Friday, April 30, 2010

Induction, Conflicted**

I'm so frustrated I want to punch a door or something. I went to the OB today and I'm not 2 cm dilated as one of the step-OBs thought. Just like Dr.MFM my OB thinks I'm 1cm dilated and the cervix is still long and hard. She then said how about get you in Monday to soften the cervix and induce Tuesday? Say what? I asked her, I thought I needed to have a ripe cervix to have success at an induction. She said she'd ideally like to see me at 2-3 cm dilated before scheduling an induction but because of my 'special circumstances' she doesn't want to have me go past my due date. What are the special circumstances:

1) Blood Thinners: This is not an issue once I'm off of it heparin is out of my system in 12 hours. Once out of my system the risks are gone, unless I've misunderstood something?
2) Gestational Diabetes: yes, I likely have a big baby. How much bigger will he get if I don't get induced Monday versus Friday or Saturday? Not much, while my odds of going into labor on my own do increase as the days pass.

Jack is bewildered. He said I thought you wanted the baby out? Now you want to wait. While I am uncomfortable and nervous I don't want to act on my own discomfort. I want what's best for the baby and I don't want to force an induction on myself that could lead to a C-Section simply because I'm in a hurry. That's stupid. I waited 2.5 years to have a baby, to speed up and consequently fuck up the last few days is just stupid.

I felt flummoxed at the appointment and agreed to induction but I feel so uncomfortable now. I don't know what to do. I was open to an induction Monday if I was dilated and ripe but I'm not. On the other hand, I'm going in just a few days prior to my due date and I will have my own OB doing the delivery and its not a guarantee that I'll have a C-section. She pointed out that there's no guarantee that I will go natural or that things will progress by waiting a few more days.

My gut, my heart is saying no don't do this, just wait. But how much do I wait with GD? I can't go over weeks. She will likely not allow me to even go past my due date. Jack is urging me to go ahead on Monday. I need to make a decision today. I might just let the OB know I'm conflicted and will make a final decision later. I'm just so confused.

***I just called again since I haven't heard back and the answering service picked up and said the office is done for the day. Not sure if that means they're not going to call me back. Well, they got the message and if they don't want to call me back that doesn't mean I have to go in on Monday for the induction. It's on them to return my call. I don't HAVE to go into an induction simply because they're not calling me back. Sigh


  1. Why not level with her and ask for clarification as to the risks of waiting? I know at my age (& I think I'm quite a few years older than you are!) they won't let me go past my due date because it DOES up some risks of last-minute complications - though I don't know if that's purely age-related, or what.

    It seems like at this point, baby's done cooking and every additional day, he's just growing - not the best recipe for a natural birth anyway.

    But seriously - this is a big decision - I'd call her back and ask for clarification on the risks & benefits so that you're not feeling confused on TOP of having to make a big decision. Thinking of you!

  2. Thanks for your input Susan, they don't want me to go past my due date because of the GD and he'll get much bigger. I get that and I do'nt want to be a week overdue or anything since I know he could potentially gain one pound in a week, but I guess here the difference is inducing Tuesday versus inducing Friday/Saturday. He's not going to get much bigger in the span of a few days but the chances that my cervix could get ripe or I could dilate further do increase. The OB pointed out that nothing could happen between Tuesday and Friday which is true, but something could? And if the baby isn't going to get any bigger by waiting a few days then what's the harm in waiting? The only reason the doctor picked Monday is because she's on call that day. It's her convenience. If she was on call Friday this would be on friday ya know? I do'nt know. Sigh. I have called the OB and am waiting for a call back hopefully with some clarification. I'm sure she wants to kill me- but I really don't want a C-section if I can avoid it.

  3. Oh and the reason I'm worried about induction when my body is not ready is because it skyrockets your chance of an unnecessary C-Section.

  4. It sounds to me like your heart is sayng to wait until your due date and I totally understand that--I was the same way with both of my pregnancies in that I wanted to avoid induction at all costs. Unless there is an imminent issues, I wouldn't think waiting a few more days would be harmful. F he's happy and your fluid is good I would think it would be preferable to wait until your due date to minimize invasive interventions.

    My best assvice is to go with your gut. If waiting a few more days feels right then go with it. Because if you end up with a C-section and you didn't wait you may always end up wondering and second guessing. If you wait and go into labor then great and if not then you gave it a good go.

    It's a tough decision but I know you'll do what's best for you and Sunflower. I'll be praying for you both in the meantime. ((many hugs))

  5. If you are worried about your cervix your OB can give you Cervadil to help soften your cervix. Since this is your first child, it is perfectly normal to still be 1 cm long and closed even in early labor. I was only half a cm with my son and had to be induced because of bp, and I did just fine. Actually I had more of a chance of C section because of my bp then my unripened cervix.

    It is true, sometimes we think things are going to go one way and they go another. So, you could be dilated 2-3 and very soft and still have a C.

    Sorry this is such a hard decision for you to make. :(. I think you should talk to your doctor about it some more so you are sure 100% it is what you want to do.

  6. a midwife tip to ripen your cervix, place primrose oil capsules inside by your cervix, helps to soften and ripen. you can get them at walmart, they look like the vitamin e oil capsules. really works. they melt and the oil softens the cervix, and is a non medicne related thing, would help to ripen things for when ever labor does happen, ive known people it went ahead and threw into labor

  7. Yikes. Rock and hard place. Hopefully you will go into labor this weekend and it will be a moot point...((HUGS))

  8. Again, I'm with meinsideout. Hopefully this self resolves. Assuming it doesn't, I say go with your gut. Your doc isn't saying the baby is in danger right? And you aren't either? And I myself am not a huge fan of scheduling births because it's convenient for the doctor, but I understand the desire to have your own doctor deliver the baby. Truly...go with your gut on this one. If it doesn't feel right, it can't hurt to wait a little longer.

  9. Tough decision, wish I could offer more than just a "Good Luck". I agree that you need to do what you fee is right for you and the baby. Having been induced a week after my due date when my cervix still wasn't ripening at all, I felt I had a much rougher delivery (2 days of inducing). And, if you go into labor this weekend you most likely will have to have another OB deliver as yours isn't on call until Monday-so waiting until closer to your due date gives you similar results as going in this weekend--But the dr being on call only matters if the baby isn't born before the end of the regular business day--if you are induced on Friday, and your cervix has made any progress, you could have the baby before 4pm and your OB should be the one to deliver him.
    Anyhow, good luck and hopefully you are able to enjoy these last few days without thinking too much about what to do come Monday AM.

  10. 2 things:

    You definitely have a higher risk of ending up with a c-section if you're induced, not to mention induced from point-blankk.

    My mom had untreated GD and delivered my almost 12 lb. brother, 2 weeks late, with no drugs and no complications. 8 of my 10 younger cousins were between 9 and 10 lbs. at birth. There is such a fear about delivering big babies but it's nothing to be really concerned about.

  11. Okay. I totally don't want to be THAT I assvice girl today? But just food for thought......

    It sounds to me like you want to wait till the due date...and I can always be easily convinced by providers (hence the changing of providers and the induction discussion a few months ago)...but you are right about the cervix being favorable...and that a few more days won't really make that much of a difference. There are no induction police. They won't come to your house to pick you up and make you do it (and am I horrid to say they probably want you to do it Monday because it's MONDAY and not Friday or Saturday when they have other plans and don't generally do inductions..........

    Another option that an ahem, L&D supernurse at a hospital I may or may not work at, suggested to me back when I was going to be induced on my due date (which I'm now not) was that you can advocate for yourself to just try the cervadil and know, you agree to check in, do the cervadil overnight, and if by morning you still aren't dilated/effaced and have a cervix favorable for a Pit induction, you can make plans to come back in a few days and try again. Again. There are no induction police...and waiting until your due date sounds like an acceptable plan really.

    As I read somewhere....if it were really that much of an urgent situation, they would never give you the option to schedule the induction a few days out. It would be 'get thee here NOW for induction' that tells you something.

    Ok. Will shut up now. Sorry.

  12. My friend was induced a couple weeks early for high blood pressure and the fear of a big baby from her GD. She ended up with a C/S, but the baby was about a pound smaller than expected based on the ultrasound. I wouldn't use the GD and "big baby" thing as a true reason to induce. I'd think the induction with an unfavorable cervix would up your chances of C/S more than a big baby would.
    And most first time moms go a little overdue, from what I've read. So if I were you, with good ultrasound results, I'd wait it out.

  13. Go with your gut sister, but take the risks into consideration!