Jen, I know you work in this field and was hoping maybe you could give me a little advice.

My due date was this past Saturday (17th) and the baby's still not here. My doctor wants to perform and ultrasound to get an idea of exactly how big the baby is and then do and induction of labor this Sunday, only a week after the due date.

My boyfriend and I were both pretty sure from the beginning that the baby would be due around the first week of February, but it's the doctors who are telling us it should have been Jan 17.

I've had a good, healthy pregancy and the baby's always had healthy vital signs and lots of healthy movement. I'm just feeling a little nervous about this procedure and am not all that comfortable about it.

Thanks for any advice you can give.

IOM, risk doesn't go up significantly until after 42 weeks, so realistically you should be able to get away with another week.  An ultrasound for size is NOT necessary unless you're measuring way too large.  Ultrasound this late in pregnancy can easily be off by a pound or more.  Plus, size doesn't always indicate whether or not you can birth safely. I had a 9lb 14 oz baby vaginally, at 41+3 weeks, and had I been under the care of a traditional OB I'm sure I would've ended up with an induction at the least, and a c-section at worst.  Because this is your first baby, induction puts you at a higher risk of needing a c-section. C-section is overall a riskier method of birth for both mother and baby (in normal healthy moms and babies), so that's something to consider.  Now, risk does increase for baby incrementally after 40 weeks so you want to pay close attention to how much baby is moving. But usually birth goes best when left largely unhindered by medical intervention. How's your doc calculating your due date? Based on your last period or an ultrasound?

I'm basing on period. The doctor's basing on ultrasound and blood testing and believes I was still able to have my period while pregnant.

What worries me is she wants to use a drug called cytotec. She told me it's not fda approved but doctors use it all the time. I did some research on it and think it's better to wait another week. And I'm worried about having to do c-section if induction doesn't go according to plan.

As much as I'd like to see my little guy, I'd rather he comes when he's ready, not when he's told to be ready.

Thanks for the help Jen. I appreciate it. :-)

If your last period was reliable, normal, and regular…. then dating based on LMP is THE most accurate method of dating. Period. (no pun intended).  Ultrasound is fine, but there's a degree of error in that.  And bloodwork???  Doubtful. We NEVER date based on bloodwork.  All the bloodwork does (early in pregnancy, before 10 weeks) is tell us if your levels are rising appropriately (indicating a viable pregnancy) or tell us that you're probably far along to be able to do an ultrasound and actually see baby. 

Cytotec is actually an asthma drug that they discovered put women into labor (or caused them to miscarry)... it also helps to soften/ripen the cervix.  I used it as a student some, but only when I didn't have a lot of options and we needed to get labor going for the sake of mom or baby's health. 

Yeah, I've only used cytotec in extreme circumstances.  Mostly in fetal demise where the cervix was in NO WAY ready/ripe enough to expel the fetus. (I was L&D;in one of the largest high risk programs in the US)

I am assuming you are a prime…but what was your cervix last visit?

The preferred method of a routine induction was the old saline foley balloon to ripen the cervix for a regular term pregnancy…along with pitocin…and the risk of c-section is high.  So unless you are ecclamptic…or there is some genuine concern regarding the baby's overall health,  (is baby moving?) I'd tell them no.  And on a Sunday?  Sounds like your doctor has plans you might be spoiling.  (Jen…any conventions coming up that you know of? Some OB doctors do pull that kind of shit)

Sounds a bit strange.

I'd go for the ultrasound….but unless she has something really significant to say…I'd be telling her no.

I'm at one centimeter. No problems with the baby. No health issues with me. Blood pressure was a little higher than previous visits, but they said they weren't concerned about it. I just feel like this doctor is trying to rush things. I'm hoping the other doctor is in tomorrow because I wanted to talk to her about it too and see what she has to say.

All the docs but one in our clinic try to get people delivered by 41 weeks, for some reason.  I think sometimes doctors want everything tidy and wrapped up, and I'm sorry but birth is just NOT like that.  Babies typically come when they are supposed to.  You shouldn't be able to schedule a birth like a hair appointment… it's one thing if there was a problem, but there isn't here. You have every right to refuse the induction.

Now that being said; after 41 weeks (or 41+3) you should probably start having some special tests to make sure that the baby is ok (either a nonstress test, basically just 20 minutes on the fetal monitor -- or a biophysical profile, a special ultrasound where they look to make sure the baby isn't compromised at all).  If you do that, there's no reason not to let you to go 42 weeks. 

I gotta chime in just to reinterate what Jen said about you having a right to refuse the induction.  Too many people (and I am NOT saying you are one of them) take whatever their doc says as the gospel.  NOT TRUE!  As long as you are comfortable with waiting AND both you and the baby are doing fine…you can say no to the induction.  Trust your instincts.  And make sure the boyfriend is backing you up…don't let anyone bully you into something.

Not to put a damper on the situation but I can't tell you how many death certificates i've had to do for baby's where the mom waited over 40 weeks and then one day the baby stops moving. I alway's think if they had induced just one more day earlier the baby wouldn't have died. Please make sure the baby is moving like normal and trust your instincts. Don't be afraid to go into labor…...

So I just got back from the hospital. Everything is fine with the baby. The ultrasound looked great. The ultrasound tech is estimating him at about 8 pounds. The nurses doing the nonstress test both said he has very good movement and a nice healthy heart rate. They even recommended giving him until Wednesday to come on his own.

I'm not really all that afraid of going into labor. I'd be happy if I were on the way to the hospital to deliver right now. I'd actually perfer it. I'm more scared of making the wrong decision.

I'm glad everything is alright!

IOM, can't wait to hear about your new bundle of joy once it gets here… you'll have to let us know!!!!  I was dreaming of babies last night, which often happens when someone I know is in labor (I know, it sounds crazy, but it's happened enough that I swear I'm picking up on something sometimes). Just wondering if it might be you.

Hmm…any news on the kiddo?

nope, not yet. I'm assuming that she's in the midst of feedings, diapers, etc. at the moment…

Well, he's finally here. The little guy decided he wanted to come out on his own, so I'm glad we waited just a little longer. Woke up at 1:30 am Tuesday, just 6 hours before new scheduled induction, and it was time to start heading over to the hospital. I'll post some pictures later when I get a chance to put them into the computer.

Congrats!

And sounds like everything went well….

YAY!

Congrats! I'm so happy for you!

Congrats darlin'!!!  I'm glad you waited, too. 

heyyyyyy another chatter baby!!!!
congrats!!!  I hope everything is well with mom and son.. and I am sure dad is beaming!
Can't wait to see pics..

yay!

congratzes!