[km5v6r]

My daughter is expecting her first child next month. EDC is March 25 or there abouts. Dates aren't terribly accurate because she was switching between the pill and Depo Provera for birth control. She called yesterday and said the military docs are "pushing" her to be induced. Her husband thinks an induction sounds good so he can plan his leave and make sure he is off when the baby comes. Many of her friends have also been induced for a variety of reasons lately. The way her friends were induced was to be admitted on Sunday for cervical ripening, then Pit on Monday. My daughter tends to be very passive and not ask many questions. Needless to say I have a few dozen questions and no answers. Is it common for docs and midwives to plan induction now? Is there a medical reason? Could they tell a medical reason to induce this far in advance? My concern is that dates are off and they will try to induce a baby that isn't quite ready to be born. Is this a legitimate concern? Can a EDC be accuratly determined by US now? My OB rotation was almost 25 yrs ago and I adopted my daughter when she was 6 yrs old. This area is totally forgien to me. Thanks.

[CEG]

It is common. Many patients are induced for "dates" at 40 weeks. If a woman is tired of being pregnant and the OB says they will induce early it is hard for them to resist.

Personally I think it is poor practice, especially if she is unsure of dates. She could believe she is inducing a 38-39 weeker to end up with a tiny 36-37 weeker. Not something I would do to my baby for convenience sake (and let's be honest, it's really the doctor's convenience we are talking about here). Also, being induced raises her risk of c-section significantly- I believe 50% is what's usually quoted. Just because the doc is military does not give him/her a right to order or intimidate her into anything. Both of my babies were delivered by a fanastic military midwife who was respectful of my choices and said she would induce after 39 weeks for me only because my DH was back from Iraq (I didn't do it).

I don't know what her DH does but I am a veteran myself and unless he is in Iraq/A-Stan there is little chance he will miss the birth (if there is something so important that he can't get away from when she goes into labor they are also not going to allow him to schedule leave at that time). He will also probably be allowed to sign out on leave once the little one arrives barring any unusual circumstances. That is just how it works in the military. Many commanders give this time as free leave as well.

The way it happens for most seems to be a casual "When would you like to schedule your induction?" at the end of an appointment. She just needs to say "No, thanks!" and stick to her guns. It seems like most of the women in the hospital have no idea why they're being induced and no idea what will happen. They just know their Ob told them to schedule it.

BTW I was induced at 42 weeks with my first child and although it wasn't horrific it certainly wasn't the birth I had envisioned. Frequent cervical checks, hooked to every machine available, needing pain meds, long drawn out labor. It's not something I would chose for myself again.

ETA: I am a nursing student, graduating in May so take it for what it's worth.

[Jolie]

Quote from Km5v6r above, "...My concern is that dates are off and they will try to induce a baby that isn't quite ready to be born. Is this a legitimate concern? Can a EDC be accuratly determined by US now?..."

You are right to be concerned about this. Working in NICU for 11 years, I cared for many infants suffering from varying degrees of respiratory distress caused by labor being induced too soon, usually based on inaccurate dating of pregnancy. Ultrasounds done very early (1st trimester) and read by a skilled and experienced practitioner (not a general radiologist) can be extremely accurate in dating a pregnancy because at that point, the growth and development of the embryo/fetus is very predictible. U/S done in the second trimester are less accurate in dating a pregnancy, and those done in the third trimester are even less so. By the third trimester, the estimated age of the fetus is based almost solely on size, which can vary greatly due to genetics, maternal health, nutrition, etc.

I understand your son-in-law's desire to plan the birth and his leave, but unless thee is a MEDICAL reason why the baby needs to be delivered at a certain time, I would urge extreme caution. Would your daughter allow you to go to an appointment with her to discuss the risks/benefits of this induction?

[km5v6r]

Would your daughter allow you to go to an appointment with her to discuss the risks/benefits of this induction?[/quote]

My daughter and son-in-law live over 4 hours away and I still work full time. I may see if one of her appointments can be scheduled on my day off and I will make the trip. Her husband is not supposed to be deployed overseas for at least another 18 months. If a trip to Iraq is in the plans we haven't heard about it yet. I think my SIL is just anxious. He was very worried last month because they didn't have a crib yet. "What if the baby comes early?" I kept try to tell him "If it comes that early it will stay in the NICU until close to the due date and you can get a crib."

Her first US was done 2nd trimester. There is another US scheduled for next week. Again I am asking why and my daughter doesn't know. UGH. Of course as a PICU nurse I see the bad outcomes and long term problems. I keep reminding myself that not all babies are born with gastrochesis, microvillas, megacolon, ect. If just feels that way from work.

Thanks for the replys.