Induction at 38 weeks??

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KittyRN's picture
Joined: 02/03/09
Posts: 1260
Induction at 38 weeks??

Hey ladies
Had my 35 weeks appt today. My bp was still a bit up so she's starting me on a low dose of meds. Urine is ok, she's not too concerned since I did this with Simon and no pe.

However, i was talking about how while I laboured with Simon I had horrible right hip pain, and he was face up, and then he ended up with a brachial plexus injury (shoulder) on his left side. My theory is that his shoulder was stuck or pressing down on my hip hence my pain and his injury. The pain stopped when the OB turned him over inside of me, and there was no resistence, he turned fine.

So this baby is measuring a little bigger than ds according to the u/s (i know, they are not accurate), but she was saying that my rising bp in combination with what happened with Simon she thinks that inducing at 38 weeks is best so that incase he was "stuck" that this baby isnt even bigger and at an increased risk of that. Right now the baby is still face up and in the exact same position as Simon. She admitted that she cant say for sure that is how he got the injury and that sometimes these injuries happen and they never know why. Thankfully Simon is totally fine now, but it was stressful to go through that and it made my labour sooooooo painful!

I'm already thinking I will not let her induce at 38 weeks especially if my cervix is the same as it was for Simon (closed), but I am also worried about what she's saying. She is not being pushy, just saying what she feels. She would wait if I wanted. And of course I would induce if anything was life threatening/dangerous. But right now they are just maybes.

What do you ladies think????

AnnaRO's picture
Joined: 07/06/08
Posts: 7033

Personally (JMO) I don't think that induction is the cure to the concerns you raised. If, at 38 weeks, this baby is in the same position as Simon was, then you are more likely to have the same problem or others when induced. There is plenty of time for this baby to turn and change position several times before being born.
I also just read a story yesterday about a woman who posted that she was induced at 38 weeks and it turned out that she was actually only 36 and ended up with a premie as a result.

My personal opinion is that it would be better to wait it out a little longer. Different labors can be very different.

redneckgirl82884's picture
Joined: 12/17/08
Posts: 955

I agree. Even if this baby is as big or bigger than Simon doesn't mean that it will have the same problems as Simon. If there is no danger in hurting you or the baby then I wouldn't do it. IF when 38 weeks comes around and it does seem like there could be some problems then you can talk to the OB about it.

Joined: 06/22/10
Posts: 5602

I agree with all of the above. I wouldn't worry about inducing unless your bp gets worse. sorry you have to go on meds Sad who is your ob?

jperry5683's picture
Joined: 02/13/10
Posts: 525

Unless its pre e or other blood pressure issues I also wouldn't induce. I got induced last time and I just feel that forced labor brings on complications..harder labor etc. I say just keep an open mind and wait to see how u feel and what's going on come 38 weeks. Are u or did u get an internal yet?

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

An induction at 38 weeks isn't likely to go any better than your last birth. If your body isn't ready, they're going to have to pump you full of pit to the max, you're going to get an epi, which will require that you labor on your back, which is much more likely to lead to malpositioning than if you were to go into labor on your own. If she's that worried that you should give birth at 38 weeks for the health of the baby and your health then she'd recommend a c/s. I've heard the big baby excuse for pushing induction before but not at 38 weeks. Now if its your BP then maybe there's a decent reason for it but wouldn't an induction be more stressful on you and therefore more problematic with high BP?

BuckeyeK's picture
Joined: 10/23/06
Posts: 3087

I agree with everyone above. I'm sure you've heard of spinning babies, but have you tried some of the positioning to help baby shift his/her position? Of course, at 35 weeks there's still lots of time for position to change, but it certainly can't hurt.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

I would not agree to an induction at 38 weeks. Chances are high then that your body and baby won't be ready for the induction, so it won't be a quick gentle one. After my induction with Aiden I don't suggest being induced unless there's a true medical reason, even after 40 weeks. Unless real pre-e develops you don't have a medical reason from what you've told us. Better to let baby bake and stay positive. I'd be on spinning babies and working on those exercises on there to help position this baby better. There is lots you can do that over time will encourage better positioning. I'm still doing exercises to get Zoe into a better position so that she's not stuck posterior like DS was.

Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On You | Frisco Women's Health Blog
"3. ?We should induce at 39 weeks because your baby is getting too big? ? Did you know that, according to ACOG:

?Induction of labor at least doubles the risk of cesarean delivery without reducing shoulder dystocia (rare situation where baby?s shoulder can get stuck at delivery) or newborn morbidity(complications). Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.?"

Cherrychip's picture
Joined: 01/31/09
Posts: 1134

Ditto what everyone else has said. I would not be comfortable with an induction at 38 weeks unless there was a severe issue such as pre-e that made it necessary.

KittyRN's picture
Joined: 02/03/09
Posts: 1260

Thanks ladies! You make me feel better!! Though I am really scared of that hip pain/injury happening again. We were lucky that his damage was temporary, it could have been way worse. I would hate for it to happen again!

I'm not really worried about my bp. I've had no symptoms of PE, and I normally have higher bp when not pg, so this is more normal for me. It wasnt even that high today 133/94. Nonpg i'm a 130/90ish girl, it's just that it drops in early pg so that by the end it looks high for me. She said she'd like to see my lower number under 90, but again thinks its just PIH, not PE and I agree.

Janice, I see Dr. McCuaig in Kitchener. I do really like her. She wasnt being pushy about it, she seemed a little confused by my description of the pain and said "there was no shoulder dystocia, I'm not sure what you were feeling. May have jsut been the result of back labour." I think she may have thought I was suggesting I be induced again, so she went along with it?? Her exact words were "Well we should probably think about inducing you around 38 weeks if your bp is still up and the baby is measuring large and you think that is what happened to his shoulder." So she is more concerned about the bp, i'm more concerned about the shoulder thing. If this baby wasnt in the exact same position as Simon I wouldnt worry so much. I'm going to try some spinning baby things.

I wish I hadnt mentioned it to DH, now he's all excited to have the baby at 38 weeks. I already told him that I will not be induced right at 38, I'd rather at least wait until as far along as I was with Simon (38w 5d), and will not agree to pitocin until I am dilating. Hes ok with that. I think next appt I will ask the doctor about just taking it week by week once we reach 38. If she checks me at 38 weeks and i'm 4 cm and the baby is measuring big, my bp is up, im much more likely to agree then if not dilated, baby measuring same, bp good, etc. I just really want a natural labour!

Now just how do I get DH to see my point of view???? But I'm also scared that if I do not get induced right away and the baby does get stuck, has a shoulder injury, requires a csection, it will totally be my fault!!! Sad I should have never even mentioned the hip pain part to my ob, she didnt even know about it. Sad

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

I'd just show him articles and facts about why it's best to not induce and go from there. I'm sure I have a few more on pinterest other than the one linked above. Blum 3

Joined: 06/22/10
Posts: 5602

i had to go look her up, she has good reviews Lol

if none of you are worried about the bp then i would definitely wait. With me, once I hit 37 weeks it was a week by week thing as well. I'm just lucky that my induction worked well for me in the end and I didn't need pit. Do you have to get extra BPP's?

KittyRN's picture
Joined: 02/03/09
Posts: 1260

No extra bpps. Had one yesterday but thats her standard she always does a 3rd tri one. I think she is more used to high risk pg's so she's used to doing things. But she's not pushy at all.

I've mentioned a few of your articles to DH Jackie, and he seems onboard for the most part. He wasnt upset about waiting longer. I dont think he'd be happy if I went to 40 weeks though. LOL! Neither would i! I dont want to be in the hospital for xmas!! LOL! I so wouldnt force the baby out though just cause of that.

I'd love love LOVE to just go 39 weeks on my own! I can wish right?!?!? I'm going to do spinning babies, RRT, EPO, sex......anything else I can try?!?!? Oh, and vit C right?? I'd do the pineapple, oregano, cinammom thing, but I already do, and that obvioulsy doesnt work for me! LOL!!

TiggersMommy's picture
Joined: 02/14/10
Posts: 6043

An induction is a medical procedure to be done when a c/s is not necessary but when it benefits the mother and/or baby to bring on labor. Big babies and suboptimal positioning are not good reasons to induce. Baby's position now is irrelevant. There is PLENTY of time for movement. If you get to 38 weeks and have the same concerns then have your OB calculate your Bishop score. If you don't have a good Bishop score then induction is not going to be fun and you and baby are much more likely to have complications. You say you will refuse pit until you're dilating but if you're dilating why would you need pit? If you really want a natural labor then the best thing to do is let baby decide when labor starts. Labor will start when baby is positioned well and your body is ready. No doctor can tell you when that will be nearly as well as your baby can.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

None of those things will bring on labor Mona. If they did I'd have Zoe in my arms. Wink But they certainly don't hurt and some actually do have a basis in fact with helping labor when the time is right. I have been taking vitamin C which I didn't do with DS. I haven't done EPO except vaginally and only for little over a week now. I did take 5W, but stopped when I ran out last week. lol. And I even managed to convince my paranoid husband to have sex twice last weekend. lol. Spinning babies is great. It's good exercises period with the benefit of helping baby get into better position. I've done way more reading and researching into labor too this time - like positions and how certain positions are better (usually) with certain babies. As in there are things you can do if a baby is posterior to help - there's a page on spinning babies in fact to get you started!

laurensmitty1982's picture
Joined: 07/30/06
Posts: 1117

If it was me, I wouldnt do it... Your labor might end up worse then it may have been because of being on pitocin, all the stuff that comes along with that.. If anything I would try more natural approach to going into labor on your own.. Try to doing some excerises to help him move, and last resort, get your membranes stripped vs pit induction..

KittyRN's picture
Joined: 02/03/09
Posts: 1260

I know those things wont start labour, but they cant hurt! Wink And yes, definitely want a good bishop score if induction is in my future. I didnt mean actively dilating and getting pitocin, more relating to my bishop score.

Honestly I'm still just totally freaked out about a shoulder injury again. If I can get this baby to face my back i'll feel a billion times better. I know it would be unlikely to happen again, but I would hate to cause permanent damage!!!! BUT if i were in labour and had that pain again I would know what to do this time (it stopped when I had DH help me get my legs way back as if to push, just before she turned him over), so I guess it opened up my pelvis more. Which you guys are totally right about had I not had an epidural I could have been doing more on my own earlier to do that.

KittyRN's picture
Joined: 02/03/09
Posts: 1260

What's 5W?

AnnaRO's picture
Joined: 07/06/08
Posts: 7033

I tried a bunch of these: Inducing Labor - 40+ Natural Ways To Induce Labor On Your Own
None of them worked for me. Of course no method works unless your body is ready for labor anyway. But as long as it was just the natural stuff that wouldn't hurt anything I kept on trying it.

alwayssmile's picture
Joined: 08/26/07
Posts: 14483

The epi probably played a big role in this! No epi = more movement for you = baby able to move and come out better!

5W: Herbal Mood Enhancer - 5-W Hydroxytryptophan 100 Caps | Natures Sunshine Products (though I didn't pay that much - there was a bunch of info on BWF support group which is now gone)

jolly11sd's picture
Joined: 02/02/05
Posts: 3327

Like the other ladies I'd wait and let LO come on his own at his own time unless there was some health dangers that warrented induction.

Have you been to the Chiropractor at all during this pregnancy? If would highly suggest seeing one, even at this point in pregnancy, to help get your body more aligned and LO in a more favorable position.

Try not to freak out about the shoulder injury stuff. I'm sorry that I don't remember exactly what happened with Simon's shoulder at birth. Odin had nerve damage to his shoulder and neck, Archer had a broken clavicle (sp?), and both boys healed quickly and well without any extreme pain or long term damage. Ironically Archer was the one that was in perfect alignment and came out without anyone touching him and Odin was the sunnyside up one that had a little more guidence out. Both boys were on the big side (9.2 and 9.9) and I will say that being in the hands and knees position with Archer really did make more space allowing him to come out faster and smoother.

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

Just saw this article posted on FB and thought of you:

Top Ten Signs Your Doctor Is Planning To Perform An Unnecessary Cesarean Section On You | Frisco Women's Health Blog
3. “We should induce at 39 weeks because your baby is getting too big” – Did you know that, according to ACOG:

‘Induction of labor at least doubles the risk of cesarean delivery without reducing shoulder dystocia (rare situation where baby’s shoulder can get stuck at delivery) or newborn morbidity(complications). Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.’