How do you decided when to get induced/C-section?

[MacMacMoo]

If you look at this pregnancy and this pregnancy alone there is no reason for me to have an induction. However based on my past pregnancy history I am now given the option to induce as early as 37 weeks.

I know an option is an option and does not mean you have to. But I want to have a kicking screaming baby in my arms, and the soon that happens the happier I'll be. HOWEVER I want my kicking screaming baby to be healthy, I don't what my fear of carrying a baby to term and losing it to case health issues.

So help me decided when I should induce. (We are currently 20 weeks, so we have some time to think, but we do have to pick a date)

[veronica]

Edited. So sorry, I got caught up in the post and missed the siggy. I completely understand. I can see how the decision will be very stressful. I agree with the other momma's, that perhaps testing the progression of the pregnancy in the final weeks, will certainly aide you in making the decision.

[SnuggleBuggles]

My good friend had a late term loss with baby #4. She had been to something called parovirus or something like that with that pg, that caused the loss and the virus is still in her system. When she got pg again the high risk fetal medicine practice really wanted her to be induced by 37 weeks, no later than 40 weeks. She had 3 healthy pregnancies and birth in her past and really wanted to avoid intervening. She is also very much a fan of avoiding unnecessary interventions just on principle. She held them out till 41 weeks. It was her comfort zone and, with the support of her midwives, she was "allowed" to go that long but there was a lot of pressure in those final weeks. Healthy baby. I know she had a really hard time putting aside the prior loss and remembering the this baby was healthy and thriving. She debated it all for a while. I don't envy the decision and I wish you the best of luck making it.

Beth

[candaceb]

Because of the classical c-section that I had for my first delivery, I was supposed to deliver at 36 weeks. We had the first amnio at 36 weeks 2 days and it was negative - lungs were not ready. Repeated it 7 days later and it was still negative. They didn't want me to go past 38 weeks because of balancing the risk to me and the risk to the baby, so I delivered at 37 weeks 6 days. DS's lungs weren't ready, so he went to the NICU for a few days and was on CPAP. He is fine now. At 37 weeks, chances are that the baby will be fine even if she or he does go to the NICU. I would be more comfortable going earlier with a girl than a boy (statistically, white boys have lungs that are slower to mature).
If there is a next time for me, they'll be looking to deliver at 35 weeks, and I'm not real happy about that, but I know that it's all a guessing game of balancing risks.

[american_mama]

I can imagine how much tension you feel between wanting baby to have as much time to grow inside and the fear of having another stillbirth. Or maybe I can't imagine, because I haven't BTDT. I did find this thread about others who had to balance fears/mother's safety/baby's safety in scheduling a birth, so it might help you or give you ideas of who you could PM for more info.
http://www.windsorpeak.com/vbulletin/showthread.php?t=371464

[bubbaray]

Are you under the care of a MFM/Perinatologist? If so, I would just let them pick the date. That is what I did with DD#2. I will admit that I asked him for a week earlier and he laughed (and said no). I had her via a scheduled c/s at exactly 38w. It was important that I not go into labor for medical reasons.

GL!

[pb&j]

I had a loss at 24 weeks. I was so anxious my pg's w/dd and ds, that going to term and waiting to go into labor was not an option. I was induced around 39 weeks with both, had a very favorable Bishop score with both, and had very easy, fast labors (no pit required) and healthy kids. I have zero regrets about scheduling induction, it gave me a lot of peace of mind. I was just a total basket case during pregnancy, and my OB lives by the philosophy that if it's good for the mother, it's good for the baby. In my case, getting my kids out of me and into the world was very, very good for the mother.

Hugs to you. Pregnancy after loss is really tough.

[Uno-Mom]

I'm confused....your current pregnancy does not require induction but you have to choose an induction date?

I think it's because Macmacmoo's son, Matthew, was stillborn at term.

I have no helpful advice to offer but wanted to send you my well-wishes! I know there are several moms and dads here who lost their children at birth, but for some reason the experiences you've shared on here, Macmacmoo, have really stood out in my head. Maybe because I first read Matthew's story right after I learned that an IRL friend also lost her son at birth. I literally lost my breath, thinking how she must have felt. By the way...that same friend recently welcomed her new healthy (kicking, screaming I'm sure) daughter!

Anyway, blessings on your decision.

[llama8]

Could you also ask your OB about weekly non-stress tests to check the baby.

With my last pregnancy, I had an anterior placenta (i have it again this time) which meant I hardly ever felt the baby move. I was paranoid ( I had a 17 week loss prior) so the doctor after, 30 weeks, had me come for a weekly ultrasound and hooked me up to a machine for 30 minutes to check the heart rate of the baby. According to the docs, this should pick up any problems or distress.

It may be extra piece of mind for you. As for induction, it is a tough decision. It is totally understandable for you to want to go early. (Maybe they could give you steroids to ready the lungs a little sooner.)

[hillview]

I would defer to a doctor if it were me and I'd have no problem with an earlier birth/induction. HUGS.

/hillary

[ThreeofUs]

I decided, after the extreme trauma of DS1's birth for both of us, that I would never do that again. In my delirium, I hear I even told the doc sewing me up to "put in a zipper". :)

So my ob and I talked early on about when we should schedule a C. She said after 38 weeks was best for the baby, but with my history she was willing to schedule a little earlier IF the baby was doing well.

At 34 weeks, my blood pressure was going up and the baby was measuring 40 weeks. I did daily non-stress-tests and we scheduled for 37 weeks 5 days.

What I liked about this was that we kept our options open, and both of us knew the history and the parameters around which the scheduling decision was to be made.

You have every reason to want to go early. Talk to your OB and see what the parameters are for her/him.

[Minnifer]

Could you also ask your OB about weekly non-stress tests to check the baby. I was going to suggest even more frequent NSTs, and u/s monitoring (recognizing of course that there is no "perfect" monitoring that can catch everything). I'm so sorry for your losses.

I had a failed induction when my placenta started to look "aged" at 40 weeks and then an emergency c-section that was relatively traumatic physically. As a result, I will be having a scheduled section this time. My dr (who is a high risk MFM) would like to wait until 39 weeks as that is now the recommended guideline (used to be 38) *but* that assumes everything is looking fine w/the baby and me (I'm 44 and this pg is already somewhat high risk for non-age-related reasons). And that needs to be the determining factor - I have no interest in pushing it further if it's going to cause additional risk (again, recognizing this is all very unpredictable).

In a way, deciding to do it earlier gives you more "known" risks (since there's good data out there about how babies do at 37 weeks) versus the unknown risks of you taking the pregnancy further, and I can definitely understand wanting to go with the known. I also agree with PPs that you should ask your MFM what s/he would suggest given your full history (not just how this pg is going). Best wishes with your decision.

[Dream]

:hug: I have no experiance or knowledge on this but kind of got scared reading it.

Is there a reason why a baby is still born in a normal pregnancy with US showing everything progressing normally?

[rin]

:hug: I have no experiance or knowledge on this but kind of got scared reading it.

Is there a reason why a baby is still born in a normal pregnancy with US showing everything progressing normally?

Sometimes yes, sometimes no. Sometimes the cord can get wrapped too tightly or compressed, or sometimes there can be infections that aren't caught in time. In many, many cases a reason is never found. But stillbirth is honestly very rare, and the vast majority of babies are born perfectly healthy, so please don't let yourself get scared! It's the rare case and unless you have medical indications worrying about it just makes you crazy. (I know from experience! ;) I've had two pregnancy losses (one early term, one mid-term) and spent my last pregnancy (which ended in my now 10-month old daughter) a complete nervous wreck. I'm surprised I didn't have a nervous breakdown. It wasn't at all healthy for me and did nothing to make things better for my daughter.) Try to trust that your medical team knows what they're doing and that their job is to do the worrying for you!

[llama8]

:hug: I have no experiance or knowledge on this but kind of got scared reading it.

Is there a reason why a baby is still born in a normal pregnancy with US showing everything progressing normally?

Sometimes things go wrong. My 1st pregnancy showed normal u/s at 12 weeks and ended at 17 weeks. We didn't find out until the 20 week ultrasound when there was no heartbeat. There was no reason found for it ending and I am in excellent health with no medical problems at all. There was also nothing found to be wrong with the baby on any test after the miscarriage.

My 2nd pregnancy was fine (my DD is now 15 months) but I had weekly non-stress tests because I had the placenta in the front and couldn't feel the baby regularly and I was no paranoid from my last pregnancy that the doctor was being nice to reassure me.

Most pregnancies don't just end, but there are cases like mine that do happen for no reason. Luckily we are not the statistical majority because it could be one of the worst experiences anyone should go through. Needless to say, I don't enjoy pregnancy, and I can not wait to hopefully have a second healthy baby in June! I can never give up my fear of something going wrong.

[essnce629]

A good friend of mine went through the same thing a few years ago. She was just 25 years old when she had a stillbirth and had always been super healthy and lived a very natural lifestyle. First pregnancy ended in a first trimester miscarriage (due to low progesterone most likely). Second pregnancy ended in a stillbirth at 38 weeks. She didn't know the baby had died before going into labor (baby was fine at prenatal appt 3 days prior) and ended up having a super fast labor and gave birth in the car on the way to the birth center (during the winter in Alaska). They never found out the cause of the stillbirth. Third pregnancy she worked with the same group of midwives plus a high risk OB. She ended up being on bedrest from 26 - 36 weeks due to her cervix starting to shorten early and she ended up getting gestational diabetes as well. At 36 weeks she was let off bedrest and started twice a week non stress tests. The doctors wanted to induce at 39 weeks (unless the NST showed a problem) since they wouldn't have to do an amnio to check for lung maturity at that point (vs 38 weeks) and since she had gestational diabetes the baby's lungs tend to mature more slowly. She planned to try and induce naturally at 38 weeks with castor oil, nipple stimulation, accupuncture, and chiropractic work first to try and get labor started on her own in order to avoid a pitocin induction. Her son was born 11 hours after she started her natural induction. He was perfectly healthy and a good size (7lbs 1oz) for being 38 weeks. Fourth pregnancy she was no longer considered high risk and planned a homebirth. All went smoothly and she gave birth at home in the water after a fast 1 1/2 hour labor. Baby was 7 lbs 2oz and healthy.

I think if I was in your shoes I'd do what my friend did-- schedule the induction for 38 1/2 or 39 weeks, but try and induce naturally before then. My friend used my castor oil regimen that has a 100% success rate so far (I and 8 of my friends/acquaintances have used it). Even if the natural induction doesn't work, it will still help soften and efface the cervix which will make a pitocin induction more likely to work.

[sariana]

FWIW, these are my experiences:

DS: I went into labor at 29 1/2 weeks. I got two doses of the steroids for his lungs as well as various drugs to stop labor. He was born just shy of 32 weeks at 4 lbs. 9 oz. He spent 18 days in the NICU, mostly for feeding issues. (The suck/swallow/breathe reflex comes at about week 35.) He is now 6 1/2 and has virtually no health issues. He does have some gross motor delays that may or may not be related to his premature birth. (They may be hereditary--my sister has some similar issues.) He also has ADHD and Aspereger's, but I am almost certain those are both hereditary. He is in first grade and academically near the top of his class.

DD: Because of my previous preterm delivery, I received the steroid shots again in my second pregnancy, at about 28 weeks, I think. DD was born just shy of 36 weeks at 5 lbs. 14 oz. She was breech and thus a c-section, so we both got an extra day in the hospital. Otherwise she needed NO extra care. She has been perfectly healthy since. She turned 3 in January and seems to be right on track with everything.

DS did get the Synagis vaccine his first year (for RSV), but he always has been very healthy. Neither of my children even get colds very often. Both have had a couple of ear infections, and both have had pinkeye (which I got too).

So if you are able to get those steroid shots for the baby's lung development, I think you can feel comfortable with inducing at 37 weeks. Of course all babies are different, but in general babies born 36 weeks onward do quite well, especially with the extra boost from the steroids.

[MacMacMoo]

Thanks for all the advice.

We will be starting twice a week NST's late in the third trimester (they gave us the option of either starting at 32 or 36 weeks. We plan on going with the 32 weeks)

Extra ultrasounds wont help in our case, so the only extra one we will be getting is a 28 week growth scan.

They said that they'll do the lung check and do steroids if need be a week prior to the induction date. So I'll just let my midwife pick the date she feels comfortable with and we'll go from there. She seems to the air of even we we do schedule something and you and the baby are fine but your cervix is a rock, we can postpone.

[Uno-Mom]

It sounds like you have a great midwife who you can trust. Glad to hear it.

Keep us posted!