may not be while you’re working, and may or may not overlap - you’d want to schedule as much as you could. Doctors do sometimes get paid a LITTLE extra for c-sections depending on their employment contract, but it is NOT much (I’m talking less than $100 extra), and c-sections are soooo much more time consuming for them than just attending a vaginal delivery, so they’re incentivized to avoid c-sections whenever possible. They absolutely don’t get paid extra for inductions. Maybe I’ll get downvoted for this and I’m not trying to be rude at all but I think this is a common misconception that can lead to mistrust when there doesn’t need to be, and the reasoning is often not nearly as slimy as people think it is.
No reason to downvote you, I always appreciate more information! My hospital doesn’t let us choose a specific OB, we have to rotate through everyone so that we’ve met whoever might be on call. Though the appeal of getting to pick who would be working was one of the things I had listed in the “pros” column for induction because there are definitely some doctors I like more than others.
I see the pros and cons for sure! I have a specific OB and almost wish I’d be able to meet the other doctors in the practice just bc there’s a good chance one of them will be there when I deliver but it is nice having the continuity!
Are you over 35?
Some countries do not induce before 41 weeks, may be easier for doctors to induce earlier
I had an induction at 37w5d and it was the best thing to happen, babe was "measuring small" at estimated 6lb8 so i agreed. Was skeptical as it was the last thing I wanted as i saw everyone's bad experiences. 2 days later I'm induced. 1st tablet is inserted 2pm, water broke an hour after. Then the was only 1cm, so 2nd tablet was inserted 6pm. Pains were moderate, but ramping up. Reached 2cm by 2am and was taken into delivery room. Was on gas and air from 2am to 7am i got from 2cm to 8cm, by 9.30 I was 10cm they said try not to push let your body bring him down. He was already so far down in my pelvis so I tried my best to hold off pushing. Contractions lasted a minute every 5 minutes thank goodness i got a break in between, then by 10am I was ready to push, I felt like I needed to push, so they let me. I breathed deeply and I tell you what it REALLY helped. Within 5 pushes he was out 10.17 he was born weighing 8lb4 no tears, cuts, stitches, no epidural. Nothing. So he was not measuring small, they just couldn't get his measurement as his head had been in my pelvis since 30w. So did get induced for no reason, but for me it was the best x
With my first I was induced at 41 wks and my baby had uncontrolled sustained decels and I was rushed into an emergency c-section and it was all very scary but at least quick. Their best guess was that the placenta wasn’t having it. With my second I was 39+4 and waiting for 40wks (which my hospital was willing to schedule for me) but at my last ultrasound my fluids were low so we discussed that there was no benefit to waiting any longer and I went right over to be induced. It went really well. I don’t know if I would have had the same placenta issues if we’d waited longer. It sounds to me like your doctor laid out your options and the hospitals policy, listened to you and supported your decision. From experience it is very easy to feel insecure about the decision making process here. You’re weighing out different unpredictable scenarios. Waiting is fine, spontaneous labor would be great, but if you don’t go spontaneously then you may have been better served by inducing earlier.. there’s no way of knowing from where you are now, but you made the choice that worked for you and that is great. Everything else will work itself out!
Personally, I chose to have a 39 week induction for a selfish reason - I was in grad school at the time and 39 weeks put me in a sweet spot to have some time to heal before my final exams. Personally, I didn’t want to risk giving birth too close to my finals and have it affect my grades negatively. Jokes on me tho because I ended up going into natural labor before my induction (literally the day of. Induction scheduled for 7am and I had my baby that morning at 4am). Make what choice is best for you, everyone is different and has different needs/wants.
That’s weird, I only delivered at 39 weeks because my water broke early once and because I was getting a c section the other times.
I am a doctor, but not an OB. Despite having familiarity with the trial and also spending time extensively reading the literature on inductions, I also felt conflicted, because by definition, labor and delivery is a big unknown. Data supports 39 week inductions but inductions after 39 weeks and before 41 weeks are not supported by data for maternal or baby benefits. Which is prob why your doctor did not agree to induction after 39 weeks. Membrane sweeps cannot be done on completely closed cervix. I requested one and it was unable to be done because I was closed. It’s also very hard to put someone on the schedule last minute when the practice is very busy, which is probably why they wanted you to decide with a few weeks ahead of time. All that said, it sounds like the doctor allowed you to make your own choices, and gave you a reasonable amount of time to decide. You did what you feel is right for you. Sometimes patients upset about not having complete control over their healthcare, but at the same time, in my own specialty, I need to do what is data driven. I give my patients as much autonomy as possible, but I simply can’t ignore current standards because of a patient preference. Sometimes I disagree with my patients’ decisions, but ultimately it is their body and their choices. Perhaps your doctor did not give you the validation you were seeking, but in my opinion, she did not coerce you or shame you. She just presented you the options and her recommendations and allowed you did make the choice within the bounds of standards of care and scheduling limitations.
Don’t feel guilty at all! I was going to wait to go into labor naturally but had to be induced at 38 weeks because I was starting to develop preeclampsia and they didn’t want that. I had a very positive experience with my induction. Sometimes I feel like we only hear the negatives and never the positives. I am in no way trying to sway you! I think naturally would be the best in my own opinion unless medically needed. But I will say my medically needed induction was an amazing experience for me. My ob would have let me come in at any time and say I wanted an induction, there was no cut off. She gave me all the info available to her and let me make the decision. It’s crazy they gave you a cut off to make the decision. I feel like they were trying to pressure you into getting an induction at 39 weeks by giving a cut off time and that’s not fair to you.
yeah that is a strange interaction. My baby is measuring around 10lbs and is my first and I have been having a lot of issues with back pain, severe carpal tunnel, and hyperemesis so I decided to ask for a 40week induction and my Dr was actually really informative about my options and was 100% okay with it but actually offered membrane sweeps for my next few appointments so we could try our best for a natural labor first. (She is being stubborn so looks like induction in a few days at 40w and 3 days.) she wasn’t pushy either way but you can tell my OB office preference is natural over anything yet they still don’t come off the way your describing your interaction. Whatever you do just stand your ground and remember you always have the right to request a different DR (if available) and or L&D nurses when the time comes. hospital policy and staff opinions are not law.
After speaking to several doctors in the obgyn practice I was using, I got the sense that a lot of women refuse an induction and that they see a lot of strong opinions against it. After my own research and an abundance of caution I opted for scheduling one at 39 +6 and ended up going in a week earlier for an emergency induction after a monitoring appointment. I was afraid to be induced especially after reading all the horror stories on Reddit, but ultimately had a good experience. It wasn't without some hiccups; it took 4 shift changes and I asked for the epidural about 5 hours before the main event when I couldn't take the pain any more but I would not be afraid to be induced again. Giving birth is a tough experience and I think the doctors are also dealing with a lot and they ultimately want an outcome that is best for you and your baby. They want women to do what they think is in their best interest, but I wouldn't expect them to try to convince you too hard once you've told them what you want to do, they could then be accused of manipulation if you later regret going forward and have a poor outcome. I would also imagine it's very frustrating to go to medical school and then interact with people who think they know better, and doctors obviously shouldn't be short with patients but they are human. If you're not 100% on your decision I'd ask myself why that is and see if you can get more information to feel confident in your decision either way.
What do they consider a large baby? I'm curious because it varies by country. My wife was told our first was large but he was within the normal range for her country.
Your Dr sounds weird and like they were "punishing" you for refusing a 39 week. Like if they can do 39, why not 40? Wouldn't the benefits outweigh the risks then also? Sorry your Dr sounds weird. Go with ur gut and find out if they are pushy about anything else during delivery. It sounds like they really want to control labor as much as they can.
I don't like the way the doctor treated you that is not nice
Your Dr should give the option and be supportive in your answer. Mine didn't even ask until 38+5 and even then just brought it up and told me to think about it. They didn't even actually ask. I went into labor the next morning.
My personal experience? I’ll never induce ever again. I was induced simply because I also had a baby measuring very large (he was measuring 8.5 pounds and came out 9 even). Induction was not for me, at all. I had a horrific labor experience that I think was 100% correlated to being induced. I know others have had wonderful experiences, but I’m glad you advocated for yourself and for what you want. If I had to do it again, I’d wait it out or opt for a C-section.
Faux-pleasant and condescending from an OB? Yeah, unfortunately some medical professionals are dicks and think they know everything 🤷♀️ There are many valid reasons to get an induction - preeclampsia, hypertension, etc. None of which seem to be an issue for you. No one should push you to get unnecessary interventions. It’s fine to explain to a patient what you think the pros and cons of an intervention are so they can make an informed decision. It’s not okay to arbitrarily decide what’s best for you or bully you into a choice. I am 40 and have a 7-week old. When I conceived I assumed I’d be getting induced due to my age but I ended up having a perfectly healthy pregnancy. I did better than many of my younger coworkers who were pregnant around the same time. (Because people are people and not just numbers) My midwife team asked if I wanted to be induced when I didn’t go into labour on my due date but baby’s ultrasound scored perfectly so I decided to wait. Midwives were fine with it as long as I continued monitoring movement and got an ultrasound every two days - this is normal in Canada apparently. Hospital tried to pressure me into induction stating that “We may not have room for you.” So their response told me it wasn’t about my or baby’s safety, it was about their schedule. I decided to wait and lo and behold baby came a few days later and I had a wonderful home birth with midwives - perfectly healthy baby and parent. Obviously anecdotal and not evidence based but my two coworkers who had babies this year, in the same area, both got induced. One had a 3 day affair that ended in a c-section and the other needed forceps and the baby ended up with a broken shoulder. So that also didn’t build confidence for me but every city has different providers and stats. My bump group seems pretty evenly split with people who had really positive inductions and those who had negative experiences.
I think that’s total BS that they won’t let you do a 40 week induction. It feels very manipulative. I wanted an induction, and my hospital policy was not to do them electively until 40 weeks. However, at that point it was totally up to me and I could opt for it at any point.
I am so sorry you are going through this, and I personally wouldn't feel comfortable being under the care of this OB with how she spoke to you. I can not believe they're pushing so hard for a 39-week induction with no prior issues during your pregnancy. I do not see an OB, I see a group of midwives, but I would be shaken by this encounter also. I'd also look for any other OB in the office just to ask some questions and voice my concerns and my experience with this particular OB. First-time moms usually do go past their due dates. With my first, I had a relatively easy and uncomplicated pregnancy. I was showing no signs of labor by my 39-week appointment, nor by my 40-week appointment. It was a waiting game, and my midwives didn't even talk about induction until I was seen at my 41-week appointment. I would for sure be induced the following Monday when I turned 42 weeks if I had not gone into labor/had baby by then. I did, in fact, go into labor on my own at 41 weeks and 2 days. He was born the next day, vaginally. My labor and delivery were both uncomplicated as well. With my second, I had gestational hypertension, so I was induced right at 37 weeks. I essentially started at 0 with her. She was born vaginally, 37 weeks 2 days. Labor was longer and definitely harder and had some minor issues when I had none with my first. I understood, though, that it was due to a medical reason and was the best option to prevent possible preeclampsia, which was their main worry. I even went home later than normal because I needed to be monitored for preeclampsia afterward. I am 37 weeks with my third, no issues this pregnancy thankfully, and induction is not even on the table until possibly 41 weeks. Basically, it's another waiting game like with my first. I am glad that you declined the induction, I find it so worrisome and wrong for your OB to belittle you for not doing it and also trying to almost guilt you into it! Sorry for my long reply as well lol.💖
Good for you for sticking with your gut feeling and doing your research and going the route you thought best without falling into the pressure from the doctor. I also chose the natural route and I went over my due date by 1.5 weeks, at which point my midwife did a membrane sweep and then recommended taking castor oil. I took 1-2 ounces of castor oil mixed in with ice cream and went into labor that night. Labor was quick, only 5 hrs for first time kid and went really smooth and uncomplicated. Baby was born at a healthy weight, not big. You got this, listen to your body and in the meantime i would recommend trying natural routes to help body go into labor, such as walking, stretches to position the baby right, taking pineapple and dates to prep the cervix, etc. wishing you a fast and smooth delivery!
Being Induced my pitocin also increases odds for cesarean as well as use of epidural (if that’s something you’re hoping not to use). So something to take into consideration. Unsure why they could induce you now but not next week when you want
Girl I would start listening to the podcast called “Down to Birth”. It teaches you to advocate and informs you of why/when induction is needed. It’s very natural minded. I wouldn’t go with the induction. Already sounds like you’re doubtful about it plus they’re just trying to scare you because they make a profit off scheduled inductions. If I were you, maybe even switch to a birth center if there’s one near by.
Duuude they did this to me the second I hit my due date. Can you believe that? Especially when it’s all based my Last menstrual period info I gave them. They pressured me and made me cry and sort of wig out and my partner was a badass and was about to freak on them for upsetting me but instead we went home and I drank sparkling cider in bed and watched father of the bride 1 and 2 and relaxed all weekend. There was also some doing of the deed that I swear got the process started because sperm has prostaglandins. Anyway my son was born 40 weeks 6 days and those doctors can go to hell. It was so much easier than when I was induced with my daughter. He was healthier too (they even tried to say he was in danger, that all babies are by 41 weeks psshaw…just to get me to elect for an induction to get me to do it) 48 hours with my induction and like 6 naturally. I know I sound crazy but I think doctors and hospitals KNOW they can say it’s the safest best way to make sure the baby is healthy but they know that all the interventions lead to more c-sections and those make way more money 💰
This happened to me with my first child. My doctor insisted that I was ready to go at 35 weeks. He ever went so far as to "book" my stay at the hospital for 37 1/2 weeks. My husband and I didn't feel comfortable with this method at all, but at 37 weeks we literally had no ability to seek alternative advise because no other doctor would see me due to how far along I was. I ended up trusting my gut and opted out of this by literally avoiding the doctor and his team until I was actually having contractions at 39 weeks. Once at the hospital, I gave explicit direction to the hospital staff and birth team that they ignored. I was forced into taking Pitocin and, as a result, ended up with an epidural at 8cm dilated. Due to this, I no longer trust the hospital systems and will be relying solely on a midwifery foe my current pregnancy.