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BR- Induce? WWYD? Long
I went in today for an ultrasound/Bio physical profile like I do every Friday. Baby looked great except once again the amniotic fluid is low at 5.80. Amniotic fluid should be between 10-20. The range of 5-10 is kind of like a warning zone and anything under 5 will send you to the hospital for induction right away. So I'm pretty low. I got a really low reading of 5.10 a few weeks ago and I had to go into the hospital on a Sunday to have it checked again. It went up to 8.6 so we got to go home.
I was hoping that we could just go in and get in checked again on Sunday but my doctor has scheduled me for an induction on Monday at 4:30pm. He says that at 38w4days baby is ready to go and since we've been dealing with this since January and fluid is so low it's time to induce.
The whole reason I get a non-stess test every Tuesday and a Bio-phys profile on Fridays is because way back in the first trimester when I had that NT scan. NT scans measure 2 proteins, one being Papp-a. When Papp-a measures really low (like it did for me) it could be because baby has Down's (which I know my baby does not, we did an amnio), or it could be mean trouble might come in the third tri. Many studies show that when there is a low Papp-a found in the first tri, those pregnancies can have "unfavorable outcomes" in the third tri -all kinds of problems all the way up to having a still born. I guess this is because the placenta stops functioning like it should towards the end. Most pregnancies w/ this come out just fine but the percentage of pregnancies with "unfavorable outcomes" have a high rate of low Papp-a. (I hope I'm explaining this clearly and that it makes sense). Doc thinks that my low fluid is an indication that my placenta is starting not to function as well as it should.
Besides my low amniotic fluid, baby is doing pretty great. I feel great. No GD, high blood pressure, etc... I understand why he wants to induce but it seems so wrong to me. I really would rather my LO decide when he wants to come. I would rather the amniotic fluid be checked again as I'm sure it will go back up a little, like it has before. He says no, he wants to get the baby out before there is a problem, we've been dealing w/this long enough.
Also, I was set to get delivered by one of the midwives at his practice but he took me away from them and he's going to deliver me himself. Would it be wrong if I told him I don't want him, I want one of the midwives? Should I insist on getting the fluid checked again on Monday before they induce? Or should I just trust him since he does have a valid medical reason behind this induction? What do you think? What would you do?
DH thinks we should just trust in our doctor and that we should be grateful that we got the few extra weeks we were hoping for. DH is beyond excited to meet our little guy, I'm worried that's why he is okay with this. I'm also worried that he's okay w/ this because that means we could have just him and I at the hospital and he won't have to confront his family and tell them not to come to the hospital. His parents come in from Maui next Friday morning (for 18 days 
). His mom wanted to be in the delivery room but I told her no. I've also told DH that I want the first 3-4 hours to be just him, I and our LO. If we have Ryan Monday or Tuesday, DH won't be feeling bad keeping his parents in the waiting room for so long and sending his other relatives away I do not want to have any of them except for DHs parents in our hospital room, most likely,even the next day.
Sorry so long. Thanks for listening and any input you may have.
Re: BR- Induce? WWYD? Long
I know this is probably not the answer you want to hear, but...if I was in your position, I would induce.
It's not a suggestion your doctor is making lightly - as you said, there is a valid medical reason behind it. And I'm very, very conservative when it comes to this kind of thing - I can absolutely understand wanting to let your LO decide when the time is right, but to me, playing it safe would be more important.
I would far rather schedule an induction than potentially face an emergency situation (although an induction isn't ideal, an emergency intervention would be far more traumatic). I don't mean to scare you, but one of the reasons that nasty complications and even death has been reduced in modern childbirth is because we now can monitor and intervene in situations like this; while it's absolutely true that some doctors over-interfere, I don't think that's what's happening in this situation, as your doctor does have reason for concern.
Yes, your fluid levels theoretically could go up again, but honestly, I wouldn't want to test that theory, especially since you're already over 38 weeks so it's not as though this would be a preemie birth.
I would induce.
I agree with pps.
I'm due shortly after you and if the doctor presented me with this exact situation, I would induce. In fact, I would induce today (36w,4d) if I had to.
Your baby is already considered full-term and, in this case, induction isn't solely to speed up the delivery process. If all were well and good, I, too, would want baby to come naturally, on his own clock -- but the rationale behind this induction seems logical. It seems like dangerous complications could occur, possibly even before you realize them, and I wouldn't want to risk that. I'm sure it's disappointing -- I will probably feel a little sad if I have to be induced -- but I think it's the safer route here.
And, sorry, I don't know enough about the midwife situation to address that question. Good luck to you and I'm looking forward to meeting little Ryan!
not sure... if you are comfortable with your doctors opinion and have discussed all the possible scenarios and the risks outweigh waiting even for a couple more days then I would follow his advice and induce.
I was faced with a similar situation (although not the same thing, so I can't say what my decision would have been if I had your specific health concerns). If I had been going to an intervention happy dr. I would have been induced due to pre-e concerns at as early as 37.5 weeks. I wasn't happy with that option so I came up with a plan with my MWs - as long as I was heavily monitored (2 x's daily blood pressure readings, daily pee protein tests, weekly 24 hour pee tests, and NSTs/AFI checks every 3 days) and nothing went up they would let me go until 40 weeks.
It sounds like they allowed that for you last week - has anything changed? is there any other tests besides an AFI that could monitor you and baby's health?
Realistically it seems like induction is the right way to go without know all the issues - as long as you feel like your doctor has examined all the pros/cons and it would be riskier to wait. I totally trusted my MWs and I hope you have the same confidence in all your health care providers - a healthy baby and mom is the ultimate goal.
Finally, I would have to know more about the MW issue - were you risked out of her care or was there another issue going on? I don't really know how your practice works, but if you have the option of different care providers attending your birth I'm not sure why you would not be allowed that option as long as you had not risked out for some reason. That part doesn't make sense to me at all - did he take you out of her care w/out discussing it with you or explaining why?
Thanks for your input. Some really good points were made. I feel much better about it now. I feel a little sad about not going into labor on my own but I'm going to get over it and just look forward to meeting my little man... on Monday!
I'm so grateful for this board. Although I've only met one person in real life from the HI Nest, I feel like I know most of you and really value your opinions. Thanks again!
(((hugs))) for you!
I'm sorry that I couldn't vote to not induce - when I started reading your post, I was really hoping that by the end I'd say, "Yeah they're just being pushy" but it doesn't seem like that kind of a situation to me. If your doc wanted to induce because he was going on a vacation to Cancun or something around your due date, then you better believe I'd be all up in his business lol. But under the circumstances, it does seem like induction is the best - the safest for your LO - option.
And I can understand why you're disappointed, but just think - you can still have the delivery you want (all induction is is a kickstart, so after that you can still do things just the way you planned!) plus you get to meet your sweet little guy so soon now!
Given all that you've explained here, I'd schedule the induction. Yes, we'd prefer to let things go naturally, but with your low amniotic levels and potential risks there, naturally progressing may not be the most favorable outcome.
As for the family situation, not a reason to induce, but if you really want to be alone, it's a good way to do that as well. That said, your and baby Ryan's health and well-being is the most important consideration...take a deep breath and schedule that induction. It will be okay. And soon enough you'll be holding your son! Good luck...you can do this!
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Oh good Julie...and as Jaime said, you can only get the Pit and work through the labor on your own. I tried. But if you need the Epi, don't hesitate. Trust your instincts and your body. I was a little sad that I didn't have the whole going into labor on my own experience (being at home, wondering if it was time, telling J it's time to go, etc.) but once Libby arrived all that went away.
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