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Forced induction

I am a Type 1 diabetic (I have had is for 35 years) and am currently 24 weeks pregnant.
I have been told that I will be induced at 38 weeks.
I understand the reasoning for this - as people with diabetes tend to have higher blood sugar and larger babies - but I am doing my upmost to keep my blood sugar within a good range (and my baby!) Can my maternity unit still insist that I am induced if my baby is not too large?

I know they will have to put in a sliding scale (glucose/insulin) but it seems that induction is for the maternity units convenience.
I am most concerned at having to be induced if there is no need. They have told me that they only do it with drugs rather than a sweep - and I have read that inducement can lead to a longer labour - which no-one wants and the whole of it will have to be spent in the hospital - which I don't want! I have had diabetes for so long and have found that in previous time in hospitals - they are very poor at dealing with diabetes, and feel that I can look after myself better.

Can the hospital (East Surrey in Redhill) absolutely insist on inducing me? Can I refuse? Can they refuse to deliver my baby if I do not turn up for the induction and let nature take it's course?

Any advice will be gratefully received.
Cheers ladies xx:\?

Replies

  • Argh just wrote a post and its disappeared!
    Basically, you can refuse an induction, they cannot refuse to deliver you, but they will try to make you feel bad and guilty if you dont do what they suggest. You do need to be strong willed though, and do what you feel right. Its YOUR body, YOUR baby, and YOU are responsible. Good luck! xx
  • This is going to be long & I am going to be brutally honest too, not to scare you but as a warning to trust your instinct...

    I had an induction at 38 weeks & tbh it was horrible,

    The sweep on Wednesday itself was ok but I was checked in on Monday night & didn't have my son till Friday morning & I had so many random doctors examine me it was very intrusive, half of them didn't even bother to introduce themselves,!!

    I was told at one point (on wednesday am, when they did the sweep) that i was 2cm dilated & would go down to the labour suite that day but that it would be later in the afternoon as they were quite busy, at 11pm I was finally seen by yet another doctor who after examining me said I was only 1cm dilated & wouldn't be going to have my waters broken then as it was now too late (I had not been examined for 12 hrs at this point & had only seen a nurse once), this was after I spent the whole day gearing myself up to have my baby.

    I was so fucked off I spent the whole night in tears & was exhausted, so the next morning I told the nurse I was going home, she said I couldn't leave!! so I lost it & really kicked up a fuss and that is when I finally got to see a consultant who said that I was dilated enough & she didn't understand why the other doctor had said I wasn't!!!!

    I was taken to the labour ward 7 hrs later & had my waters broken at 6pm & was then put on a sliding scale in one arm ( practically butchered to get it in) in such a stupid place I couldn't' bend my wrist ( only a stupid male doctor would think to do it like that) and I had the stuff that speeds up labour placed in the other arm meaning I couldn't walk around or even go to the toilet & had to have a catheter, Which is the polar opposite of what I had discussed in my birth plan.

    I managed to last for 7hrs with the contractions getting stronger & stronger but eventually asked for an epidural, the doctor who did that was the same idiot who did the one in my arm & totally messed that up too, it took him around 30 minutes to get it in & all the while I was having really harsh contractions but he got there eventually, sadly it only worked for about 30 minutes & then all the pain was localised in my right ovary but all the anesthetists were now too busy so I didn't get it moved. It was not fun.

    All in all it took 16 hrs from waters broken to having my son & I later found out that that is far too long for a diabetic labour, as when my son came out of me, his bm was so low he was hypoing & had to go into SCBU for 48hrs. Which was very scary & upsetting.

    The whole process from checking in for induction to getting him back from SBCU was a really traumatic experience & if I have another kid I am insisting on a c-section as no matter how much they can try to assure me that things will be different next time, I just know it will be the same.

    2 weeks after being home with him I had terrible baby blues & the only thing I could focus on for a few days was the the labour & how bad it was. Never again.

    Oh & about knowing the hospital not being able to cope with diabetes, don't' I know it,

    I hypoed twice in 24hrs when I first got there due to not being given food on time or having such inadequate meals provided. I am a type 2 & had never had a hypo & all through my pregnancy I kept my bms & weight gain so well controlled that I didn't even have a dizzy spell but for the 3 full days & 4 nights I was in before having my baby I had 3 hypos & after the first 2, my mum & husband were bringing me my meals as what the hospital provided was so laughable & completely inadequate. I had brought snacks as I had been advised to do by the diabetic clinic but I didn't expect to have to provide the 3 main meals as well cause of the stupidly small portion sizes not to mention grossness of the food for any pregnant women let alone the lack of diabetic options.

    Sorry to rant on but do what you think is best & try to keep completely in control of your stay. If this post can prevent another women having to go through the same as me then it is worth it.

  • I don't have any personal experiences to share with you but I just wanted to reiterate what others have said about you not having to go ahead with an induction just because that's what they've advised.

    I also don't necessarily believe that things like this are always offered because it's in yours or your baby's best interest. I don't mean that they do it just to suit themselves, but I think often they do things because it's standard procedure and don't actually look at the individual circumstances of each case.

    i think it sounds like you're concerned they're recommending induction because it's standard procedure for those with diabetes and not because you necessarily need it. I would ask them to lay out exactly why they want to induce you and then think about it carefully before you decide what to do. If it were me, and I feel like you th at I would rather avoid an induction if possible and if it isn't necessary, I would ask them to monitor the baby's weight etc and if all is progressing normally hold off any induction. Even if your baby is big, is that necessarily cause enough to induce you? I am having a big baby (he's been measuring on 97th centile since his 20 week scan and I've had lots of growth scans since) but I don't view that as reason enough to be induced early. Surely it's better for your baby to come when s/he is ready rather than force him or her out into the world early just because there is a chance s/he might be big and that might be harder to deliver? Apologies if I'm missing something else about being diabetic and being in labour / giving birth - presumably you also need to control your blood sugar throughout, but would that not be the case either way - being induced or going into labour naturally?

    I'm not saying you should definitely refuse the induction, but if I were you I would ask them to lay out all the bare facts first so you can make an informed choice. Don't let them bully you by saying that you should be doing the best thing for your baby - obviously that's what you should be doing and that's why you want to be sure that inducing really is the best thing. I think there's a lot to be said for allowing a baby to come into the world when the time is right for them!! Sorry if I am banging on!
  • Thank you so, so much for your replies - I know the interest of my baby is the most important thing - which is why I am so concerned - labour is distressing enough for the baby - without the addition of what Beebee went through.

    I am going to see the consultant on Tues - and if I get to see the head honcho I am going to have a full discussion with him and want them to go through EVERY detail! I do not want an experience like Beebee, which is what I am expecting unfortunately form past hospital care as a diabetic.

    I know scans are only approximate - but surely the difference between a 6llber and a 10llber is possible. I came out of my 'lil Mom and I was 9llb11oz!

    I undertsand inducement if the baby is huge - but not if it is normal size - and that is what I object too.

    Cheer laidees - I will let you know xx




  • Hi

    You can refuse induction it is your baby, your body and don't let them bully you.

    Also be aware that scans can be quite inaccurate paticularly with larger babies. I had a friend who had gestational diabetes which she controlled well. They insisted on inducing her at 38 weeks and thinking they new best went along with it. Her baby was born weighing 5lb 9oz - hardly big at all. Trust your instincts.

    I was also with East Surrey and had the opposite problem to you. My baby was measuring small for dates. I had many scans which showed everything was fine and she was naturally small. She was growing well but they still wanted to induce. I was unhappy with this and couldn't understand the reasoning. They would just keep writing in my notes induction at 40 weeks despite my saying I was unhappy with that and didn't feel that intervention 'just in case' was necessary. I had a terrible experience with them in my first pregnancy and was bullied into induction (due to high blood pressure which I knew was just white coat hypertension). This time I just refused deal with them in the end. I initially decided to change hospital but at the last minute changed my mind again and bypassed the NHS and their catchall policies and hired an Independent midwife and had my perfectly healthy 6lb 9oz baby at home (small compared to average but fine for me and hubby born 6lb 10oz and 6lb 13oz respectively and my first daughter 6lb 11oz).

    I am not suggesting a homebirth for you but just pointing out that East Surrey are not very women centred in their care (as told to me by the three Independent Midwives I interviewed all of whom wanted me to change hospitals just in case I needed to transfer if I took them on). I found East Surrey terrible to deal with, I only booked with them a second for ease of antenatal appointments but if I ever get pregnant again I wont touch them with a barge pole. Stand up for what you want and don't let them bully or scaremonger you in to toeing their line if you don't feel it is right.

    [Modified by: Bec + Emi + Thea on March 20, 2009 12:29 PM]



    [Modified by: Bec + Emi + Thea on March 20, 2009 12:31 PM]

  • maybe im being naive, but i would like to add a different perspective to whats been said ( as i have GD and am being induced on monday) the reason why i am going along with the inducation is purely for the small reason that still birth risk is much greater if u choose to leave your baby, and i'm sorry but if i choose to leave it to nature and that happened i don't think i could do it. Also why would thre hospital want you to have an induction if it wasnt necessary? that's just using resources, time and staff that they needn't be needing, and the chance of needing assisted delivery is higher with induced labour. i'm not having a rant just getting my point across. i have only ever had good experiences with my hospital Addenbrookes Cambridge, and my opinion is only from what i have experienced there! let me know how it goes! xxxx
  • hi
    i have no personal experience but i do have the experience of a friend who had diabetes (albeit undiagnosed at the time) who gave birth at full term to her baby and she lived a week only. now this WAS because it went undiagnosed and the baby couldnt control her insulin production etc and couldnt survive. her other children are fine as it was recognised early. The doctors would never induce you unless absolutely necessary hun. my mum was induced with all 3 of us. labour can be just as long without induction my first labour was 40 hours naturally.

    just be careful. whats a few hours of pain to have a healthy baby? seriously even if it was a natural birth it will bloody hurt! and last forever! if it is your first you have nothing to compare it with.. also i would speak to your midwife about it all for advice on waiting hun xxx
  • Induction does carry risks to both mother and child. Hospitals tend to other induction as routine in certain situations rather than looking at individual circumstances and cases as it saves time and also as protocol. I agree that induction is the best thing when there is a true medical reason and an actual risk to mother or child it is the right thing to do but all to often it is offered as routine. Everyone has the choice to accept and go along with protocol or to think and question whether it is actually necessary in their situation. It was not necessary in either of my pregnancies but the hospital wanted to purely because that is the ways things are done . In my first pregnancy I accepted that and went along with it but later relised that different hospitals and different professionals may have looked at it in a different way.In my second pregnancy I decided that I had to research, look into things, look at the facts and make a decision that I was happy with.

    Induction is offered as routine for people with diabetes at 38 weeks regardless of the size of the baby, if you want to ask for the size of the baby to be checked and then make your decision the hospital should honour your wishes.

    Induction is so routine that people do not question the issues that can arise from it and people should be made more aware. From my experience the hospital did not advise me of any of the of risks of induction.

    I think people should question and look into the facts of induction rather than just accepting it if they don't feel it is right for them. I don't feel that is being irresponsible but the actual opposite and someone taking the care of themselves and their baby into their own hands rather than just blindly accepting a protocol.

    You have to do your research and decide whats best for you. If nduction is the best thing then make sure it is your decision made with as much info as you can get your hands on. It is hard to take the responsibilty I very nearly just went along with what was suggested but the IM's I spoke to (one whom had been a sister or ten years at the hospital I was going to transfer to and was later a lecturer and trainer) all felt it was not necessary. I took a lot of advice and did a lot of research before making my decision and you would need to too to feel truly happy in the decision you make.

    I am sorry I know that what I am saying is pretty controversial to people on this site and my intention is not to antagonise.

    [Modified by: Bec + Emi + Thea on March 25, 2009 07:39 PM]

  • hey, .

    I think that you should keep an open mind and not make any decisions now. You need to go for the safest option for you and your baby at the time and until then find out as much as posible so you can make an informed decision. You may find that closer to 38 weeks you want to meet your baby sooner rather than later.

    I have to agree that I wasn't told about any risks of being induced, I hated being overdue in hot weather, was swollen, uncomfortable and didn't want to wait to meet my baby.

    One good thing about being induced is that once they start you know you will meet your baby soon.

    I was also induced at East Surrey, I cant say I had the best experience that was down to my body not doing what it should abd my lo being very cramped (normal bump, big baby!) and being back-to-back. Yes induced labours can be longer but then just be open to pain relief options such as an epidural.

    The most important thing is that you and your baby are safe, yes you can refuse an induction but it would be silly to put your baby at risk.
  • Thank-you so much for all your opinions and it has given me a lot to think about. The consultant has reassured me that they will not 'force' me to do anything - I said I am remaining open minded about it - but wanted to let them know I am not keen on it if is at all possible to avoid it. (Apparently raspberry tea, lots of curries and sex nearer the time - LOL!!!)

    I am almost more put off by the sliding scale (insulin and glucose) - I have had very bad experiences of this in hospital in the past and found most nursing staff to be quite inadequate at dealing with it. It always so stressful - and I think giving birth is going to be traumatic enough!

    I will address this with the diabetic nurse when I speak to her next week. I am not making any decisions yet - but just wanted to be forearmed! - and am doing my research. I can't tell you all how much I appreciate your input.
  • I personally wouldn't accpet induction purely to meet my baby quicker. Babies generally come when they are ready which is hy induction can lead to a long labour for some - the baby just isn't ready to come. In my case it lead to a very short and intense labour and caused problems for my baby. i was told I had a reaction to the pessary and that was also why I was told to avoid it second time round. I don't give two hoots about myself but I was concerned about my baby when induction was mentioned second time round I was keen to avoid her being putting under any distress after my experience first time round. Had I felt it was truly necessary though I would have been banging on their door begging them to get her out. Because IUGR would have had a more negative effect on my baby than the induction. It's a matter of weighing things up in your individual situation
  • I think what started me off - and to question it - was that at my first appointment - they barely glanced at my notes and went you are diabetic you will be induced at 38 weeks. I felt like a product being moved through - which is why I wanted to look into this - esp with it being my first - and none of my friends have experienced being induced.
    I just keep my fingers crossed for a healthy baby - that is what we are all aiming for!

  • I also don't necessarily believe that things like this are always offered because it's in yours or your baby's best interest. I don't mean that they do it just to suit themselves, but I think often they do things because it's standard procedure and don't actually look at the individual circumstances of each case.

    I completely agree - they do what's best for them - they never look at the individual cases - my sister too had an awful time bos she was forced into being induced.....she learnt though and refused to be induced with her second and third babies! Go with your instinct! xxxx MKB 19+5
  • Just wanted to share with you my story of induction - I was induced at 39 weeks, and I thoroughly enjoyed the experience. My waters broke spontaneously about 20 hours after the first dose of prostaglandins (I had two then spent the night resting on the ward). I spent the next three hours bouncing on a birthing ball and walking about, as the contractions were irregular. About 11am they became a lot stronger and about 5 minutes apart, at which point I went back down to the labour suite. I was 3cm dilated, and by 2pm I was fully dilated and ready to push. Rachel arrived at 3.45pm, perfectly healthy and weighing 7lb5. The midwives were fantastic, and I don't think it could have gone any better.

    So don't be put off the idea of induction just because of any bad stories you hear - it can go either way.Trust your instincts, because you will make the right decision for you and your baby, I'm sure.

    Good luck!

    Hannah xx
  • I am in a different situation i have severe S.P.D and am trying to get an induction but to quote the midwif i spoke to this morning according to the clinical excellence rules i have been told that it is not safe to induce a baby before 39 weeks due to possible respiratory problems so i find it very interesting hearing about all the women who have been induced at 38 as i am being told this is not possible. I have been advised to be admitted to hospital for pain relief until she is born but am not willing to take morphine. hope everything goes well
    Sarah x
  • hi sarah sales i was induced at 38 with my youngest because my spd meant i couldnt walk or care for myself image it took 5 days for the gel to work! they can and will do at 38 if you are in unbearable pain but you have to show them its that bad and please please hun make sure ur delivery mw knows how far ur knees can go appart i was put in stirrups and now a year on still cannot walk unaided and the spd has not stopped. back to origional post i had gestational diabetes my daughter was allowed to go 4 days over and weighed 10lb 11oz she was v poorly at birth her bs wouldnt stablize she was shaking and i remember crying thinking isd loose her that first night. she is now two and everyday i think how lucky i was that something worse didnt happen. it was a looong labour and i was sooo sick i couldnt stay still enough for epi or pethadine she was born with no pain relief and no stitches thank goodness lol do what you thionk is best but let them monitor you incase xxxxxx
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