Oct 05, 2010 03:10 PM
I am in the 39th week of my first pregnancy and my last doctor's appointment was yesterday, the doctor checked me and found that i was softening but not dilating. He scheduled my next doctors visit in 1 week and stated that if they was no change, he would induce labor the day following that visit. I haven't had any serious issues during my pregancy, I did test positive to the group B strep test, but will receive the needed antibiotics when I arrive at the hospital. But I am really against the idea of induction. I don't really understand why he is so quick to induce me. I want the baby to come when she wants to come with as little intervention as possible unless it is absolutely necessary. Is the doctor doing this because of the positive strep B test? Also, what are the negatives or risks to inducing at 40 weeks? shouldn't induction be if the pregnancy goes past 42 weeks? I am totally confused, but know that I need to follow my gut instinct and it is telling me to give it time and try natural inducing methods.
Thanks for any comments or advice
Oct 09, 2010 01:36 AM
The Centers for Disease Control guidelines for women who test positive for group B strep say nothing about inducing labor, and, yes, you are right that the risk of stillbirth doesn't begin to rise until after 42 weeks. Unless your doctor can give you a compelling medical reason for inducing labor, I would refuse. Inducing labor in a first-time mother roughly doubles the likelihood of her labor ending in cesarean surgery, and the odds are not reduced by using cervical ripening agents. It also exposes her and her baby to the potential adverse effects of induction agents, some of which, although rare, are life-threatening. Unless there is a good reason to do otherwise, it is safest and healthiest for labor to begin on its own.
As for why your doctor is recommending this, you should ask him. You might like to read this blog post before you do, though. It makes clear that many inductions are elective inductions initiated by the doctor, although the woman herself thinks the induction was medically indicated, and it makes clear that many doctors are not informing women of the potential harms, which they need to know in order to make an informed decision. If you want to know more about your right to informed consent and refusal, this article can help.
I will add, too, that your doctor's peremptory announcement that he plans to induce you is not a good omen for his practices and philosophy in general. If you don't already know it, I would find out his cesarean surgery rate post haste. The World Health Organization recommends no more than a 15% cesarean rate, and numerous studies bear out that the cesarean rate can safely be below 15%. If your doctor's rate is much higher than this--or he won't tell you what it is--you will know that you will not be able to trust his judgment in labor. It will then become more important than usual to make sure you get satisfactory answers to the questions in the informed decision-making article to which I referred you before agreeing to any medical intervention--barring an emergency situation, of course.
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Please note that this Forum is intended to help women make informed decisions about their care. The content is not a substitute for medical advice.