I am neither a midwife nor a doctor, so I cannot advise you what
to do. I can, however, suggest questions for you to ask that will
help you make informed decisions about your care. To help you
remember, they form the acryonm BRAIN. I don't know who originally
came up with this acryonym, or I would give them credit.
Benefits: Why is this being
recommended? From reading your story, I would ask the doctor to
clarify the connection between inducing labor and the baby not
being engaged, meaning the head is below the pelvic brim. The fact
that your baby is not just small but is falling behind over time
and the presence of fibroids means that everything isn't as you and
your doctor would wish, and inducing labor may be the right thing
to do. However, it isn't uncommon for the head to engage only after
labor is well established, and the contractions press the baby
lower in the pelvis.
Risks: What are the
potential harms, including the need for further medical
intervention? How likely are they to occur? I can tell you that
inducing labor, especially inducing labor in a first-time mother
whose cervix, the neck of the womb, isn't ready for labor*
greatly increases the likelihood that the labor will end in a
cesarean. If you do decide to agree to induction, discuss with
your doctor whether you can wait for a favorable cervix
if it isn't already.
Alternatives: What are the
alternatives, including watchful waiting? What are the benefits vs.
harms of the alternatives?
you have considered the information you have been given, what is
your heart or gut telling you to do?
No or not now: You have the
right to say "no." Informed consent is meaningless without the
option of informed refusal. If you do decide to say "no," I
recommend discussing the circumstances under which you would
change, or consider changing, your mind.
*In pregnancy, the cervix is long, thick, firm, and
closed like the neck of an old-fashioned Coca-Cola bottle. In
preparation for labor, it softens, thins, shrinks back into
the body of the uterus--purse your lips and then draw them back
against your teeth to see what I mean--and begins to open.