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Another discussion topic re: induction
I have a dear friend that is expecting her first baby at the end of next month. She had a really rough road to get pregnant including multiple losses and subsequently was diagnosed with a blood clotting disorder (not sure the name but its not Factor IV or MTHFR). She is on a blood thinner (Lovenox) for the duration of the pregnancy but will be switching to Heparin at 36 weeks. Anyway, we were talking last night and she is entertaining the idea of early induction. First off, the OB will not let her go past 40 weeks regardless because her disorder causes premature aging of the placenta and the risk of stillbirth increases quite a bit. So if she would go to 40 weeks and not go into labor on her own she would be induced then. However, she is leaning towards induction at 39 weeks for a few reasons- partially because of the fear of stillbirth and also because she will not be able to get an epidural within twelve hours of taking her blood thinners so there is the worry that if she goes into labor on her own she would not be able to get the epi. If she had a planned induction she would be able to schedule her meds accordingly.
What are your thoughts? I am just curious as obviously it is up to her and the OB to decide but I was just thinking about it today and wondering what others would do. After being induced with Ella for medically necessary reasons when I was nowhere near favorable and my body was clearly not ready, I feel like my advice would be to wait until at least 40 weeks. Ella didn't tolerate labor well at all and I was thisclose to a section which I am confident was due to the fact that my body wasn't ready (and I know her IUGR played a part as well). I think as far as the stillbirth concern that is definitely a big factor to consider but possibly NSTs at the end could provide a sense of comfort in that area? The other thing is the ability to get an epidural- I am a big baby so I am sure that especially the first time around the thought of not being able to get one would terrify me. However I had failed epis with both kiddos due to spinal curvature and I lived to tell the tale and I know many of you on here did med free births so I don't think that would be a reason for me to induce. Thoughts?
Re: Another discussion topic re: induction
In your friend's situation I would ABSOLUTELY do an early induction. The entire reason why I had to be put under general anethesia and miss my child's birth was because of blood thinners. So I would have much rather had a controlled environment.
Inductions just for the sake of convenience I have a hard time with though.
With regards to your friend, I would definitely be induced. I did not have a pleasant induction w/ DS1 but he is here and he is healthy. Given her current medical situation, I would definitely support her decision to induce.
I would probably wait to make that decision if I were her, unless she needs to decide very soon. I know the difference between being induced with no progress vs being induced with progress.
With Maya I was not at all dilated, but was induced because my water broke and I did not start labor on my own after 12 hours. I didn't deliver for a very long time (about 31 hours) and was very close to a c/s.
With Cam, I went in 3cm dilated and delivered within 5 hours. It was a piece of cake.
So I guess what I'm saying is based on the concerns, I would definitely induce early if her cervix if favorable. If not, I might wait it out a bit until it is.
I was induced at 39 weeks due to MTHFR (finally diagnosed after having several losses). I had an excellent experience with my induction, and will do the same if we are blessed with another child. I had NST's every week for the last month or so, and it does help ease your mind. If she really wants an epi, then that would be a big deciding factor. I didn't get an epi, so that wasn't a factor for me. I had heard so many induction horror stories, but I just went along with what the dr suggested and got mentally prepared for anything that might happen. My baby was also measuring bigger, so I'm glad they did induce when they did! The dr also assured me that a baby born at 39 weeks is fine developmentally, which is something I was worried about.
I would say that being induced is a wise decision given her blood clotting disorder and prior losses. Tell her good luck!