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Induction for 'older' mums
Automatic induction at 40 weeks?

15 replies to this topic

#1 Still hopeful

Posted 11 April 2012 - 09:10 AM

At the first appointment with my OB, he said that 'AMAs' (women of advanced maternal age) can only go to 40 weeks and are then automatically induced. The reason he gave was the increased risk of stillbirth. Ofcourse, I don't want to take unnessecary risks, but I was really surprised. I always thought that you could go +2 weeks (or at least 10 days). I have just turned 40 and this is my first baby. I am very keen to avoid interventions if possible - even though the OB seems good, with a nice manner, I am starting to think about switching to midwifery care. Any thoughts or experiences on AMA induction??

#2 katpaws

Posted 11 April 2012 - 09:25 AM

I was 34 when i had DD. Getting to 40 weeks, my blood pressure went up and there were some indications that the placenta might have been degrading. I spent a day at hospital to make sure everything was ok (It was). At 41 weeks my OB suggested an induction the following week if no baby popped out by itself. However, it was not a case of policy of induction for women of my age but more concern about the baby staying in the womb okay (not overcooking lol).

At 42 weeks plus i had two pessary inductions that were not successful and ended up with a hormone drip and manual breaking of the waters, although i was given the option of an elective caesarean.

For some women, inductions work out ok for them, others like me not so good results. All i can say (advise) is that you fully understand the implications of having an induction ie what happens if a pessary induction is unsuccessful or successful, what happens if you progress to a hormone drip induction ie will you have stay on a monitor for the length of labour and what happens if that form of induction is not successful. Inductions for older women is often associated with increased interventions, from what i have read and anecdotal stories.

Some women can go past the 40 week period with no negative outcomes for mother or baby but each person is a different case and has different medical needs/circumstances. A good health provider would ensure proper monitoring and testing to ensure the placenta was working ok and the mother and bubs health was being maintained.

Edited by katpaws, 11 April 2012 - 09:26 AM.

#3 Wigglemama

Posted 11 April 2012 - 09:28 AM

My workplace offers inductions for that reason, however, women have the right to decline the induction. It is in the public system, and I don't know the policies of the hospital you are attending, but surely you can refuse an induction? I would also consider changing obs to someone who is more flexible and woman centred.

#4 heffalumpsnwoozles

Posted 11 April 2012 - 09:33 AM

I was AMA for both my babies (35 for first, 37 for the second) and neither of my obs cited that as their policy.

I was induced at 41 weeks with my first, my second I would have been allowed to go to 42 weeks with monitoring as long as all was going well, but she showed up spontaneously on her due date.

If it was me, I would consider changing obs. He sounds a little intervention happy, and a little as if he just works to rule rather than to the needs of the individual.

#5 liveworkplay

Posted 11 April 2012 - 09:45 AM

I was AMA for my 3rd child. I was also VBAC so no mention of inductionat all. I am guessing here, but I assume the reason for increased still birth is due to placental function. I, again assume, that this declines more rapidly the older you are. If this is the reason, I would be requesting placental function monitoring after 40 weeks instead of an induction. You never know, you may go into spontantious laboour well before that original.gif

#6 Etcetera

Posted 11 April 2012 - 09:52 AM

I would find a new OB.
I had one try to pressure me into an induction before I was even due! I was 26. Some OBs are very into interventions.

#7 PurpleNess

Posted 11 April 2012 - 10:35 AM

Find a new carer, that's crap & I'd be very very annoyed & angry. There is no reason for an automatic induction. If they have concerns about you , the baby, your placenta, pre eclampsia etc then you should be monitored and kept informed & be involved in the decision making process.

I had my first at 40 and there was no way I was having an unnecessary induction just because of my age, especially after a perfect pregnancy.

Get a new OB, or better yet join a midwife program.

#8 Guest_bottle~rocket_*

Posted 11 April 2012 - 10:40 AM

Well I suppose at least your OB was upfront about his policy on AMA women and mentioned it at your first appointment.  I wish I could have said the same about mine.

I vaguely remember reading a news article about the higher risk of stillbirth in mothers aged 40+, perhaps this is what he was referring to.    

In any case it is your choice whether you are induced or not, regardless of whether you are a public or private patient.  I think I would be seeking another OB or switching to midwife led care in which you are encouraged to be involved in decisions about your care.

Edited to add link to article about inducing women over 40:


Edited by bottle~rocket, 11 April 2012 - 10:48 AM.

#9 SeaPrincess

Posted 11 April 2012 - 10:41 AM

I was 35 when I had DS1, he was induced at 41+1 due to my blood pressure increasing.
I was 37 when I had DS2 and there was some talk of inducing early due to GD, but he came on his own at 36+5.
I was 39 when I had DD, and she was induced at 40+1 for a number of reasons, none of them the fact that I was AMA.

OP, where are you located? Perhaps someone can suggest a different care provider?

#10 Still hopeful

Posted 11 April 2012 - 10:51 AM

QUOTE (shmach @ 11/04/2012, 10:41 AM) <{POST_SNAPBACK}>
I was 35 when I had DS1, he was induced at 41+1 due to my blood pressure increasing.
I was 37 when I had DS2 and there was some talk of inducing early due to GD, but he came on his own at 36+5.
I was 39 when I had DD, and she was induced at 40+1 for a number of reasons, none of them the fact that I was AMA.

OP, where are you located? Perhaps someone can suggest a different care provider?

I am in Sydney Eastern Suburbs - happy for all recommendations! (I previously received PMs after asking for OB recs).

#11 cinnabubble

Posted 11 April 2012 - 11:01 AM

Sounds ridiculous. I had a child at 41 weeks when almost 37. Labour started naturally, but was augmented. At 40, I was induced at 41+2 because I was considered overdue enough.

Honestly, I'd ditch the OB and go public unless something other than your age puts you at risk.

#12 Shellby

Posted 11 April 2012 - 04:04 PM

My friend had her little baby 6 months ago and she is also 40. I asked her when she was reaching 40 weeks if they did induction due to age and she was saying no, they just following your pregnancy along like everyone elses - if a problem comes up then they will deal with it just like someone who is 24. She ended up going into natural labour at 40+1.

So I would ask him if he is willing to allow you to go over if you wish at the time - he maybe willing to be flexible with what he does. If he isn't then I would be looking for someone else also - unless you really want to be induced at 40 weeks and not go over.

#13 katbalou

Posted 11 April 2012 - 04:11 PM

DS1 - I was 37 and was induced at 38 weeks due to IUGR, but nothing to do with being AMA.

DS2 - I was 39 and birthed naturally at 40 weeks + 6 days.

DS3 - I was 42 when labour started naturally at 40 weeks (waters broke then contractions), then stopped. I needed a little help to get things going again.

No-one at any stage mentioned being induced due to age - only due to how baby was progressing.

Good luck.  First bub at 40 - how exciting for you!

#14 50ftqueenie

Posted 12 April 2012 - 01:26 PM

DD arrived at 41 weeks when I was 35
DS arrived at 42 weeks when I was 38

I wasn't induced for either and my OB was happy to see how things went with some monitoring after 40 weeks.  I can't advise you what you should do, but just wanted to let you know how things worked out for me.  A second opinion won't hurt, but I can tell you that those last 2 weeks with DS were the longest weeks of my life!  I'll cross my fingers that your baby arrives happy and healthy and "on time"  biggrin.gif

#15 Etta

Posted 12 April 2012 - 02:20 PM

I was pregnant at 41 and a midwife dismissed any worries that I was too old for Family Birth Unit - she didn't seem to think that 41 was old at all. Later when I had GD the obstructician told me 'we induce at 40 weeks and 39 if you are insulin dependant'. I managed to get out of obs control and back to FBU, and went into natural labour at 40+3 days.

I stuck to what I knew was my due date rather than the hospital's date - by their reckoning I would have been about 2 weeks over. Everything was fine - healthy baby and natural labour, although some placental deterioration. Nobody but creepy obs seemed to be fussed about induction and dates - more concerned with monitoring mine and my baby's health.

#16 au*lit

Posted 12 April 2012 - 02:28 PM

I was 37 when I had DS. I was induced with gel on the evening of 41 + 1 with the intention of coming in for ARM/drip the following morning, but the gel was enough to get me going.

My age was never mentioned as a reason for inducing, my OB only talked about the possible degradation of the placenta.

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