What happens if you refuse induction?

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krazykat's picture
Joined: 08/11/07
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What happens if you refuse induction?

So what if you get to 41 or 42 weeks or whatever and they want you to induce and you just refuse?

I have always wondered what would happen if I just stopped showing up to the doctor until I was in labor lol.

Also, are the risks to the baby really THAT increased if you are "over due". It just seems weird since you can't be absolutely positive of the exact moment that the baby should come out, kwim? Don't they (and your body) know what's best?

kvo
kvo's picture
Joined: 12/18/06
Posts: 902

I know that if you are certain your dates are correct, then going past 42 weeks can mean a reduction in amniotic fluid. I believe your fluids can be checked via u/s though so they should be able to tell if and when you reach that point.

I went to 41 weeks and it was 100% my choice to be induced or not.

MrsMangoBabe's picture
Joined: 04/09/07
Posts: 2276

No one can make you be induced against your will, since there is no informed consent without informed refusal. I guess they technically could say you were endangering your unborn baby and get a court order, but I've never heard of that happening with an induction, only c-sections.

Here is a good article about the "overdue" issue: http://www.midwiferytoday.com/articles/timely.asp

Joined: 03/16/15
Posts: 53852

No they cannot make you. But really you would not want to just stop seeing your doctor. Once you are post dates it is really safe to be monitored in case a problem does arrive. Research shows going post dates is safe as long as you and baby are being carefully monitored.

morrisbuddy's picture
Joined: 11/25/06
Posts: 130

Your placenta actually ages too, and can stop functioning as well if it gets too "old", which means baby will get less oxygen. If it comes up, I'd just discuss it with your OB, and say you'd rather wait, what are the risks? I believe too that as long as you're monitored and baby is doing fine, then there's no reason not to just wait it out.

cactuswren's picture
Joined: 10/19/09
Posts: 4658

Because of the placenta issue, I might consider it after 42 weeks, but not a moment before. They can't force you.

rainymama's picture
Joined: 08/24/07
Posts: 409

Yes to all of that, too. I don't know how common it is to go past 42 weeks. I went to 41 with my last and even though the doctor "said" he would schedule me for an induction at my next appt. after that, I didn't plan to actually do it, and he knew that. I was doing kick counts and had a few NST's anyways. My mother was 42 weeks with my sister (34 years ago) and was induced for lack of amniotic fluid.
I've never been one to know my dates EXACTLY, though. I have never kept track of cycles, ovulation, etc. Some women do and know their bodies very well.
There's that bell curve to remember...between 38-42 weeks is supposed to be thought of as term and 40 weeks is where the bell curve peaks with the ends tapering towards 38 and 42.
It's because of this, that this pregnancy I have avoided telling anyone a "due date." When they ask, I always say around mid-May. I don't even know if my midwives have a "due date" listed.

Winky_the_HouseElf's picture
Joined: 02/10/02
Posts: 292

Some docs will "fire" a patient and refuse to be her doctor anymore if she doesn't comply. In some areas docs will pursue a court order. Those are pretty extreme scenarios, though. In a situation where a doctor and patient strongly disagree, it can help both parties to categorize the actual benefits and risks. Ultimately, it's up to the patient to decide which risks she's willing to take (the risks of induction vs. the risk of continued pregnancy). Not all docs feel that way, however, and will badger and bully and frighten a patient into complying ("you don't want a dead baby, do you?"). :rolleyes:

What I've seen is that a compromise can usually be reached. If a doc really wants to induce at 41 and a mom really wants to wait until 42, maybe they could compromise at 41.5. Or maybe they go ahead and schedule it for 42 with stress/non-stress tests or biophysical profile before then. The question of induction for post-dates is one of the many topics that is good to ask in an interview/earlier in the pregnancy. Smile

cactuswren's picture
Joined: 10/19/09
Posts: 4658

We talked about this a bit last night in my HB class, and the instructor (who is also a doula) said it often helps if when you tell them you want to wait, you also assure them of all the things you'll do to self-monitor and be safe in the meantime (such as regular kick counts, staying extra well hydrated, etc.) so that they get the message that you are a highly informed person making a good decision, not just being stubborn about a number.

Joined: 03/16/15
Posts: 53852

"morrisbuddy" wrote:

Your placenta actually ages too, and can stop functioning as well if it gets too "old", which means baby will get less oxygen. If it comes up, I'd just discuss it with your OB, and say you'd rather wait, what are the risks? I believe too that as long as you're monitored and baby is doing fine, then there's no reason not to just wait it out.

Yes, I've heard this as well.
That being said - it is a fairly recent thing that babies are not "allowed" to be born after 42 weeks. My sister was 6 weeks late - born at 45.5 weeks. Her doctor was doing bloodwork/urine screening weekly after 40 weeks to make sure the placenta was doing well. The last test my mom had did come back abnormally - but my mom went into labor that same night and my sister was born at only about 7 1/2 lbs. My mom didn't know until afterward though that the last test had come back off and she would have been scheduled for an induction the next day. He OB also told her that my sister likely lost almost a pound because she was in there so long.

My brother was born 3 weeks late and I was born 2 1/2 weeks late.

CaBlondie918's picture
Joined: 01/27/07
Posts: 260

From the midwives that I've been interviewing a lot of them have been saying that once you hit 41 weeks they would have me to NST and an ultrasound to check levels and as long as everything was fine they'd be fine with going to 43 weeks..... that's something I think if I asked my OB she would look at me like I was nuts.

krazykat's picture
Joined: 08/11/07
Posts: 1143

"Barefoot~Mama" wrote:

Yes, I've heard this as well.
That being said - it is a fairly recent thing that babies are not "allowed" to be born after 42 weeks. My sister was 6 weeks late - born at 45.5 weeks. Her doctor was doing bloodwork/urine screening weekly after 40 weeks to make sure the placenta was doing well. The last test my mom had did come back abnormally - but my mom went into labor that same night and my sister was born at only about 7 1/2 lbs. My mom didn't know until afterward though that the last test had come back off and she would have been scheduled for an induction the next day. He OB also told her that my sister likely lost almost a pound because she was in there so long.

My brother was born 3 weeks late and I was born 2 1/2 weeks late.

6 weeks!!! Whoa!! I had never heard that babies can lose weight from being in "too" long. I was always told they were concerned about a baby being "too" large. That is interesting. 6 weeks late... man, that's a long time!!

krazykat's picture
Joined: 08/11/07
Posts: 1143

I know my OB won't start talking induction or anything until 42 weeks. I am comfortable with that, as I don't think I will go that long. I think they have my EDD later than what it should be anyways, and that is fine with me. I went a week early with DD, so hopefully it will be around that time with this baby as well... or whenever little Peppy wants to come is fine with me. I just hear so many people saying "I was overdue and had to be induced" and was wondering if I really would HAVE to be induced, kwim? Of course I am willing to consider the risks and benefits, be monitored appropriately, etc. Hopefully it won't ever come to that, but I just wanted to get your take on it.

morrisbuddy's picture
Joined: 11/25/06
Posts: 130

"Barefoot~Mama" wrote:

Yes, I've heard this as well.
That being said - it is a fairly recent thing that babies are not "allowed" to be born after 42 weeks. My sister was 6 weeks late - born at 45.5 weeks. Her doctor was doing bloodwork/urine screening weekly after 40 weeks to make sure the placenta was doing well. The last test my mom had did come back abnormally - but my mom went into labor that same night and my sister was born at only about 7 1/2 lbs. My mom didn't know until afterward though that the last test had come back off and she would have been scheduled for an induction the next day. He OB also told her that my sister likely lost almost a pound because she was in there so long.

My brother was born 3 weeks late and I was born 2 1/2 weeks late.

Every situation is different, that's why I believe in the monitoring. Though, my sister was born almost 3 weeks late, and I don't think my mom even had a single ultrasound! My mom said she was the ugliest baby ever, all wrinkly (from losing her vernix and getting wet) and gross! But, definitely, some babies are fine waiting longer, and some hafta get the heck out!

OperaMommy08's picture
Joined: 12/11/09
Posts: 27

My DD was born at 42 weeks. My OB really pressured me into inducing, though I kept putting her off. Finally, she looked at me and said, "Babies just DIE after 42 weeks!". I knew that this was not the case, so I just kind of stared at her in shock and then told her that I would NOT be induced before 42 weeks (I was 12 days overdue and my sister was 10). She had me scheduled on the evening of the 12th to be induced and I went into natural labor at 10:00am that morning. My daughter has always known how to make a grand entrance! So, the rule of thumb is to stick up for yourself and be informed about the choices you are making. This time around, my OB has a due date based on LMP, while my midwife has the date based on conception (I was a super tracker!), which is 3 days earlier. I wanted to have as much of a cushion as possible as it's entirely possible that this little one will be so comfy that it won't want to come out either! ROFL

cactuswren's picture
Joined: 10/19/09
Posts: 4658

"OperaMommy08" wrote:

Finally, she looked at me and said, "Babies just DIE after 42 weeks!".

:eek: That's horrifying!!! I'm glad you're planning your birth with a MW this time around...and good for you for being informed and not giving in to that the first time, too!

I'm convinced I'm going to be really late too, because I was 2 weeks late and my mom had to be induced--her water broke and she never went into labor. I know I am not my mom but since my birth center kicks you out to the hospital after 41 weeks, it's my main stress point. I'm trying to be zen about it, though, since there's nothing I can do but lay low and refuse induction until 42 weeks (...my birthday Lol

OperaMommy08's picture
Joined: 12/11/09
Posts: 27

"cactuswren" wrote:

...since there's nothing I can do but lay low and refuse induction until 42 weeks (...my birthday Lol

That's SO FUNNY! I was set to be induced on my birthday! Instead, I spent all day on my birthday in labor. The next year, my DH asked me what I wanted to do on my birthday and I told him that anything would be more fun than being in labor all day! ROFL

krazykat's picture
Joined: 08/11/07
Posts: 1143

"OperaMommy08" wrote:

That's SO FUNNY! I was set to be induced on my birthday! Instead, I spent all day on my birthday in labor. The next year, my DH asked me what I wanted to do on my birthday and I told him that anything would be more fun than being in labor all day! ROFL

OHHHH NOOOO!! I'm due around my birthday! Mine is September 5th and I'm due September 7th... :eek:

Spacers's picture
Joined: 12/29/03
Posts: 4104

In my state, a homebirth midwife has to transfer your care at 42 weeks 1 day unless you're in labor. After 41 weeks, they request you have an NST & BPP every 2nd or 3rd day to keep an eye on baby while you encourage labor to start naturally. I told my OB that I would insist on continuing the NST/BPP routine until at least 43 weeks. With Tiven, my placenta did likely start to fail after about 41.5 weeks. Her fluid levels dropped, but would rebound with hydration, and then at 42 weeks they dropped & didn't rebound at all.

Re: what Winky said about your doctor firing you... legally an OB can't fire you within 30 days of your EDD, unless s/he sets you up with another doctor who agrees to provide the service your doctor is refusing to provide. So if you're sensing that induction talk might get heated, I'd recommend holding off on any express refusals until after 36 weeks. That way, either doc can't fire you or s/he has to do the legwork to find you someone better.

krazykat's picture
Joined: 08/11/07
Posts: 1143

"Spacers" wrote:

In my state, a homebirth midwife has to transfer your care at 42 weeks 1 day unless you're in labor. After 41 weeks, they request you have an NST & BPP every 2nd or 3rd day to keep an eye on baby while you encourage labor to start naturally. I told my OB that I would insist on continuing the NST/BPP routine until at least 43 weeks. With Tiven, my placenta did likely start to fail after about 41.5 weeks. Her fluid levels dropped, but would rebound with hydration, and then at 42 weeks they dropped & didn't rebound at all.

Re: what Winky said about your doctor firing you... legally an OB can't fire you within 30 days of your EDD, unless s/he sets you up with another doctor who agrees to provide the service your doctor is refusing to provide. So if you're sensing that induction talk might get heated, I'd recommend holding off on any express refusals until after 36 weeks. That way, either doc can't fire you or s/he has to do the legwork to find you someone better.

The legal part is very interesting!! I didn't know that. I don't anticipate any problems with my OB, I was just wondering what would happen or if anyone had any experience with it. I actually believe as a VBAC I have much more room to move with my OB than I would if I was VBACing with a MW. I guess they have pretty strict requirements by law here? Dr. Elrod allows much more than any MWs I have talked to around here. I really have a feeling he would go with anything as long as me and baby are doing alright. I'm sure he would want to monitor after 42 weeks, but I don't think he would really push me. I think he would just want me to be educated about the benefits and risks. I am truly lucky to have such a great OB Biggrin

Joined: 03/16/15
Posts: 53852

Yeah legally here they also have to transfer care after 42 weeks. So after that no hb for me. My mw starts NST after 41 weeks and also at that point starts stressing castor oil. With DS he was born at 41 weeks exactly. Actually an hour before I was supposed to go in for monitoring. I was happy to avoid the castor oil. I wish they were more lenient like they used to be. I was 16 days late and my mom's OB did not talk induction, but just had her monitored to make sure everything was fine.

MrsMangoBabe's picture
Joined: 04/09/07
Posts: 2276

Yeah, my mom told me that when she had her babies, the OBs and CNMs never induced before 42 weeks without a medical reason.

The OB whose practice I left during my first pregnancy (who has been practicing a really long time) told me that he feels more confident inducing now because he thinks 1st trimester u/s's make the EDD's more accurate, decreasing the risk of ending up with a baby who is actually premature. He also threw in that in the one case he had where the mother refused induction, the baby died. Did I mention he was a jerk?

Although it is not a good idea to stop being seen when you are past 40 weeks because being monitored for indications for induction is a really good idea at that point, you can always let them schedule you for an induction and then just not show up.

Spacers's picture
Joined: 12/29/03
Posts: 4104

I remember when my mom was pregnant with my youngest sister ~32 years ago, they still weren't using "due dates," she was due "in early December," and they still dated pregnancy by the month rather than by the week. I loved going to appointments with her, that was during my "I want to be a doctor" phase. Blum 3