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What to do if she refuses to induce

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What to do if she refuses to induce

Postby sparkedjenn » Fri Mar 07, 2014 01:48 pm

by sparkedjenn (17 Posts), Fri Mar 07, 2014 01:48 pm

At my last appointment, my OB told me that she would be inducing at 37 weeks. I told her if that was the case, then I would stop working after this week. I'm 35 + 2 today. So I made arrangements at work for today to be my last day, and I'm taking my full 12 weeks of FMLA in order to not lose out on time with my newborn. (I originally planned on taking 10.)

Now today, even though I went in just yesterday for a bp of 158/108, and I was spilling protein this morning, she told me that it's not bad enough to schedule an induction and we just need to wait and see. I am upset. Now I'm afraid that she will wait until I'm practically dying to induce me, even if it's past 37 weeks. I know I'm not a doctor, but I can read, and the most current research says she should induce me at 37 weeks.

Plus, had I known she would be changing her story, I could have made arrangements to keep working from home and/or with a modified role. But I'd feel really dumb doing that now.

What would you do? How can I ask her why she doesn't agree with the ACOG recommendation without pissing her off? Should I get another opinion? She didn't even draw labs today. Haven't had them in almost 2 weeks, and I've had a marked increase in bp and an increase in protein since then.
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Re: What to do if she refuses to induce

Postby jenh » Fri Mar 07, 2014 05:53 pm

by jenh (117 Posts), Fri Mar 07, 2014 05:53 pm

Ask her to put her reasons in writing, something like, "Patient is concerned about symptoms ABC and wishes to induce at 37 weeks in accord with HYPITAT study, but I recommend waiting based on XYZ." Then ask for a copy. Many doctors will back down when they see you have a paper trail in place in the event that something would go wrong and you might sue. Not that you should phrase it that way!
Jen
Wife to Brett 6/30/02
Mom to Ethne Joy 10/12/03, 35 weeks, severe PE
Mom to Catie Grace 12/8/06, 37 weeks, mild PE
Mom to Riley Faith and Gavin Arthur 7/7/09, 36 weeks, PIH 22 weeks, PE 31 weeks, severe post partum PE
Mom to two angels 12/05 and 7/08
Running a Marathon for the PF: http://www.whatyourunningfor.blogspot.com
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Re: What to do if she refuses to induce

Postby MomTimesThree » Sat Mar 08, 2014 12:39 am

by MomTimesThree (570 Posts), Sat Mar 08, 2014 12:39 am

I agree, sometimes playing a little hardball is necessary.

I forget if you already had a consult with a MFM, if so, I'm sure the recommendation was to induce at 37 weeks. So you might call that office ask for clarification and to send you the recommendations so that you can then discuss them with your OB... or just plan the induction with the MFM.

And I would reeeaaaallly insist on labs. I did them once a week outside of any changes of symptoms- with a change of symptoms they were immediately drawn.

Keep posted as you're able. Don't worry about making your OB upset- it's your peace of mind that is most important.

Lauren
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
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Re: What to do if she refuses to induce

Postby sparkedjenn » Sun Mar 09, 2014 06:44 pm

by sparkedjenn (17 Posts), Sun Mar 09, 2014 06:44 pm

You're right. I need to speak up. She hasn't consulted an MFM. At one visit, it seems like she is really concerned, and the next, it feels like I just made up everything we've talked about in the last visit up! Sometimes, I am a little bit jealous of the women I see on this and other boards who are being so closely monitored, even though I know it's a huge pain in the rear for them. With my son, I got severe nausea and vomiting that sent me to the ER that led to my induction. I didn't even know what pre-e was. It could have been much worse. Of course, I don't want my little guy born before he's ready, but the thought of waiting until it gets to the point of either of us being very sick is really scary to me!
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Re: What to do if she refuses to induce

Postby MomTimesThree » Thu Mar 13, 2014 05:52 pm

by MomTimesThree (570 Posts), Thu Mar 13, 2014 05:52 pm

I can only imagine how frustrating it must be. With your history they should be the ones who feel silly for not taking you seriously and monitoring you and baby more closely.

I would for sure ask about an MFM consult.. even this late in the game and you can also put her on the spot... "So I am planning my work schedule/childcare etc for delivery, we discussed inducing at 37 weeks, that's Tuesday (for example)... what's the plan? What time should I check in at the hospital."

Your peace of mind is always worth it. In a few days/weeks she'll never remember you making her feel uncomfortable, but you'll always remember. So do what you have to do to make this journey easiest for you.

Keep posted as you're able.
Lauren
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
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Re: What to do if she refuses to induce

Postby sparkedjenn » Thu Mar 13, 2014 09:04 pm

by sparkedjenn (17 Posts), Thu Mar 13, 2014 09:04 pm

We had a very good appointment yesterday. She took the time to explain to me why she wants to wait to see how things are looking at my next appointment (37 weeks) to make the call on induction. She wants one more growth ultrasound and to see how my cervix ripens since my first u/s at 7 weeks showed me about 5 days past my dates based on lmp, and he was measuring a little small compared to my son, who was 8 lbs, 10 oz at 37 weeks. I appreciate her reasoning there. I just wish she always took the time to explain herself. I think she gets in a hurry and those are the appointments that really worry me.

That said, my bp is bouncing back and forth between 140/96 and 150/104 tonight. No swelling, and just when I tell myself that I'll go in if it's over 100 in 15 minutes, it falls into the 90's. I know I should go in to be monitored for diastolic over 100, but I just know that I'll go in and it will go down with some rest, and I'll be home in 4 hours. So I'm going to rest and watch it for a little while longer. If it goes up again, I guess I'm headed into L&D again.
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Re: What to do if she refuses to induce

Postby sam10 » Thu Mar 13, 2014 09:26 pm

by sam10 (1437 Posts), Thu Mar 13, 2014 09:26 pm

Those pressures worry me. I'd rather go in and be seen with pressures so high. I completely understand how annoying it is (I made friends with the triage nurses, b/c I showed up so often in my second pregnancy).
What are your call-in numbers and what are your go- immediately-to-L&D numbers?
~Julija (40)
MC 3/2009 and 3/2011
Henry (1/1/2010-1/7/2010) - forever loved and missed; severe PE with Hellp; partial placental abruption, classical c-section at 25.6 weeks
Matilda (Nov. 2012, born at 35.4 weeks) - severe PE


Our pain has been put into words, placed into empty cradles, to remember that all our babies lived, that they mattered and always will. - Field of Cradles http://www.fieldofcradles.org/
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Re: What to do if she refuses to induce

Postby sparkedjenn » Fri Mar 14, 2014 08:46 am

by sparkedjenn (17 Posts), Fri Mar 14, 2014 08:46 am

My call-in and ask to be seen numbers are 160/100. Anything lower, and she said to log it and let her know at my next appointment. I didn't get back over diastolic of 100 last night, so no visit. Back to 140's/low 90's and hanging steady there this morning. But that's high for the morning, so I'm going to keep a close eye on it today.
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Re: What to do if she refuses to induce

Postby sparkedjenn » Sat Mar 15, 2014 08:13 pm

by sparkedjenn (17 Posts), Sat Mar 15, 2014 08:13 pm

There is a woman on my Baby Center birth board tonight complaining about how her OB dropped her for refusing to be induced before 39 weeks with pre-e. I could just cry.
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Re: What to do if she refuses to induce

Postby MomTimesThree » Thu Mar 20, 2014 04:18 pm

by MomTimesThree (570 Posts), Thu Mar 20, 2014 04:18 pm

How are ya holding up?
2008-Our Baby Girl, PTL born too early at 30w6d, Fought so hard... Forever Loved & Missed
2010- Lil' Bro, Pre-E at 29 weeks... Induced at 36w6d, Born 37w
2012- Lil' Sis, Super-imposed pre-e at 25 weeks, PTL & GD at 35 weeks, Evicted 36w
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