Sep 092012
 

“The baby is still high and you are not dilated at all. I am going to have to induce you if nothing happens by next week.” – OB to mother at 38 week prenatal.

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 September 9, 2012  Cervical exam, induction, OB  Add comments

  47 Responses to ““The Baby Is Still High & You Are Not Dilated At All. I ‘m Going To Have To Induce You…””

  1. Good luck inducing from my house!

  2. Really? 38 weeks? This is why I want to be a neonatologist, so I can go to these OBs and say, “why is this 38 weeker in my NICU when they were doing perfectly well still being pregnant?”

  3. Here is my response to your uh, advice OB:

    YOU ARE FIRED!

  4. Damn, I first read it as “The baby is still high and you are not dilated at all. I am not going to induce you next week.”

    ….and then I realized that today is not Thursday.

  5. It just drives me nuts when Dr’s (any Dr) treats everyone with the “one size fits all” mentality. Just because at 38 weeks she is still high and not dilated doesn’t mean she won’t, and planting the idea in her head wont’ help that!

    I have 7 children. I never soften or dilate and I carry the baby super high up until I go into labor. I can be 40 weeks, with a high and tight cervix and deliver vaganially the very next day with no problems. Just because someone doesn’t fit in the “norm” doesn’t mean their body is broken!

    • Likewise, only I was fully high, not dilated or effaced at all, and delivered within hours, not days – seven times.

      • Same with my 2nd son. Saw the doc at 1pm on a Tuesday. No dilation or effacement at that time. Labor started out of the blue in the wee hours of Wednesday morning. At 1pm on Wednesday, I was holding my son. No induction needed. :-)

  6. Can someone explain this to me? If the baby is still high and the mom is not dilated at all, then the mom has a very low chance of a successful induction…so *that* is the reason this doctor wants to induce?

    Whereas if the baby is engaged and she’s begun to dilate, the doctor won’t induce her because her body is preparing to give birth?

    Not that I think either way is a reason for induction, but seriously? Why would you say to a mother “if you continue to be an unlikely candidate for a successful induction, we will induce you?” Do these doctors even listen to themselves?

    • They wanted to induce me for the same thing. I was at week 39, and my cervix was so tight, my doctor was concerned I would go WAY past my due date, and my son was large already. I started crying when she said the words “schedule your induction” and she backed off.

      Flash forward to 40 weeks 3 days, and my water broke on its own. I did not, however, dilate. I was in labor for 24 hours and had not gotten past 1/2 a cm. I was in distress and exhausted (I accepted pitocin at hour 19). After I got an epidural at hour it took another 12 hours for me to dilate enough to push.

      Did you know that when labor happens spontaneously, the baby’s brain secretes a hormone that triggers the mother’s production of oxytocin and other labor hormones?

      I don’t think my son was ready even though he said he was ready. But after my water broke, there was no going back…

      • ” But after my water broke, there was no going back…”

        Perhaps a little more patience would’ve been key. With my 3rd my water broke and my midwife and I had patience. No markers for infection on my blood work so we just waited. 30 hours later and labor finally began, and I held my baby 1.5 hours later. Broken water does not always mean rush to the hospital and jump on their clock!

      • Actually, Kristin, if you don’t mind my sharing this anecdote– I have an acquaintance whose water always breaks prior to labor, and nothing much happens for about 24-36 hours. Then boom, labor hits, and the baby is out within 2-3 hours. She has honebirths and no cervical checks, to prevent infection. Her mother and sister labor exactly the same way. Just a thought– it’s hard to say how labor might go for any given woman without lots of interventions.

        • Anecdotally – I am the same. All three births, my waters released before contractions started. I am exceptionally lucky that my contractions began within minutes of SROM each time. Funny coincidence, with both my sons’ births, I SROM’d at exactly the same time of day – 11:30 pm.

        • The same thing happens with me. Out of seven pregnancies, six times my waters broke before contractions started. Twice preterm (at 19 weeks, babies born at 25 and 26 weeks respectively, no labour started, no infections present). The other four times it was at term, and labour started either within minutes or within six hours. And just to really screw with me, on the only occasion when my waters didn’t break at the beginning, the baby head was born while the bag was still intact, and it burst as her shoulders were delivered. LOL

      • If you get pregnant again, you could try eating a lot of oranges, especially the white part. It might help your water remain intact. My sister is trying this. She is having her seventh baby and all six of her other labors began with the water breaking, but no contractions. Only one birth was pitocin-free.

        • I’m curious about the oranges. Why would that keep the waters from breaking? (May sound snarky but I’m really curious.)

          • I had heard that they have a high amount of elastin in them, which supposedly helps with elasticity in tissues. It seems like a good thing for a lot of things in pregnancy.

          • Improbable, since I do believe the elastin protein would have to break down before being absorbed into the blood stream, thereby rendering it not-elastin.

            On the other hand, Vitamin C is a crucial part of the process for forming connective tissue,* and that’s present in extremely high concentrations in orange rind (way more than you get from the juice!), so this method may well have some validity to it. ^_^

            *Learned about this Tuesday, and need to go back over my notes to be sure I have it right. I am super duper excited to have a direct use of the things I’m learning in biochemistry and nutrition, though!

          • I believe the vitamin c helps keep the sac strong. There is an older study that shows a correlation between increased Vit C intake and decreased PROM. Don’t ask me the source, I can not remember, and it was at least 10 years ago.

          • Here is a link with some info on dietary ways to grow a strong amniotic sac. It does list Vit C, as well as beta carotene, dark leafy greens, and adequate high-quality protein. This is just a blog post, with links to other posts, not official research or anything. But obviously there is no harm in eating a diet rich in these nutrients, so it would certainly be safe to try.
            http://prenatalyogacenter.com/blog/strong-amniotic-sac-less-likely-to-rupture/

    • He wants the induction to fail, so he can just section her.

    • I know…this drives me NUTS. I had a friend who was attempting a VBAC, and her MIDWIFE gave her that line…”well you aren’t dilating or effacing at all, so we need to induce you. If you were dilating or effacing we’d let you go for another week.” HUH???? After a 3 day attempted induction, she wound up in the OR again…surprise, surprise.

  7. see http://www.acog.org/~/media/Patient%20Safety%20Checklists/psc002.pdf?dmc=1&ts=20120428T0157243026

    This is ACOG’s safety list–the Bishop score should be over 8 for a successful induction. The OP’s doc is incompetent in this case, even by the interventionist -orientation of OBs.

  8. Technically, since the W.H.O. considers overdue as FOURTY TWO weeks, instead of 40, he’d be inducing her 4 weeks early! O.o

    I think I would have laughed right in his face, even when I was an ignorant 16 year old, pregnant with my first.

  9. High and tight until 42 weeks. At 42+2, I started feeling that something was different. I can only describe it as a pressure in my hips. Doc said baby was engaged and I was 1 cm dilated. Baby was born the following afternoon. If we’d attempted an induction at 39 weeks, I’m fairly certain I would have ended up with a section, and baby would have been 3 weeks early, and because of the timing, I would have been recovering from this c-section instead of slightly uncomfortably pregnant on Thanksgiving. Fortunately, my doc knew what she was doing.

  10. Go ahead and schedule it. I just may have a case of “pregnant brain” and “forget” to show up ;)
    what do they do if you don’t show up? call you? harass you? punish you more when you do come in?

    • While it is rare, there have been cases were the hospital will send the cops to harass the mother or even try to get a court order.

      • Oh wow :( Bullying on a whole new level :( that’s so sad.
        Patients of hospitals are not the hospitals’ property. And I think sometimes drs/nurses/staff may either forget that or just I don’t know? Be on a super high power trip?

      • Which is why it is *almost* coming to the point that any women who is considering going against medical advice in any way have a lawyer on retainer. :( I am highly considering it.

        • When I was pregnant with my first, I had a nurse who ran an “optional” pregnancy course for all first time parents at the military base we were at. If you didn’t take the course, you got bullied into this program where she came into your home to visit after the baby was born and just “make sure everything was ok.”
          You’d think that’d be a great idea. Midwives who do a similar program nation-wide in the UK prove to be a great support for new moms who may need help with breastfeeding or have questions about how to swaddle the baby, etc.. But this was not the case. We went in for our interview to decide if her program was right for us. She asked very personal questions about our pasts, then said that because I was abused as a child, that automatically meant I would shake my baby. (Sidenote: we practice positive parenting, don’t raise our voices much less raise our hands to our children.) Then she said in order to protect my baby she would look for any reason to call CPS and have my baby taken from me. At that point I told her that she was not welcome in our home and then I went home and started looking into attorney costs.
          That was 4 years ago, and in the past 4 years, I have done alot of things against the advice of doctors and nurses in my life (breastfeeding, baby led weaning, delayed vaccinations, never vaccinated either of them against the flu, denied antibiotics they didn’t seem to need, kept them out of daycare, etc..) and every time I find myself in an disagreement with any medical professional, I always think back to that nurse and I find myself praying silently in their office that I won’t have a legal issue on my hands. Luckily no one else has been crazy enough to try and threaten to call CPS on me. But now days, you just never know. You gotta be prepared for these things. So many medical professionals seem to have this false sense of power in making decisions for parents. It starts during pregnancy but thats just the beginning. The older my son gets, the seemingly more invasive and less medically relevant questions I’ve been asked at his well-check ups. Like what do you care what time I put him to bed, or what sort of stories I read to him?

  11. Don’t you just love doctors that create reasons for “necessary” sections? Because that’s exactly the path this doctor is attempting to send his patient down.

  12. You aren’t smart enough doctor, let me hit you with a medical book on the head so some information seeps inside that empty thing of yours

  13. “You went to all those years of school and took an oath to first do no harm, yet none of that is evident in the way you practice; I’m going to have to fire you! “

  14. So… The baby is clearly not ready to be born yet. So we are going to force him to be…. In what world does that make sense
    ?!

  15. Translation: “I want you off my hands, so I’m going to do something that might put your baby in the NICU. Because then they have to deal with you.”

    Doc. Become a night auditor. Or a forest fire spotter. Or an off-season remote fish cannery caretaker. Please.

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