Consultant Wanting to Induce - I'm not so sure

laurpat

Currently my partner is just 39 weeks passed. We are attending a consultant privately. Last week during our consultation our consultant advised that the baby was quite small and he was going to induce my partner one day after her due date. We were both shocked with the news as this was the first real indication that there were any complications. The baby is currently 6lbs which I thought was quite a good weight. Both Mummy and I are quite slight of build so we are not expecting a big baby.

The questions I have -

Is 6lbs small for a new born?

Is it normal to induce labor as a result of a small baby?

We are not happy with being induced, are we putting our child at risk by not taking the consultants advice?

I can help but wonder is it because of the time of year that the consultant would like the baby to arrive on time and not interfere with his Christmas holidays

Anyone have any similar experience

How Strange

I can't comment on whether that weight is considered small or not (apparently I'm having a monster!) but I have heard that private consultants are more in favour of medical interventions as they like to be able to schedule the births.

Why not ring one of the maternity hospitals and ask a midwife just so you get a 2nd opinion. I've rung mine before over little things and they don't ask for your hospital no.

vibe666

6lb would be small for a turkey, but not for a baby.

spot on average would be 7.5lb, but anywhere between 6lb and 9lb is considered a normal healthy weight for a newborn (check online or any baby book) and you still have a week to go yet, so it doesn't seem abnormal to me. it sounds like your consultant is trying to schedule your birth for his own convenience and personally I'd call him on it.

if he's happy to swear to you that his decision is solely based on the health & welfare of mother and baby and nothing to do with the free time in his calendar then consider letting him talk you into it, but remind him you will be following it up and if it turns out to be bad advice you'll be taking it further.

this is your partner and baby and (i know i don't need to even say it) your sole responsibility is to look after them as best you can no matter what. by all means give him an opportunity to convince you that he's on the up and up, but make sure he knows what matters to you.

marvsins

6lbs is fine. We had baby in April and she was 5lb 4oz and was wife was induced 2 week early as the baby was not growing/feeding as they would have liked. When the baby is out they can monitor feeding etc. if thats the reason.

Das Kitty

I would clarify with the consultant as to why he is planning to induce so soon. The estimates they make on baby weight before birth can be totally off the mark. I was told I was having a 10lb monster. He was only 8,5. I've seen it the other way too, people being told their baby is small and a 9lb + baby in the end.

Talk to the consultant or midwife to get clarification.

January

I'd ask the consultant out straight what the reason for being induced is.

It's either a medical reason or for convenience... if it's for convenience for the consultant I'd be more inclined to refuse it.

Joeyjoejoe83

As you said, your wife is slight of build, maybe a larger child would put too much strain on her body. I do feel you should listen to the professionals advice, he's not going to do anything to endanger both lives.

lynski

Induction may not endanger the lives of mother or baby, but it WILL make for a much tougher labor, that is an accepted fact. It will also start you on the cascade of interventions - https://www.birthinternational.com/products/charts/ace-cascade-of-intervention and dump most of your birth plan.

If there is a problem with the baby or with the mother then yes, but 6lbs is not a too small baby by any scale, also, there estimates are usually way off - told dd was bigger then ds (8lbs 6oz) and she was actually over a lb smaller.

more info on inductionhttp://www.drspock.com/article/0,1510,5344,00.html

Boardnashea

Will your consultant put their reasons for this action in writing?

Das Kitty

Joeyjoejoe83 wrote: »

As you said, your wife is slight of build, maybe a larger child would put too much strain on her body. I do feel you should listen to the professionals advice, he's not going to do anything to endanger both lives.

Oh absolutely the advice should be heeded, however I do think that the reasons behind the advice need to be clear. It is running close to christmas and many hospitals have the practise of starting inductions before the week of Christmas due to reduced staff numbers. No a consultant wouldn't do anything to purposely endanger lives, however early induction can be distressing and tiring and is usually not preferable to spontaneous labour. Under normal circumstances they rarely will even suggest induction before 10 days overdue. So as Adrieanne said above, the OP needs to find out if it is just for the convenience of getting the baby out before Christmas.

angelfire9

I have to say and I know it will totally go against the grain here but I have an antenatal appointment this afternoon and am thinking about asking to be induced next week
Hubby will have no problem getting time off next week plus the weekend after (17/18/19th) is his scheduled weekend off which is handy
The following week he is working straight through til Stephen's day and from the 26th to 2nd Jan he won't be able to take leave at all

So there is the convenience aspect
BUT
There is also the size
I'm 6ft hubby is over 6ft and built like a tank so we are looking at a big babs anyway
Midwives & consultant at last check up (2 weeks ago) both said from measurements & scans etc that we are looking at a 9lb babs :eek:

Am I being selfish?
Part of me thinks I am
But being married to a cop I know that getting time off next week is going to be easier than any of the 3 weeks after and I don't want to get into the situation that I had with No. 1 where he was in court on the day I went into labour and was only present for the last 30 mins of agony

Thoughts??

Das Kitty

You're not being selfish. I would say though that induction can take days and days where you can't leave hospital and there are a massive number of internal exams associated with it. Plus you're more likely to end up with an intervention.

I wasn't induced but was given a suntocin drip to speed things up and I found it terrifying. I felt like I had to push and I was only 6cm and I ended in an emergency C.

lynski

HTH angelfire: I was induced on first one and went natural on sec. first labor - 10 days over, gel applied, in pain from midnight, full labor from 6am to 7pm, Gas, pethadine, epi, failure to progress ended in emergency section and bad infection and 9 nights total in hospital.
Second one - pains from early in day saturday, but manageable, hospital by 10pm, in full labor from 3am used gas and hypnosis, gave birth at 6:30 am no interventions, some tearing but no stitches. left hospital 11:30 am monday.
Scheduling is one thing, but your chances of a cs increase significantly following induction, so how would the extra stay in hospital, plus 6 wks recovery time affect you?

Notes: http://www.reference-global.com/doi/abs/10.1515/JPM.2004.005

January

You're not being selfish but listen to your consultant. I was induced on my first child after my waters broke and I didn't go into labour by myself and I don't think I was ready for it at all.

They broke the rest of my waters and gave me an hour to go into labour then put me on the syntocin drip at 12pm. At 6pm I was still only 2cms dilated and baby was distressed and I was tired from all the poking and prodding that was being done to me. I ended up with an emergency c section under general anesthetic.

There may be other ways, if you're favourable, ask for a membrane sweep, there's no guarantee that you'll go into labour from it but it's worth a shot. IMO none of the old wives tale stuff works either!

crazy cat lady

Labour and birth are a natural process which, the majority of the time, a woman will achieve naturally when the time is right.

Induction is not a natural process. Most of the time it will lad to further interventions which can be both traumatic for the mother and the baby.

You are more likly to need an assisted delivery - suction or forceps - which is both invasive and raumatic for the mother, but also painful for the bby and can leave the baby bruised and in pain for the first few days of their life. This can impact on feeding and bonding and is very unpleasant for a mother and father to see.

You are also more at risk of C-section. Once induction begins you are comitted and there is no turning back. If things don't progress well or if complications arise (as they often do when you try and control nature) you will end up needing an emergency section. This is traumatic, frightening and leads to a much longer recovery after the birth.

6lb is not too small. And it is very rare that a woman would grow a baby so big that she couldn't deliver it. A perfect example would be little chinese women. They are so petite yet because of their high carb diet, they usually have huge babies!

Having worked in Maternity services, let me assure you that consultants will try and induce women for convenience before christmas. Its not always the consultants decision, mothers often want their babies before chrismas too.

If you really are against induction, ask for a more detailed sizing scan with one of the midwife ultresonographers. Don't be bullied into something which could ruin your birth experience and cause unnecessary problems

cynder

Ive never been induced, so dont really know on that one, i have know women that were induced for one reason or another and it worked for them, there are other i know that should have been induced and weren't and it did not fare well for them (one died in the womb at 9 days over due (the placenta wasnt doing a great job), the other very nearly had to have a hysterectomy baby was ok though).


I know a woman whose baby was small he was only 5lb when he was born (he was induced because they thought he would do better outside than inside) he turns 4 next month ( 2 weeks after my guy turns 4) my guy was 8lb 15oz and 1 week early and to look at them you wouldn't know that there was such a big difference in birth weight.

(i have big babies that who i am) some people will have low birth weight babies regardless, others have big ones. I was 7lb 5 born and i was 3 weeks early I'm 5 foot 5 my hubby was 7lb born at full term he is 5 foot 11. My dad was 10lb 5oz born and was 5 foot 6, my dad aunt was 15lb and that was 90 odd years ago she was only small in stature as well my dad at 5.6 was the tallest in his whole family.

At the end of the day its yours and your wife's choice, you can either go with the advice of the consultant (who should have years of experience but can make mistakes) or go with your own gut instincts, you will hear pros and cons to induction and sometimes induction does not work at all. At least with a planned induction in this weather you know whats happening and can plan for it but what about going in to labour at 2 am in the morning and roads thick with ice. Its a dangerous journey even for an ambulance.

Whatever you choose, best of luck.

common sense brigade

Get a second opinion. If in doubt ask your consultant straight out why he wants to induce is it to time his holidays. this is your wife and baby we are talking about. you have every right to question whats happening. my sister in law is midwife and both her babies were 6 pounds and not a thing wrong with them they are perfect. she is of a slight build so it makes sense. you wife is slight too so its normal.

vibe666

grindelwald wrote: »

...my dad aunt was 15lb and that was 90 odd years ago she was only small in stature as well my dad at 5.6 was the tallest in his whole family.

:eek:

crazy cat lady

grindelwald wrote: »

Ive never been induced, so dont really know on that one, i have know women that were induced for one reason or another and it worked for them, there are other i know that should have been induced and weren't and it did not fare well for them (one died in the womb at 9 days over due (the placenta wasnt doing a great job), the other very nearly had to have a hysterectomy baby was ok though).

There definately is a time and a place for induction, but I would sy only when medically indicated. I really wouldn't consider a matter of convenience a good enough excuse to play around with nature.

Inuction can go well, but I can only speak from experience of what I have seen and dealt with, and I can honestly say that induction can lead to more problems than necessary, especially on a first baby.

Get a second opinion and be sure of your decision. Even if your baby is 6lb now, he or she could gain another 0.5-1lb between now and your due date. Consider your options carefully and be sure of what is involved and the associated risks before you make a decision either way. It can be daunting telling 'The Professional' that you do not agree with him/her, but even they can be wrong and at the end of the day, you are just another pregnant woman to him/her, they see this every day. To you it is going to be the most important and magical day of your life, your biggest and most life changing event so far. Make sure its about you and not about convenience

cynder

crazy cat lady wrote: »

There definately is a time and a place for induction, but I would sy only when medically indicated. I really wouldn't consider a matter of convenience a good enough excuse to play around with nature.

The medical profession plays around with nature all the time (all over the world 1,000 000 times or more a day), many people would not be alive today if the medics had not played around with nature, anything from inducement to insulin to bp mediation, thyroid medication and so on and on and on.

I did say it was their choice and they have to make the decision. They have to way up the pros and cons not you or I as its not our baby.


Im saying one pro is that if the weather makes them housebound then it might be worth considering, well that or a trip in an air ambulance.

crazy cat lady

I'm not disputing that, I'm just trying to give educated, experienced and informed reasons as to why induction may not be the best option if there is no real necessity to go down that route. I would never dream of trying to make a decision for someone, but I would like someone to make a decision armed with enough knowledge to make the right decision.

The 'playing around with nature' that you mention, bp meds, insulin, thyroid meds etc... are only given when there is a medical implication to do so.

cynder

crazy cat lady wrote: »

The 'playing around with nature' that you mention, bp meds, insulin, thyroid meds etc... are only given when there is a medical implication to do so.

Very true, the same could not be said for the pill or the coil or the injection or serialisation. (i would say most women out there have no medical grounds to prevent pregnancy) We pick and choose every day when we want to 'play with nature'.

Induction for some does not work and they need a c-section and some opt for a c-section because they are too posh too push. Im sure the docs will give them all the info regarding complications of induction, just as they would with a c-section.

crazy cat lady

Although there isn't a medical implication for contraceptive methods, there is also very little risk associated with them. I'm sure that when someone takes the decision to use a type of contaception, they make sure they know what it is they are signing up for. Induction, without medical necessity, may result in turning what should be a very natural and memorable process into a horrific experience.

If someone decides to have a social induction or even an elective c-section knowing and understanding all of the risks, then that is their choice and I would be the first to respect that. A consultant will be very good at informing of the risks and giving a few statistics here and there without really ensuring that the woman and her partner fully comprehend what is being said. At the end of a pregnancy, women can feel very vulnerable and unsure of themselves and in the presence of a consultant may not feel able to speak up for what they want. They can also be forgetful and may not ask relevant and important questions to help inform them in their decision making, especially in a rushed antenatal appointment. And as I said, a consultant will throw around some tempting statistics, and use medical jargon that may not be fully understood. And we all think 'that'll never happen to me' even when we do hear some of the bad things that can go wrong.

I'm not trying to scare anyone or anything, I'm just speaking from experience. I'm sure if i was sat in my uniform in an antenatal clinic telling you all of this it might be better recieved.

Squiggler

crazy cat lady wrote: »

A consultant will be very good at informing of the risks and giving a few statistics here and there without really ensuring that the woman and her partner fully comprehend what is being said. At the end of a pregnancy, women can feel very vulnerable and unsure of themselves and in the presence of a consultant may not feel able to speak up for what they want. They can also be forgetful and may not ask relevant and important questions to help inform them in their decision making, especially in a rushed antenatal appointment. And as I said, a consultant will throw around some tempting statistics, and use medical jargon that may not be fully understood. And we all think 'that'll never happen to me' even when we do hear some of the bad things that can go wrong.

That matches the experience of my sister, my mother and of several friends of mine. And they found that when they questioned the validity of the information being provided or countered with some of their own research they were subjected to varying degrees of abuse by these professionals (verbal in the case of my sister, physical in my mother's case - but that's a whole other story).

I agree with those who have suggested that the OP request that the Consultant put in writing his reasons for recommending intervention at such an early stage.

Regarding the baby's weight, as others have said, the estimates can be way off and it doesn't seem sufficient reason for an induction procedure.

OP, get as much information as you can, from your consultant and on your own bat, and then make the decision you and your partner are happy with.

Das Kitty

Can I give a bit of a warning about Membrane Sweeps as well. They can work, but don't ask for one if your cervix hasn't dropped at all.

I swear that's why I was in agony for 3 days. I pushed for a sweep at 1 day overdue (very impatient), he wanted to wait for another week.

I spoke to another consultant after the birth and she told me that from her experience giving sweeps before the cervix dropped on first babies nearly always ended in intervention. I definitely won't be having one if I have another baby.

Just wanted to share that.

crazy cat lady

Das Kitty wrote: »

Can I give a bit of a warning about Membrane Sweeps as well. They can work, but don't ask for one if your cervix hasn't dropped at all.

I swear that's why I was in agony for 3 days. I pushed for a sweep at 1 day overdue (very impatient), he wanted to wait for another week.

I spoke to another consultant after the birth and she told me that from her experience giving sweeps before the cervix dropped on first babies nearly always ended in intervention. I definitely won't be having one if I have another baby.

Just wanted to share that.

Sweeps are not 'advised' anymore although many old school midwives and doctors will still perform them.

cynder

crazy cat lady wrote: »

I'm not trying to scare anyone or anything, I'm just speaking from experience. I'm sure if i was sat in my uniform in an antenatal clinic telling you all of this it might be better recieved.

As i said before it works for some and does not with others,
You could be sat in a uniform in a nurses outfit but it might not be better received, Ive spent all last week sitting in crumlin hospital telling consultants and nurses that they were wrong and refused to alter my child's medication, they backed down on the 3rd day and added an extra dose of the medication she was on. It started to work and we were let home on the 7th day.


As i said before they can always go with there gut instinct.


Your experience must have been horrible for you to be so against it, what would have happened if you were not induced would you have been very overdue or would you have gone into labour naturally or would you have needed a c-section, would the placenta still have been doing its job? whose to know. Was you baby healthy afterwards or did the baby have complications, did you yourself have long lasting complications from the induction (not c-section)?

Totally agree with das kitty on the membrane sweep.

Das Kitty

crazy cat lady wrote: »

Sweeps are not 'advised' anymore although many old school midwives and doctors will still perform them.

Good to know. Everyone on a pregnancy board I was on at the time was having them done, and repeatedly.

It's a really unpleasant procedure. I remember feeling so sick after and 3 hours later I was in agony.

crazy cat lady

grindelwald wrote: »

Your experience must have been horrible for you to be so against it, what would have happened if you were not induced would you have been very overdue or would you have gone into labour naturally or would you have needed a c-section, would the placenta still have been doing its job? whose to know. Was you baby healthy afterwards or did the baby have complications, did you yourself have long lasting complications from the induction (not c-section)?

I waited it out all over the Christmas period and went into labour naturally and made it from Wicklow to Dublin in the bad snow in January. Was it ideal? No. Was it better than being induced? 100% yes!

I'm not against induction, not at all. I think if there is a valid necessity for induction then it is 100% the right thing to do. Whether an iduction is advised or whether a woman wants to be induced for social reasons, they should always know the risks and complications that may arise, and also the cascade of interventions that are pretty much inevitable when starting the induction process.

My experience of induction comes from working with women who are having an induction for whatever reason. Sometimes they do go well, and most of the time there is a real necessity for an induction. If there was a risk of compromising the mother or the baby I'd be 100% encouraging an induction. It would be within my scope of practice to make sure that they knew the risks involved though - whther that be the risks involved with having an induction, or the risks involved should an induction be refused.

I am against induction when there isn't a necessity. Why should a social calendar (yours or your consultants) come before the health of you or your baby? How do you think a mother would feel if a serious complication arose just because they wanted to have an induction for a reason that was not a medical one?

cynder

crazy cat lady wrote: »

I am against induction when there isn't a necessity. Why should a social calendar (yours or your consultants) come before the health of you or your baby? How do you think a mother would feel if a serious complication arose just because they wanted to have an induction for a reason that was not a medical one?

Im not saying the person should have a induction because its xmas or because its icy, im saying that under the circumstances it would be a pro rather than a con. It she the only patient to the consultant I DOUBT IT VERY MUCH, the consultant will have loads of babies to deliver, do you think that the consultant is going to induce everyone of his/her patients so s/he can have an xmas holiday?


Just to add my husbands neighbour was told he had cancer and had weeks to live, his partner was pregnant they induced her at 37 weeks the husband died 4 days after the baby was born, the only reason she was induced was so the husband could see the baby before he died, no medical reason.

crazy cat lady

Thats a very sad story and under those circumstances incuction was definately the best thing to do.

May I ask what your reasons are for fighting me at every corner here?

All I'm trying to get across is that induction isn't always the best option, and sometimes it is. I've given many reasons as to why if it isn't necessary, it should really be avoided. If I were to care for a woman having an induction for whatever reasn, I would be 100% supportive of her decision. Its her baby and her choice and my priority would be with the health and safety of the woman and her baby.

However, if a woman has an induction and isn't fully aware of everything that can go wrong and the interventions that may be necessary, it can make for a very frightening and unpleasant labour experience. Induction removes an element of control and empowerment, and a feeling of a loss of control is one emotion you don't want to be dealing with in labour. Labour also is not a time and a place to be asking 'why is this happeneing to me?' and 'what is that intervention for?', hence giving as much info as possible prior to making that decision and being aware of the risks.

No a consultant isn't going to induce every woman on his private books, and a hospital isn't going to induce every woman because the roads are icy either!