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I'm 'due' today...40 week appt less than encouraging...think through this with me.


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I'll try to keep this short(ish) and as concise as possible.

 

My LMP was Jan. 9, making my original EDD Oct. 16.

 

At my 18 week ultrasound baby measured 'large' for date (between 1/2 to 1 ounce larger than expected, according to my practitioner). She insisted on bumping my due date up by 9 days, making my revised due date today, October 7.

 

Today I went in for my weekly appt. I was dilated to 3 cm, 50% effaced. The previous 3 weeks I was 1 cm, 50% effaced. My midwife said that she will let me go until next Friday, Oct. 14. If baby isn't born by then she wants a biophysical profile and if baby scores perfectly on that (8/8) she will schedule an induction for Monday morning, Oct. 17.

 

So. I asked her if she would be comfortable with a bit more wiggle room on the dates (so long as baby is doing well in there) being that I am very sure of my LMP. She is insistent on the Oct. 7 date as being the 40 week mark. No wiggle room according to her.

 

I asked her what induction would entail. She said pitocin. I asked about breaking my water first (really, at that point I expect to be dilated more anyway and breaking my water has always done the trick with my labors). She said that's not an option because I am GBS+ and the risk of infection is too great.

 

I asked, "But if my water broke naturally before labor began I'd be at the same risk, right?" I asked about the possibility of admitting early in the a.m., starting the IV antibiotics, and then breaking my water after the antibiotics were in my system. She said no. I asked why. She said that if my water is broken and I don't go into labor then I'd have to have pitocin anyway. Okay. I get that. I asked, "But why start out with it when I may not need it at all? Couldn't we at least try without it?" Then she just asked me why I didn't want pitocin and when I said, "Well, because it hurts!" she shook her head no and insisted that the contractions would feel the same as natural ones because the dosage would start off very low (yeah, untl I don't progress as quickly as the on-call OB would like...:glare:). She insisted that wouldn't happen.

 

Ugh. What are my options here? Can I just flat out refuse an induction on the 17th (one day after my original due date) if I don't want one? She acts like this is all set in stone and that I have no say in the matter.

 

Another question: I asked her about pitocin after delivery -- if I could decline it and just wait and see if I need it (if I'm bleeding too heavily). She said no, that I have to have it. Her reasoning was that because I've had several babies already I am at a much higher risk of post-delivery hemorrhage. I asked her for the numbers -- what is my actual risk, percentage wise, just give me a ballpark figure to work with. She either couldn't or wouldn't, just insisted that it was in my best interest to receive the pitocin. Is that really correct? That can't be right. I've already been told by a L&D nurse that works at this hospital that *everyone* gets pitocin following delivery, standard procedure, I can't decline it.

 

I just want to be left alone to have my baby. Really. I want to be safe, I want baby to be safe. Of course I do. This just all seems premature and unnecessary at this point.

 

Another wrench in the works...she is not likely the one who will deliver my baby anyway. There are 10 practitioners on rotation -- 9 OBs and her. I have a 90% chance of delivering with a complete stranger. So I can argue this till I'm blue in the face with her but if I walk in to be induced on the 17th I'll most likely have to argue it all again with whomever is on call that day.

 

I am a perfectly healthy, 31 year old woman. I have never had a pregnancy complication. Not one. My only risk factors, at this point, are the fact that my EDD (according to her) has come to pass and that I've had several children already.

 

When I went to schedule next week's appointment I was scheduled with a different provider and told that she is not available that day to see me. Great. I wonder if she just doesn't want to see me because I am asking too many questions. She has been so kind up until today but was clearly uncomfortable by my...resistance...to induction.

 

Input please. (And if you read this entire thing through to the end, thank you so very much. I know it's long).

Edited by Pretty in Pink
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Um, what exactly is she going to do if you simply don't show up on the 17th? Come to your house and shoot you up with drugs? Not hardly. :p

 

I kind of have a serious issue with doctors who violate people's rights over their own bodies...

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First of all, :grouphug:

 

I'm on my 5th baby, and the only one I've had pitocin with AFTER the delivery was Diva, b/c I was bleeding out...after an induction and forcept delivery. So, I honestly don't understand the automatic application for after the baby is born. Talk about afterpains from H*ll!

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:grouphug: :grouphug: :grouphug:

 

I have no advice; I don't know what your options are (can you just...not show up for the induction? can you refuse the biophysical profile?).

 

The whole thing seems just...wrong to me. I just have HUGS.

 

I'm sorry but - WHY can't she take your word on your LMP? I'm just :confused:

 

I will pray that you just go into labor all on your own in the next couple of days so you won't have to worry about any of this. :grouphug:

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First of all, :grouphug:

 

I'm on my 5th baby, and the only one I've had pitocin with AFTER the delivery was Diva, b/c I was bleeding out...after an induction and forcept delivery. So, I honestly don't understand the automatic application for after the baby is born. Talk about afterpains from H*ll!

 

Seriously. With my last birth I was in so much pain that I was vomitting and full-on sobbing with afterpains. When the midwife came back to check on me a few hours after delivery she had trouble palpitating my uterus. It was already near it's pre-pregnancy size according to her. She just sort of laughed it off and said, "No wonder you were making such a fuss!" :001_huh:

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I'm sorry but - WHY can't she take your word on your LMP? I'm just :confused:

 

She thinks that I had a period after I got pregnant. Because the baby was less than one ounce larger than average on the 18 week ultrasound.

 

GBS+ is Group B Strep positive.

 

Is there any chance of another provider at this point?

 

I don't think so. I'm 9 days out at this point. I don't even know how to go about that. They are the only practice in town.

Edited by Pretty in Pink
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my only experience is a friend who's delivery date was pushed around as well, she delivered naturally and all, but the baby had sucked in myconium (sp?)and was in ICU for like two weeks. it was her fourth. the doctors told her at one point that her baby was in the worse shape of them all (all the ones in the NICU). yikes. i suppose i would push for a second opinion if i were in that situation at the moment. waiting too long to deliver could have consequences too. i wish you luck, we all want a pretty great pregnancy and delivery, mine were both preemies and i learned to forgive myself because both deliveries were nothing like i imagined and the first had heavy interventions. the flip side is they are happy and healthy and that is really what matters in the end.

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Would the biophysical profile be a different day than the induction? You don't have to show up to an induction, but it might be harder to say no if they do the profile and then want to send you right to the hospital.

 

I don't know how to refuse the pitocin after birth if they really insist. When I got the hospital records for dd1's birth it said that I was given pit in the iv after the birth. I didn't even notice.

 

:grouphug: I'm sorry the midwife can't even really answer your questions with any evidence!

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Would the biophysical profile be a different day than the induction? You don't have to show up to an induction, but it might be harder to say no if they do the profile and then want to send you right to the hospital.

 

I don't know how to refuse the pitocin after birth if they really insist. When I got the hospital records for dd1's birth it said that I was given pit in the iv after the birth. I didn't even notice.

 

:grouphug: I'm sorry the midwife can't even really answer your questions with any evidence!

 

The BPP is next Friday. If baby scores perfectly then the induction would be scheduled for Monday morning. If baby doesn't score perfectly then I would be sent directly for induction. My original due date was that Sunday (so, 2 days after the BPP and 1 day before the induction).

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With my first, the OB got the date wrong, induced me for one and a half days, then stopped and sent me home. I was due to move in a week and a half later (military and it was based partly on dh's school and partly on my supposed EDD). I quit that doctor, spent the weekend in terror that I would be giving birth in a hallway (the norm for moms without doctors in Southern California in 1989), and then got a doctor on Monday. I went into natural labor on Friday- a full week after she stopped the induction. She got the date wrong by weeks.

 

My advice to you is to do the diagnostic tests and then go from there. You don't want to wait too long but I would want to make sure the baby is really 40 weeks or older. My son was born probably at 41 weeks and she was inducing me at 40 weeks. He was less than 7 pounds so inducement wasn't a good thing with me.

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I agree, too. You run the risk of her dropping you as a patient, and the risk of ending up delivering with whomever is on call if you wait til you go into labor, and I guess you have to weigh that against all the interventions she wants to run.

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For my first, I had an OB who completely ignored what I had to say. He scheduled me for a c-section and didn't even ask me if that's what I wanted to do. I saw a different doc at my next visit and told him how uncomfortable I was with the other doc and the decisions that had basically been made for me. He canceled my c-section and helped me work toward the birth scenario I wanted. All of that to say, docs in a practice do have differing opinions. It might be a good thing for you to see someone else in the practice and hear what he/she has to say. I would recommend majoring on what you want for your birth rather than making it about a disagreement between you and the other doc. Obviously another doc will be more helpful if you aren't openly attacking his/her peer's opinions. Do you know anyone else who goes to this practice who might be able to tell you which doc would be most sympathetic?

 

I hope everything works out for you, and you get the birth you want!

:grouphug:

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I went the rounds about induction with my last baby. Basically, I refused. I told the OB that my answer was no. Full stop. So, if you want to roll the way I roll, just say no. If your doc is anything like mine, she'll be too stunned to do anything. It was a battle of the wills, and I won. Baby was born a few days later, happy, healthy and in the middle of a hurricane. My OB didn't care for me much by the time we were done with each other.

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I forgot to answer the other stuff-

 

1) I would not go the water breaking route if you're GB+. I'm with your OB on that one.

 

2) I would let the hospital staff no that you are refusing the pitocin. Put it on writing on the chart and make sure you take down the names of any nurses working in your room. Let them know that you'll file a written complaint if they administer the drug without your consent.

 

It sounds like you are going to have to be a tough cookie to get the birth you want. What a shame that it's gotten this way.

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I would not want that women anywhere near me. Ever. You know better than she when your LMP was. Their measuring is often wrong, and some babies are big, and some small. She may just be a big baby. I would refuse the scheduled induction, I would refuse the pitocin unless absolutely necessary. They can NOT force you to have something you don't want. Tell them if they don't like it they can talk to your attorney! :grouphug::grouphug::grouphug:

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She thinks that I had a period after I got pregnant. Because the baby was less than one ounce larger than average on the 18 week ultrasound.

 

 

But, that's just...I'm sorry to get all hot and bothered about this, but wouldn't you be in a position to KNOW if you had a period after you got pregnant. Why on earth would she not take your word for it? Why would you lie about it? This seems like a basic lack of trust and I'm just all :001_huh: at her attitude. Argh. I'm sorry you're dealing with this, I don't know what to tell you advice-wise.

 

In your shoes, I would probably really be weighing the pros and cons of not showing up for the BPP.

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I'm sorry you are dealing with this! :(

 

Let me first say, that YES you can deny ANY procedure. You could, technically, deny an emergency C-section, walk out, and go home. You always have the power and the right during your birth..keep that in mind. :) I tell this to every client, at every meeting. :)

 

Like another poster said, I would just flat out refuse anything you do not want. If you have the Non Stress Test and the baby is fine, and she insists on doing an induction...tell her no, you will be waiting until X date. When that date comes around and you and the baby are still healthy, tell her no again. Go into the hospital when you are in labor or when you feel comfortable. Legally, she cannot force you into any procedure, and that includes an induction.

 

Positive thoughts your way!!

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If I was sure of my dates, I'd refuse to consider an induction unless the biophysical profile is not reassuring. For reference, my first was a 42 weeker, my second was born at 41w1d.

 

Yes, you can refuse to show up for the induction. She can refuse to continue to see you as a patient. This isn't necessarily a horrible outcome. The hospital would still admit you when you're in labor, insurance would still cover the same stuff, and you'd end up with the same nurses. It's just that the birth would be managed by the attending OB if your current practice has decided to drop you.

 

In your shoes I might offer to undergo a second biophysical profile on Monday. But I'd be cautious about doing that if the test is going to be done in the hospital, as you might get some really serious pressure to stay even if baby looks great.

 

In the meantime, eat spicy food, make tea if it's even remotely appealing, take long walks, and have a chat with this baby, letting him/her know that anytime soon would be great. :)

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Would there be something wrong with "stripping the membranes"? I realize there is an issue with breaking the bag of waters, but do those same issues apply for stripping? I know that for me, when I was close, my midwife stripped the membranes and I was in labor within 12 hours. It was essentially a slightly "rough" exam, but was far from painful.

 

There are ways for dh to help you with that, if your midwife won't.

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I'd tell her to kiss my arse! My body, my pregnancy, my baby, my birth.

 

They cannot "make" you induce. They cannot "make" you take their drugs.

 

Refuse it all. Tell them to shove it where the sun don't shine.

 

Trust YOUR gut on this. :)

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I'd tell her to kiss my arse! My body, my pregnancy, my baby, my birth.

 

They cannot "make" you induce. They cannot "make" you take their drugs.

 

Refuse it all. Tell them to shove it where the sun don't shine.

 

Trust YOUR gut on this. :)

 

I think I love you. ;)

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I absolutely hate hate HATE that birth has become this way. You truly need an advocate for you while you are in labour, a person who will speak for you when you may not be able to speak for yourself. (I do not specifically mean a doula, although that may work. I am not a doula nor a birth advocate, ftr).

 

It is true that you can refuse. I would. My first two were pitocin-induced while the third was born at home in water after my water broke naturally. Apples and oranges, my friend, apples and oranges.

 

Pitocin pushes a baby that is not ready against a body that is not ready. Ugh. :glare:

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First I seriously doubt that you will need to worry about it since you are already at 3. My guess is you are on your way. I have been induced with pitocin 5 times. Really no big deal. My Dr breaks your water first and I am guessing that that in itself will put you into labor. Why not ask for a membrane strip or for them to try that? Don't get upset. I really think that you will be delivering soon. :grouphug:

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I'd tell her to kiss my arse! My body, my pregnancy, my baby, my birth.

 

They cannot "make" you induce. They cannot "make" you take their drugs.

 

Refuse it all. Tell them to shove it where the sun don't shine.

 

Trust YOUR gut on this. :)

 

Yep, memorize this line:

 

"Nancy Reagan taught me to Just Say No to drugs". :001_smile:

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Just say no. You will be seeing a different provider next week anyway. If they ask about it, you can say that she must have misunderstood and you are not going to be having an induction - you intend to wait until you go into labor naturally. Just be positive and say no.

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Just say no. You will be seeing a different provider next week anyway. If they ask about it, you can say that she must have misunderstood and you are not going to be having an induction - you intend to wait until you go into labor naturally. Just be positive and say no.

 

Yep, it sucks, but it sounds like you will have to flat out refuse. They may try to convince you by saying things that they are only guessing at, like ultrasound shows the baby is big etc.

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I wouldn't have anything to do with her instructions. I would myself tend to avoid going in at all until I was in labour, because I've had bad experiences with doctors trying to force me to do things once I got into their territory.

 

But there is no way I'd get that induction - she's very likely trying to force you into labour early. Ultrasounds are notoriously unreliable when used that way, and most dates are set a little early already.

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She thinks that I had a period after I got pregnant. Because the baby was less than one ounce larger than average on the 18 week ultrasound.

 

 

 

I don't think so. I'm 9 days out at this point. I don't even know how to go about that. They are the only practice in town.

 

My OB told me (head of dept at major teaching hospital) that ultrasound, doctor's palpation, and mother's guess are equally accurate at determining fetal size: IOW ultrasoun is not particularly accurate.

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When I went to schedule next week's appointment I was scheduled with a different provider and told that she is not available that day to see me. Great. I wonder if she just doesn't want to see me because I am asking too many questions. She has been so kind up until today but was clearly uncomfortable by my...resistance...to induction.

 

 

This may be a good thing. There are some excellent, caring OBs out there who listen to their patients.

 

Discuss this with him/her in depth if you can.

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I'd tell her to kiss my arse! My body, my pregnancy, my baby, my birth.

 

They cannot "make" you induce. They cannot "make" you take their drugs.

 

Refuse it all. Tell them to shove it where the sun don't shine.

 

Trust YOUR gut on this. :)

:iagree:

 

She can't make you do anything. Period.

:grouphug: For having to deal with this.

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First I seriously doubt that you will need to worry about it since you are already at 3. My guess is you are on your way. I have been induced with pitocin 5 times. Really no big deal. My Dr breaks your water first and I am guessing that that in itself will put you into labor. Why not ask for a membrane strip or for them to try that? Don't get upset. I really think that you will be delivering soon. :grouphug:

 

I allowed her to strip my membranes today. I felt like it was a small concession to make even though I didn't really want to have it done. She wasn't pushing it but I knew it would appease her. So far nothing, but maybe it will work. I'm keeping my fingers crossed.

 

She is saying that I cannot have my water broken first because I am Group B Strep+. If I am induced I have to start with pitocin, according to her.

 

If she dropped me from the practice I'd still be in the same boat I'm now when delivery rolls around. They are the only practice in town -- all 9 OBs and she work at the same practice. I'll get whomever is on call anyway.

 

So...I will have the BPP next Friday. If it is reassuring then I'll refuse the induction and tell the provider that I am willing to come back on Monday or Tuesday for another BPP if they want me to. Those are performed in their office. And I had already written it into my birth plan about not receiving routine pitocin following delivery, but maybe I'll go ahead and bold that portion for good measure.

 

My husband is promising to be my guard dog and question every person who walks within 5 feet of my hep lock. :tongue_smilie:

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I used to be a hardcore natural birth believer... not so much anymore, I consider myself more middle of the road-- I'm no longer afraid of medical interventions within reason.

 

Is it possible that what you thought was a period was ovulatory bleeding? This happened to me and bumped up my due date by nearly 2 weeks.

 

I've had 4 completely unmedicated births including a homebirth, one medicated (epidural) birth, and 2 induced medicated births. I really expected the worst from the inductions but they turned out to be the most positive birth experiences I've had. I was induced just a week ago and everything was over within 4 hours. I went in 3cm 80% effaced but no contractions. I contracted for about 2 hours without an epi, 2 hours with, and she was out in 3 pushes.

 

If you are really dreading an hospital induction you could always try castor oil induction at home?

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You can refuse even if they send you straight over with a bad result. With the last baby, I was horribly sick and needed ivs. They gave me the ivs with the intent to load up the pict and get that baby out!! When you refuse, it is like time stops. They stare, they babble, they storm out....they come back with the "head" dr because of course your dr is nowhere around then. Out of 4, I've only had one ob who saw me through to labor. Then they talk slowly and go over everything in careful detail. I get tickled at the slow talk. I then say NO. I've had gbs+ twice and both times my water was broken by the drs because you still have 24 hour time window according to them. But my labors are quick and broken waters produce a baby quickly. They always threaten to start pict at such time and when they come back, I make them tell me how far I have progressed and then refuse again. If you are steadily progressing, the baby is dropping and doing fine, they have no reason to force a labour. Now if there were ever any trouble, we would have considered other things but with normal progression and good baby signs, I tell them no. They try to argue and I ask for the labs and proof as to what they are basing their opinion on. You've done this before and you know if it is not going right and you need help. :grouphug:

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I allowed her to strip my membranes today. I felt like it was a small concession to make even though I didn't really want to have it done. She wasn't pushing it but I knew it would appease her. So far nothing, but maybe it will work. I'm keeping my fingers crossed.

 

She is saying that I cannot have my water broken first because I am Group B Strep+. If I am induced I have to start with pitocin, according to her.

 

If she dropped me from the practice I'd still be in the same boat I'm now when delivery rolls around. They are the only practice in town -- all 9 OBs and she work at the same practice. I'll get whomever is on call anyway.

 

So...I will have the BPP next Friday. If it is reassuring then I'll refuse the induction and tell the provider that I am willing to come back on Monday or Tuesday for another BPP if they want me to. Those are performed in their office. And I had already written it into my birth plan about not receiving routine pitocin following delivery, but maybe I'll go ahead and bold that portion for good measure.

 

My husband is promising to be my guard dog and question every person who walks within 5 feet of my hep lock. :tongue_smilie:

 

 

 

I had great luck with stripping the membranes. I had it done on an afternoon around 3pm and I was in labor by 3am. Very easy and gentle.

 

I wish you well and hope you get the delivery you desire :)

 

:grouphug:

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I was GBS+ with at least two of mine, (I think I was with one other as well, but my brain is failing me right now), and I had them break my water. If you are already receiving the antibiotics I do not see what the big deal is to wait on the pitocin?

 

Do you have someone who can advocate for you while you are laboring? if so, I would just stick to my guns about the pitocin and let it hit the fan.

 

FTR- I have had epi free births with and without pitocin, with and without iv pain meds, with and without L&D staff that were worth a darn, and with and without an OB who was on the same page as me.

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I really expected the worst from the inductions but they turned out to be the most positive birth experiences I've had. I was induced just a week ago and everything was over within 4 hours. I went in 3cm 80% effaced but no contractions. I contracted for about 2 hours without an epi, 2 hours with, and she was out in 3 pushes.

 

 

I didn't dread my inductions (I didn't know any better) but they were positive experiences as well.

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Can you ask for the IV in your hand? My fourth was GB+ and a birth center. She just gave me a dose through a vein in my hand. I hate needles and it was super easy. Once, the dose was gone I was done. Had the baby before we got a second dose started.

 

That's what I am planning and had discussed with her previously, just getting the hep lock in the back of my hand. I've had it with my other natural births.

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