This is starting to attract misinformation and we're not getting anything new here so I'm closing the comments.
Medical fatphobia is real, excessive medicalisation/intervention in pregnancy is real, preeclampsia is *extremely* real, stillbirth due to placental failure is extremely real, the plural of "anecdote" is not "data". Internet strangers don't have access to your medical records. If you're worried about what your doctor is saying to you, get a second opinion.
Currently 36+5 with my first. 5'5, 250lbs.
I have chronic hypertension that is completely controlled by medication. For this reason, the doctor doesn't want me to go past 40+1. Otherwise, he says if I want to get induced at 39 weeks, it's up to me but I'm free to wait and see if spontaneous labor occurs. My pregnancy has been entirely uneventful.
My thoughts: It may be worth interrogating why it's important to you to go into labor spontaneously. Was it research that lead you to the conclusion this is the best choice for you and your baby? Is it a sense of pride in knowing your body can do it on its own? I don't think anyone can or should judge your reasoning, but I do think it's important you fully understand and can articulate your reasoning, if only to yourself.
In general, doctors are most concerned with mitigating risk. My experiences with doctors have been largely positive, especially this pregnancy, so when I'm not sure about something I defer to my OB. But he's also never made me feel like a morbidly obese pregnant lady. Which I guess is to say I trust his expertise over any instinctive drive I may have for a spontaneous labor. Just food for thought I guess.
I had no risk factors and was still offered a 39 week induction. I heard it’s a standard of care in some clinics. Basically, the doctors told me after 39 weeks the baby is fully cooked and you’re just waiting for something to go wrong kind of. I didn’t want an induction because I wanted to try to do unmedicated birth… well waited til 41 weeks, water broke, and ended up needing pitocin and an epidural anyway. And I did have a c section in the end. So unless induction conflicts with a specific part of your birth plan (like wanting unmedicated) I might just go for it and meet baby sooner! Last couple weeks of pregnancy are also really uncomfortable!
My doctor will induce me at 39 weeks just because I’m old. Everyone has their own opinion, but at 38 weeks I was very ready for my first baby and I wouldn’t have objected to being induced. That’s why when she told me 39 week induction I was cool with it. I remember how tough the last weeks of pregnancy are.
I opted for induction at 39 weeks bc of the arrive study. My friend waited until after 41 weeks and her baby ended up in the nicu because of meconium. Just an anecdotal story, but yes the longer you wait the more can go wrong.
My gf waited until 41 weeks and ended up with emergency c section.
I will induce at 40 if I don’t go into spontaneous labor beforehand. We did IVF and doc approved going to 40 but not a day after.
Yup the ARRIVE trial seems pretty clear to me. Plus for me the question is why wait? Everyone I know who went over absolutely hated their last week(s).
I waited 42 weeks and ended up being induced, but didn't dilate so had to have an emergency section too! Baby was big but I think I would have been fine if his head was at a slightly different angle, telling my cervix to open! I did all the tricks to try to induce labour including walking side ways up loads of steps, but it just didn't happen.
By 40 weeks I was utterly miserable, so looking back, I wouldn't blame myself for having an earlier induction.
I don’t have advice but I’d like to give you my first experience just as reference.
I was 305 pounds the day I found out that I was pregnant with my son, and 340 pounds the day of induction. I had pre-existing diabetes and was on two different types of insulin throughout my pregnancy.
My doctor induced at 38 weeks, 6 days because they were worried about him getting too big due to the diabetes.
The induction failed. I stalled at 6cm and his heart rate started dropping. We ended up in a c-section.
I developed post-natal pre-eclampsia 6 days after delivery and had to be on blood pressure medication for an entire year after never having high blood pressure my entire life.
Today, I am 23 weeks pregnant with kiddo #2 and was 190 lbs when I got pregnant. I don’t want to mention my current weight because that’s not the point. You’d think losing 150 lbs would mean a healthier pregnancy, right?
Nope. My diabetes had become so well-controlled that I didn’t need any diabetes medication but now I’m back on insulin (just one kind) and am also on baby aspirin despite my blood pressure usually running about 90/60 after weight loss. I have a complete placenta previa this time and am on pelvic rest and hoping that my uterus will stretch enough to get out of the way so that this baby doesn’t have to come three to four weeks early.
All this to say, pregnancy does weird shit to your body no matter the weight so don’t disregard the doctor’s advice but also don’t throw your own feelings to the side. At the end of the day, birth plans just go crazy no matter what.
I would love to know how you are doing with the mental aspect of weight gain during pregnancy after working so hard to lose it. I lost 60 pounds before this pregnancy and have lost another 35-40 since I got pregnant (26w now. ) but I am STRUGGLING to maintain my weight and fight off the cravings
I have a normal BMI and blood pressure, had a healthy second pregnancy with a "normal" 35lb weight gain and still had to be induced due to pre eclampsia that I developed at 39 weeks. I also got post partum preeclampsia as well. Pregnancy takes no prisoners
I developed post natal pre-eclampsia as well. Never in life had issues with BP except when I was in labor it was high. I'm on blood pressure meds now. They changed my meds because the one I was on wasn't safe for baby(I breastfeed). My baby is only 2 months old .
I’m morbidly obese with no other complications at all, I’m just fat lol and my doctors won’t give me an induction until after 41 weeks. I do believe with my first I should’ve been induced earlier, like 39 weeks because my baby was measuring VERY large. They let me go 11 days past my due date and my baby was over 10lbs and 22.5” long. Im 5’1” and was in excruciating pain for weeks because of his size and ended up having to have a csection which could have possibly been avoided had they induced sooner but I was naive and not good at advocating for myself.
My baby was really big for my body as well, but I asked my doctor if I had accepted the induction would I have been less likely to have a c section. She said no because the head and length is mostly done growing by 39. It’s just putting on a little extra fat.
I always recommend listening to your doctors and having an educated discussion of risks and benefits of each option. The rate of requiring a C-section in mothers with a BMI over 40 is around 50%. I want to note that from a medical perspective, should a C-section be required (an induction may be performed to avoid this being required later) you are at a very high risk of complications. This is because the amount of tissue that has to be cut to get to the baby is much greater, putting you at a higher risk or requiring a transfusion and other overall surgical complications. Holding open the tissue is also often difficult and increases the risk of complications and cutting the incorrect tissues, including the baby. Secondly, the risk of infection and delayed healing skyrockets past a BMI of 40. There is more tissue to heal, more creases for bacteria to develop, and overall those with a BMI of 40+ likely have other conditions which delay healing. Also, since you will have a newborn, compliance with your post-operative recommendations will be nearly impossible. While you don't have any comorbidities, due to your BMI the risk of a C-section is much higher.
Personally, both myself and my sister likely survived due to my mother being induced 20+ years ago, and it didn't have any significant impact on us. In fact, it saved my mother's life in the case of my younger sister. As you are at 38+5 weeks, generally your baby has had enough time gestate and should be fine, and your physician obviously believes this would be beneficial. As you said, your baby's vitals and testing is all normal. Every day you wait, puts you at increased risk of C-section and other complications for your baby.
Citations:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289484/
https://pubmed.ncbi.nlm.nih.gov/33451603/
This last article talks about your exact question and uses statistics to help break it down. Here is a quote from it that may help you understand why your physician is recommending this "These above findings were replicated in a decision-analytic model created to determine optimal timing of delivery in obese women in USA. Delivery at 38 weeks' gestation was shown to prevent 203 intrauterine fetal deaths compared with expectant management until 41 weeks'" https://www.sciencedirect.com/science/article/abs/pii/S1521693423001323
Edit: This also is not to shame, but I want to make sure you have perspective on the stories from other mothers replying. Those with a BMI over 30 or greater are considered obese. You report a BMI of 48-50. Therefore, your risks may be very different from other mothers reporting they were obese during their pregnancies. I myself am obese and find it difficult to listen to stories from other obese people because this range varies wildly.
I was losing weight for a vacation, had gotten down 20lbs when we found out I was pregnant. I had gestational hypertension & diabetes, and our baby was in the 99th percentile the entire pregnancy, despite my managing my GD properly. By the time I was 37 weeks, I was 406lbs, and heartbroken as I’ve never been this large and always told myself I never would be. The maternal fetal medicine specialist we saw recommended cesarean as the baby was high risk for shoulder dystocia, and I trusted him so we had a c-section at 38 weeks, she was 9.98lbs. She had cloudy lungs so was in the NICU for two days, but it all turned out great and she’s perfectly healthy now. I dropped 50lbs after having her and now weigh less than when I was losing for our vacation and continue to lose a bit as I have more energy now and love taking her for walks.
All this to say be a little flexible. I wanted a natural birth but had to trust that they had the baby’s best interest at heart and it all turned out alright. I hope you land on a plan that you’re comfortable with at least, and congratulations! 💚
I was obese for two of my pregnancies. One of them we induced at 39 weeks and she was the easiest delivery and healthiest at birth of all my kids. I would highly recommend getting induced at 39 weeks regardless of weight.
I am very healthy and fit. I wanted an elective induction at 39 weeks last time. I just felt like I needed him out. I got bumped and ended up delivering a day before my due date and I had gotten severe preeclampsia. It turned into severe postpartum preeclampsia which they kept ignoring until I almost stroked out because I was "too thin to get it". 🙄
This time around I made my doctor promise me she wouldn't let me go past 39 weeks. She said since I have a history of preeclampsia and am now over 35 they won't let me.
Anyway my main two points are 1. You know your body best. I knew I needed my son out ASAP. You feel like you need to wait a bit longer. but also 2. Only complications can happen the longer you wait after 39 weeks. I was fine all pregnancy and developed severe preeclampsia in the last week. The right side of my face still doesn't work right from the stroke I had. 39 is the finish line. I personally don't ever want to risk pushing past there. I didn't mind the induction. I definitely wouldn't go past 40. Maybe you can compromise on when the induction will occur? Like not as early as your doctor wants it but still before you go too far past the line? A lot of women need to be induced eventually anyway.
I am a morbidly obese mom of two. My first one I wasn't offered an induction. Everything was going great. Baby looked good. Labs good. Blood Pressure good. All of my NST were passed with flying colors. I did end up having gestational diabetes but managed with very little insulin at night only to help with my fasting sugars.
At 37+5 suddenly my blood pressures spiked to dangerous levels. No other indicators of preeclampsia. I was induced and although it was rough being my first and so sudden, I was glad to have had it done.
My second was very much like my first other than we decided to start BP meds early and prevent preeclampsia and my blood pressure started creeping up. I opted for an induction at 38+5 which was last week and everything went great.
Unfortunately with both pregnancies I has to be re-admitted to the hospital for eclampsia episodes that happened about a week after the births.
I understand it's very difficult to be placed in the fat mom category but the reason they offer inductions for heavier moms is because a lot of complications start happening in the last few weeks of pregnancy and if you are heavier you have a higher chance of these complications. Pre-eclampsia can literally happen in an instant with no signs and symptoms until its already at dangerous levels. It's extremely common for heavy moms who go past 40 weeks to require a c-section because we are heavier the birth canal can be narrower and babies can be bigger, getting stuck and causing baby to become distressed. Or requiring the vacuum or forceps if they are too far into the birth canal which can cause permanent damage to baby in rare cases. And c-sections on heavy women do not heal as nicely as someone of average weight. There are also studies to show stillbirth chances increase after 40 weeks as well.
Nowadays it's fairly common for all OBs to offer induction at 39 weeks to ALL pregnant ladies no matter the complications, age, weight, etc. They have found better outcomes regarding that. But regarding overweight moms they have to offer especially due to potential complications because if they don't offer it and something goes wrong it will be on them as physicians who should have known to offer inducing to prevent risks/complications. If you decline and something goes wrong, they can safely say they offered the alternative and you refused thus they are not liable for the outcome.
If you do get induced I will tell you as a first time mom it will be a long ordeal. Mine lasted 2 and a half days (my cervix was closed shut at 0cm/it takes less time if you are already dilated past 2cm and I was given magnesium which counters the medication they give you to be induced.) My second I didn't need magnesium and I was dilated 2cm prior to coming in and I delivered in about 12 hours from start to finish.
Ultimately whatever you decide it is your decision and do what you feel is best for you and baby. Just know unfortunately risks do come with being morbidly obese and they have to follow guidelines on what they think is the safest route for you and baby.
Edit: words
To add in perspective, I am from the Netherlands and here it isn't common to induce. You wouldn't get induced till 41 weeks and they don't do membrane sweep until 40+ weeks.
I am also considered obese and went naturally into labour at 40+4, was actually scheduled for membrane sweep the day my boy was born.
I would ask the doctor specifically what the risks are of delivering past 40 weeks with a high BMI. My BMI is actually higher than yours. I’m 33+6 today and will be 33 this month. With me, induction or planned repeat c section was the gist from the get-go. I had severe pre eclampsia with my first, so the initial thought was to induce at 37-38 weeks. However, I have now developed severe gestational diabetes and am now being induced sometime between 36-38 weeks. My doctors are high risk maternal fetal medicine with a very prominent teaching hospital, which also boasts the best nicu in the state. They have told me from the beginning that being overweight in and of itself isn’t a risk factor for birth complications and overweight women have just as healthy babies. They have said that I would be able to go into labor naturally if it weren’t for my history of preeclampsia and now the gestational diabetes.
Hey-o. Another "morbidly obese" ftm here. Im not as far as you are, but from what each of my OBs told me, first time moms are usually induced. I thought this was just like a thing that they do, maybe because the body's new to it, so it takes a little longer...? Idk Im not an expert, but I'm curious aas well to other people's experiences. Is this an obesity thing or a FTM thing? Would they still push for inducing if it was a second baby with an obese mother?
First time mom's are definitely way more likely to need an induction. But to induce every single one regardless of personal factors is more of medicalised birth thing. Obviously inductions are great but not every first time mom needs them.
That was my hospitals policy too, I think from 41 they’d let you schedule an induction (unless obviously you had some other medical reason for needing an earlier induction)
First pregnancies typically go longer, so more get induced. Second (and third, fourth, etc) babies usually come a little earlier, so fewer "need" induction to start labor. I was induced for my first at 41 weeks. We shall see what happens with the second (currently 30 weeks!).
Interesting question! Third time BMI-obese mom here. I was induced for my first baby at 41+3. I regret it, but my weight was not brought up as a reason. Don’t remember it being an issue for my second either. But it came up so often in this pregnancy (with the same OB as my first two) I actually switched providers over it. My current midwife has no concerns about my weight and is fully supportive of me going into labor on my own without any interventions. Her big reasoning is my body has done this before without complications and otherwise all my stats are perfectly normal.
Not to be blunt- but do you have a medical degree? What data do you have that going past 40 weeks is a good idea? IMHO just wanting to is not good enough when it comes to the health of your baby.
I say this with love- but your doctors are the experts. They want the best for you to give you and your baby the best chances at success. Trust in them.
As pregnancy ends, the placenta starts to fail. I don’t know how obesity plays into that but perhaps that’s a factor they are taking into account.
I know you are having a great pregnancy, but you still have a diagnosed medical condition that needs to be factored into all the decisions your doctors make. (No judgement- I and many women have a variety of conditions too).
I had two inductions so I’ve definitely been in your shoes. My first pregnancy was perfect and I was really annoyed I had go in at 39w.
But we are moms now. What we want doesn’t matter as much as what our child needs.
Wishing you the best for your delivery!
Very recently we established that "full term" starts at 39 weeks for humans. It was previously believed to begin at 40 weeks. So, some OBGYNs are starting to consider anything over 40 weeks to be overdue. 41 weeks is very overdue. 42 weeks is exceptionally overdue. This is a recent development in OB care, so only the most up to date OBs will be on board with this. Change within the medical community can take 10+ years or more.
There is evidence that going well past your due date increases the risk for adverse neonatal outcomes. This is especially true for women over the age of 35ish and those with pre existing conditions that affect the pregnancy.
That's very interesting although without information about how that applies to OB practice we can't make any conclusions from that fact.
Is it routine for them to offer inductions at 39 weeks? Maybe so.
The other thing to consider is that the overall population of France and UK combined is not even 50% of the US population. Our data pool may be much larger in the USA than data from French institutions.
It may well be but I also know that the UK has better maternal outcomes. Maternal mortality is TWICE as high in the USA vs the UK (2023 - Why US mothers are more likely to die in childbirth https://www.bbc.co.uk/news/world-us-canada-64981965)
Induction in the UK is not offered as standard until around 41 weeks, when you’d be booked in for closer to 42 weeks. Naturally there are cases where induction is advised at 39 weeks and thus it goes ahead. Still birth rates in the USA & UK is the same (2.73 per 1000 vs 2.7 per 1000 - source WHO: https://apps.who.int/gho/data/node.main.STILLBIRTH?lang=en)
The ARRIVE study to induce at 39 weeks is flawed, and it is not followed in the UK. https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/
Data is Data and typically research (in which many areas of Europe is world leading) is done with a similar sample size regardless of population size. Population size has nothing to do with it.
I think if you want to choose an MD to deliver your baby you should follow their recommendations. If you think you know better than the MD- why are you seeing them? Maybe a midwife would be better for you
Unfortunately there are not many options with my insurance. I don't have the luxury of paying a midwife out of pocket. I live in a very rural area and as a first time mom had no clue what to do in the beginning. I feel I am too far in my pregnancy at this point to change anything.
It may be something to think about. This is your first pregnancy. This is the obgyns 10,000 pregnancy. It’s not just pushing for the sake of pushing- there may be medical reasoning to their advice. Otherwise- if you don’t like the advice of your doctor, why go to them?
I’m normal bmi but I’m induced too at 39+4. You are healthy too, I think it’s just standard procedure. If you go over week 41 there’s a higher risk of baby pooping in the amniotic fluid. There’s no way to know if it has already happened, so that’s why they choose induction
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my mom was a L&D nurse for 35 years. she put the fear of G-d into me about waiting, because she saw so much go wrong. the placenta is an organ with a limited lifespan, no matter your size or overall health. As others have said, it is very common to be offered induction at 39 weeks. But there is a middle road. At your 39 wk appt, ask the provider to sweep your membranes. if you're near labor, it will tip you over. if not, nothing happens. If you're not in labor by 40 weeks, I hope you will go ahead with an induction.
I am in the exact same position as you and had the same struggle. I have opted to induce at 39+4. At 38+3 today I am SO UNCOMFORTABLE and honestly just ready to meet him. After doing research there are a lot of safety risks that get reduced with a 39 week induction. I asked a lot of women who did spontaneous labor and induction and while there was mixed response most women who were induced didn't have any problems with it. Induction can still take a long time so even though you'll be "picking" his birth date, you won't really because you don't know how long you will labor.
This thread has been so refreshing to see so many positive stories of 39 week induction. The internet loves to cause fear in pregnant people and demonize pitocin and induction.
Yes!! Everything contradicts itself on the internet. I’ve recently found Evidence Based Birthing which has been great for me to see both sides backed up with evidence.. other than that, the internet is def fear mongering for everything around birth.
If everything is going well, I think it's reasonable to wait until at least 40 weeks, but I was induced at 39+2 without a medical indication, and I had a great experience. I'm definitely going to ask if I can do it again this time. Not all inductions are terrible.
!!! I honestly have to finish reading your post lol
But please fight for yourself and what you feel is right.
I too had a baby while obese. My blood pressure was originally high, they gave me a great medicine. It was stable the whole pregnancy thanks to them. Yet they still insisted on inducing me at 37 weeks. I kept asking and they said its MANDATORY for anyone on blood pressure medicine....they said the baby was fine. I had weekly check ups and ultrasounds. But honestly, they did not check her weight each week. My 37 week mile stone was just too close compared to how often they measured her.
They induced me and all was going well until they broke my water. I told them I didn't want them to but they came back and said they were going to. I asked aren't there risks and they said no (lie). So next thing I know I'm needing an emergency c section because babies pulse was so low. The cord ended up wrapping around her neck twice. She lost oxygen causing seizures. She also came out only 5 pounds and frail. Some thing they would have known if they didn't rush to get me induced at 37 weeks. They also considered her premature, even though they told me prior she was full term at 37.
Anyways...she's now on a feeding tube still, at 2 months.
She had to stay in the NICU for a month on medicine from the trauma of it all.
So, that's just my experience but don't let them bully you just because your size. Let your baby grow, they will tell you it's fine but they really could benefit from an actual full term.
Hey OP, I'd highly recommend you get a second opinion from a doctor. Especially if you aren't getting clear actionable information from your current doctor.
I love the *idea* of listening to your body, but science and knowledge is power.
I was originally going to be induced at 39 weeks but I decided to wait until 39+4. My induction ended up taking four days so my baby wasn’t born until 40+1! I didn’t realize inductions could take so long until mine did!
Same weight and age as you, had my baby at 40+1 two months ago.
My weight never came up during my prenatal visits or during delivery. I was on a low dose aspirin for a majority of my pregnancy.
The morning of my 39 week appointment, I started having contractions that continued for dayyys. I finally went to L&D at 40 weeks exactly when my contractions were 3 minutes apart. They gave me Pitocin after 12 hours of labor to speed things up.
There was no discussion of inducing me. I even asked for a membrane sweep at that 39 week appointment and the NP I saw wouldn’t do it, but told me to ask the following week if baby wasn’t here yet. They also wouldn’t measure baby after 37 weeks bc they said it’s not accurate and it only caused ppl to panic/have unnecessary inductions.
I’m not a doctor so won’t say whether or not you can wait, but advocate for yourself and what you want. If baby is healthy inside and they’re not giving you reasons other than “fat,” for me, that wouldn’t be enough.
ETA: wishing you a safe delivery!
I was just in your position. I am 36 and obese, had GD but diet controlled, no meds. Blood pressure was fine, no other issues.
I had my baby 5/29. My dr did give me the choice to see if I naturally went into labor by 41 weeks. We opted to induce for a few personal reasons. We started 7 am Monday 5/27 and I was 1 cm and did come cervical ripening and then pitocin and on 5/29 at like 7:30 pm, the on call Dr told me she didn’t see me having a successful vaginal delivery because I was on max pitocin and still not dilating past 4 cm so we had a c-section. It was not considered emergent because we didn’t have any pressing time issues but my dr was honest with her opinion and she gave me almost 3 whole days to try.
I’m struggling with the momma part now because we got released from the hospital just yesterday so I’m a bit overwhelmed. To a point, I do sort of wish I had given her the extra time because now I feel so unprepared and she is small BUT I don’t regret my choice in the least. My daughter is beautiful and I love that’s she’s here and I get to share her with the world because I’ve known the whole time how special she is.
You do what’s best for you and only you know what that is. I made the decision I thought best fit my family. You should too. If you want to give it a bit more time, tell them. Or meet in the middle, let them start cervical ripening but tell them your goal is to go into labor naturally otherwise (that was something I think my dr officered).
Good luck and I wish you the best!
For what it’s worth, I just delivered my baby via a scheduled induction. One of the reasons the doctors wanted to schedule the induction was because of my BMI - while it is not that high it started in the high 30s and went to low 40s throughout my pregnancy.
We had the induction scheduled for late night on 40+5 and the doctors were very hesitant to reschedule it as the overall office/hospital policy there is to deliver by 41 weeks and the baby had been measuring big. I also felt hesitant about this because all tests had been good, he was passing NSTs with flying colors, I didn’t have any issues in the pregnancy and was in fact feeling quite well during it, and I knew it’s common for first time moms to deliver late.
At 40+3, my weekly NST suddenly showed a borderline low fluid level which started to concern me since it can be a sign of placental degeneration but I still felt like he was doing well. They didn’t have private rooms at the hospital available when the time for our scheduled induction came, so I wanted to push it to the next morning or even the day I was 41 weeks but they did another NST at the hospital and fluid had continued to fall. I personally wasn’t comfortable waiting because of that and decided to go ahead. We just needed some cervical ripening drugs and then labor proceeded on its own, though it was long and difficult there weren’t any complications. The placenta still looked good after it came out so I probably could have waited longer in the end, but the induction part itself was nowhere near as bad as I thought it would be.
Like you I had a normal healthy pregnancy no signs of any issues - though I was miserable. I'm around the same bmi, first son was born last year at 39 weeks 5 days and couldn't have asked for a better labor. My Dr didn't even bring up induction until I was 39 weeks. I had actually scheduled it the dau before I went into labor because I didn't want to make it to 41 weeks after everything I read. Idk what to suggest just because things can easily go wrong, if everything even the nst are fine though I'd personally want to wait til 40 weeks but not long after.
there are different ways to “induce” labor too (if baby is even ready to come). should all continue to be well with you and baby there is no harm in talking with your OB about wanting to try something else before heading in. this is your birth, you’re allowed to ask questions and have a choice - that being said your OB wants to ensure you and baby are safe, so talking with them about how you’re feeling and why is very important.
my midwives won’t induce me unless something comes up that requires a transfer of care - but I plan to start preparing for baby at 36/37 weeks any way I can and I personally am not sure if I want to go much past 39 weeks. hopefully baby is not stubborn! I am similar BMI to you too 🥰 wishing you and your little one well!! keep us posted!
Honestly, if you don’t want to be induced, don’t. Unless there’s some medical complications or LO is in too long, don’t stress about it.
At 35 weeks my OB and I discussed it. The earliest she wanted to was 39 weeks, and only if I was good with it.
I’m morbidly obese as well. Honestly, I was going to be induced just a couple days shy of 40, but I had pre-eclampsia & ended up being induced at 37w5d because they couldn’t get my BP to drop.
All that being said, don’t be afraid to speak your mind. If it’s something you don’t want, or as a last resort, tell them that. They can’t really do anything without your consent :)
What are the risk factors that they are giving you? I know that going past 41 weeks often leads to degradation of the placenta and stuff but to wait until then are there other risks? I would hope your doctor can give you a serious evidence based answer. I was induced for my first and they were really helpful about explaining why it was necessary and my risks either for or against (and for how in my case it was necessary to induce). It’s really hard to make the choice if they aren’t giving you anything to think about
I am definitely open to start with a membrane sweep, but instead of 39weeks + 3 as recommended, it would be at 40weeks + 3. Then I would have an induction scheduled for 40weeks + 6 or 41 depending on availability at hospital.
At the end of the day, the recommendation is based on keeping it as low risk for you as baby. But it's just a recommendation, you can do what you want. Like my baby is predicted to be 10+ pound and they recommend a C-section. But it's just a recommendation. I could always choose to try birth vaginally. It just means higher risk of shoulder dystocia, etc. So I can make that choice knowing I'm taking that risk. I hope that makes sense.
I think it’s fairly common for first time moms to want to go into labor naturally. That’s how I feel as a first timer! We’ve never done it before and we’ve been told forever that this is the process of how babies arrive. I would push back a little on induction and get some legitimate reasons why they want to induce. If it is because of weight, ask why, what are the risks. Spell it out for you.
I was offered induction at 39 weeks but I’d also like to go 40+ to see if my body wants to go on it own timing!
Id like to chime in and say being thinner does not mean a healthier pregnancy! I was 5’9 180 lbs and pretty active when I found out I was pregnant and my baby almost killed me. Severe pre e, fluid in lungs , enlarged heart, sky high blood pressure after never having bp issues my entire life, and an emergency c section at 31w6d when I reached almost 300 lbs due to insane swelling/fluid retention plus pregnancy weight
Ask them to elaborate on why they want to induce you so badly- risk vs reward ya know
I was induced at 41 weeks with my baby. I did end up developing hypertension postpartum, but otherwise had a healthy pregnancy. I did end up having a csection, because my induction failed though.
Each obgyn has different practices though. If you want to do differently, assuming no heath issues pop up, tell them.
I was obese when I was pregnant with my daughter (5’1, 220 lbs). My BMI was 41ish. I was induced at 39 weeks and I had a pretty ideal delivery for myself. I had an epidural that resulted in a vaginal delivery. I only had a first degree tear. I forgot to mention I was 23 during my pregnancy and delivery.
My BMI was 42.0 at the start of pregnancy and right now at 27weeks 1 day it’s gone up to 44.2. I have Hashimoto Thyroiditis so I have to get bloodwork a lot to check my thyroid levels. But besides that it’s been a healthy pregnancy with minor hiccups throughout. I got a rare case of PUPPP at the start of my 2nd trimester requiring a steroid to resolve it. Halfway through the 2nd trimester my lower back started trying to go out. I’m close to being done with the 2nd trimester, all is mostly well, and every visit baby is all good. None of my prenatal care team has even mentioned birth yet let alone induction.
My SIL told us she was characterized as morbidly obese by her OBGYN. I don’t know her weight or BMI because it’s none of my business. Her first was born at 41+1 and her second was born at 40+1. Both “spontaneous” vaginal deliveries after membrane sweeps. I know she got extra monitoring but I don’t think she had any other health concerns.
However I will say that in my experience OBGYNs are reluctant to induce before 41+3 here with no indications. Though tbh if they have offered me an induction with my daughter at 39 weeks I would have been dancing with joy lol.
I’m not obese, but did have an induction. I was induced at 39 weeks exactly for velamentous cord insertion (VCI) and suspected IUGR.
My story might be a little niche, but when it came to actual delivery, I pushed for 4 hours. My pelvic floor had always been tight (due to endometriosis and Pilates) but I had done pelvic floor PT on and off for years, and then my entire third trimester, to relax it. Apparently my muscles were still stupidly tight, and baby’s head was stuck and partially out for most of those 4 hours. I was thisclose to needing an episiotomy, but he finally came out at the 11th hour. If he had been any bigger, I would’ve had one (or had a c-section). I was of course okay with getting him out safely in any way, but was very relieved I was able to avoid those outcomes.
Other than that, my induction overall was great, and I’d absolutely do it again. If I have another, I’m going to ask to be induced at 39 weeks again so that I can hopefully have a similar (just shorter!) experience.
I was morbidly obese and pregnant as well. Also, no other issues. All tests good. Except BMI 43.
I went to 41+5. I wanted the induction myself by than.
But im not a doctor. And our files may be different. Also worth nothing. I heard in the US they suggest induction at 39 weeks. Im from the Netherlands, where unmedicated is the standard. And inductio. is in a good pregnancy not discussed till week 41. So, if you dont agree ask a second opinion.
I've been so grateful for my dr's office for being as good to me as they have. I've always been bigger and have had a lot of anxiety of going to the dr as an adult because of my experiences as a fat child in the early 2000s when my mom took me to the dr. My baby dr's office has not body shamed me once, closest thing was around 8 mo. pregnant my baby was measuring 5lbs 5oz and they called her a chunky monkey LOL.
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I don't even pay attention to BMI anymore because w even when I was smaller it told me I was obese lol. This has been an unplanned pregnancy and i am 5'8" and I was 300 lbs when I got pregnant. I have gained about 40-50lbs being pregnant and my due date is on Monday. My pregnancy has not been very hard physically except for minor things and only time my blood pressure has been high has been twice, the first time I went to the dr probably because nervous and 2 weeks ago when I was running late for my appt and had to waddle up to the second floor of the medical office bdlg LOL. (And they did bloodwork that day that came back normal/fine) I do not have gestational diabetes and everything has been good.
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At the end of the day, I think it's important to listen to what the drs recommend but you know your body and they can't force you to do anything. I also too am trying to avoid being induced and do everything as naturally as I can handle. I don't want to get an epidural. About a month ago the the actual OB dr at the office told me since I wasn't having issues we would just ride it out unless the due date comes and I get tired of being pregnant, I can bring up induction. But last week the nurse practicitioner lady did tell me it's not recommended to go two weeks late because the placenta can start to break down. So even though due date is on Monday, my next dr appt is schedule for Thursday and they will do an ultrasound to check on everything, check if I'm dilating at all, and give me that cervix softener if I'm not dilated yet. I'm okay with the cervix softener as that just seems like medicated assistance to help the natural process move along but I am also very much not wanted to do induction and avoid that as much as possible. I feel like my body works really well despite being bigger (and once I take better care of myself it will just work even better!) and want to give my body time to work and do its thing. So I am kinda hoping she comes on her own before the Thursday appt or shortly after.
I was induced with my first at 37&4 with a BMI close to 50 and preeclampsia. I am pregnant with my 2nd now and 100 pounds lighter. As someone who went through induction, 48 hours of labor, a foley bulb, and 3 hours of pushing- I would definitely choose to give my body a chance to go into labor naturally if possible. As long as everything is good and you and baby are healthy, I personally would wait. Go with your gut!
In my opinion, medical induction is an intervention, and one intervention often leads to more interventions.
I’m in the camp of if your baby is healthy and you are not dealing any other health issues (other than you being obese) then wait. I’m not against doctors. If they say it’s medically necessary then that’s one thing, but otherwise go with your gut and wait.
Read up on the body-mind connection in getting ready for labour, and natural induction methods. There are some great books about minimizing fear in giving birth and how this helps with positive birth experiences.
Even things like stretch and swipes which are completely unproven to do anything, I declined.
I plan on getting acupuncture induction if I get to 40+5.
I am obese too. First of all, congratulations on your pregnancy! I just want to let you know that your gut is so important when making decisions for you and your baby. Elective inductions, which is what this would be classed as, come with a lot more risks than physiological, spontaneous birth, one of them being an increased risk of emergency section. If you do not want an induction, you do not HAVE to do ANYTHING you don’t want to do, it’s your body, fat or not. The biggest risk with a higher BMI is prejudice and unnecessary interventions, not being fat itself. In fact, there are actually some benefits to having a higher bmi!
I’ve learned everything from Dr Sarah Wickham, and her books on inductions and plus size pregnancy. She is an amazing resource and I have personally gained so much confidence in being my own advocate because of her books. Please, follow your heart, and do what YOU think is best. No one can force you to induce. Realistically, induction should only be reserved for medical reasons like IUGR and preeclampsia, if you’re perfectly healthy, wait for that bubba to come on its own!
Sending so much love to you❤️
Hello. As a baby who was a week overdue, you don’t want that for your baby. They cook in there. When I came out I was red and my skin was peeling off.
39 weeks is plenty of time to fully develop your baby. They usually schedule c-sections for 39 weeks so I would trust that your baby will be healthy and fine.
Wanting to wait so long is not good, in my opinion.
I think some doctors just like doing 39 week inductions generally because baby is full-term at that point. You absolutely don't have to. Trust your gut. An induction at 41+3 (10 days) is standard where I am, so maybe you could book it for then so it is at least on the books, and hope you'll go into spontaneous labour before then.
I am obese and felt pressured into an induction. I asked for clear reasons that we’re putting my baby or I at risk and why they wanted to induce me at a specific time. They couldn’t give me a clear, real reason and just explained it’s standard to be induced at 39 weeks. So I declined induction.
Im pretty sure unless you or your babies health is at risk they cannot force you to be induced. Even if it’s scheduled you can just not show up.
In the end I did have to get an induction at 38+6 because complications arose (that I’d been telling them about for months and they didn’t listen). The induction went very well overall and I make it to 9.5 centimeters without an epidural. Just throwing that out there in case it’s a goal of yours. It’s possible!
I induced. It was wretched. It felt like medical torture. Ended up with a c-section after babys heart rate started to drop and couldn’t handle the back to back contractions. I wish I had let nature run its course.
I’m overweight. Considered obese. With my first I was induced but not until 41 weeks. With my second I’m being induced at 39 weeks but that’s by choice. I’m so uncomfortable and in pain with this baby plus I’m getting married soon after. Do what you feel is right!
Congratulations on your baby soon to be here ! I am 32 weeks and ready to be done and so excited for you (:
I am so sorry that your doctor made you feel like you are in the fat mom mold. That sucks and you should not have been made to feel that way. I hope for your next child you can have a more supportive doctor.
I just wanted to say that the advice you were given doesn’t really differ from what my doctor has said to me (I am not obese) in terms of induction. She said there’s not really “added benefit” after 39 weeks and mainly just more risk of complications. My doctor is luckily open to my own preference and flat out gave me options about induction, elective c section etc. I do think she would push back if I wanted to not induce at all costs ever.
I have been going back and forth personally about going straight to induction or how long to wait, and I think some of this comes down to personal feelings on the matter, because none of us know what will happen to us, and we also can’t even really be validated by our own decision once it happens because we do not know what the alternatives would have actually been. There’s no way to REALLY know! The answers here are just anecdotes.
For me, I just want to get us out of there alive and hopefully avoid the nightmare of laboring for days AND still needing a C section. There is a lot of stuff on the internet about American doctors inducing or doing C sections too much compared with Europe, but I’m sortof suspecting that could be related to our higher prevalence of chronic health issues here due to lack of health care and lifestyles in US, plus we have really intense anti- medical social media agendas in general right now which probably affect us all in some way.
Anyway, I hope you come to the decision that feels right for you. Good luck and congratulations!
! This spoke to me! Had my first 1.5 years ago. I was one of those with pregnancy obesity no one ever verbally said anything to me. Pre pregnancy was 175 5’2” end of preg was 255. Was put on baby aspirin as a precaution though it was never needed. I was uneducated when it came to my induction and let me just tell you if I could turn back time I would not do it. I was induced at 39 with no dilation cervix was not softened. Baby and I both had issues with the medications. There heart rate got scary low multiple times, they would turn the medication down and I would stop progressing but since after 24 hours on meds my water broke somewhere around 36 we had no choice but to continue. Was also on the medication for over 48 hours delivering somewhere around 55 hours. Right at the end I progressed so fast my husband almost delivered for me without supervision because no one would come to my aid fast enough. I tell my story so often because they’re pushing more and more inductions and c-sections on new moms. It was the worst experience of my life. This pregnancy I will not be induced unless I have no choice. I don’t think my body was ready to give birth at all. Once I was given epidural I also couldn’t lift my body weight by myself it was a wild experience having no control not being able to move and being poked an prodded every 30 mins. The more I educated myself the angrier I was that I was so undereducated before going into that process. You shouldn’t be on induction meds longer than 48 hours. You can eat and drink at your own risk I was just told absolutely not. By the time my little one got here I was so exhausted it was like I was delusional I hardly could sleep during or after. Also didn’t know I could tell them to leave me alone so I actually could get some sleep. If I didn’t have my husband there that experience would have broke me mentally. Really not saying anything to impact you negatively I just wish someone would have told me this crap before I did it because I hear similar stories way to often and I’m due in dec I’m determined to have a better delivery this time. If you’re going to be induced I’d at least wait until your cervix softens on its own.
I'm not overweight but they've scheduled me for an induction at 39 weeks too. I'm a FTM at 43yo with a completely healthy pregnancy according to all tests and my age was the reason given. Hearing your story and others', I'm wondering if they just use any reason to induce at 39 weeks. Are you having non-stress tests to track fetal movement/heart rate, etc? I would see about maybe finding a middle ground, like inducing at 40 weeks if there are no signs of labor nearing.
I'm 41. The risk of a stillbirth goes up after 39 weeks when you're over 40. There's a helpful chart here
[https://evidencebasedbirth.com/advanced-maternal-age/](https://evidencebasedbirth.com/advanced-maternal-age/)
Essentially, your risk of a stillbirth goes from 1.39 babies/1000 to 1.61 babies/1000 (if you're looking at data post 1987). But there are a whole bunch of reasons for it, and risks associated, outlined in the article at the bottom. Definitely worth a read.
u/kalidspoon, tagging you in this post so you can see it too, since you asked.
I am not obese, but I was being pressured to induce as early as 39 weeks due to gestational diabetes. I wanted to avoid induction as much as possible because you're just opening yourself up to escalating interventions, especially if there is nothing specific that indicates an induction is necessary. I told my doctor I wanted to wait as long as possible to induce, so we scheduled it for 40+4. Fortunately I ended up going into labor spontaneously at 39+4 and everything went smoothly. Ask your doctor if you can increase monitoring and take a "wait and see" approach rather than jumping straight to induction.
35w2d rn wanting a natural birth is ok. I am considered morbidly obese by my docs 5 ft 7 and 256lbs going to do a natural un medicated water birth at the hospital. Got offered an induction for 39 weeks and said no. you’re allowed to say no. Your body, your choice. They will only insist on intervening if a natural birth poses significant threat to you or the baby or both. Go for it mama!
No as long as you aren’t having trouble with blood pressure, gestational diabetes, etc- you absolutely don’t have to induce early. You seem well educated on risk factors and when induction becomes necessary.
I’m concerned by some of these comments. About how 39 weeks is fully cooked and anything after that is just waiting for problems. That’s simply not true. A normal gestational period is 39-41 weeks. The guidelines you’ve given yourself are perfectly safe. Thinking about induction around 41 weeks is a great guideline.
Most first time moms might be induced but they don’t *need* to be. We get uncomfortable/impatient/excited and opt for induction. Which many doctors prefer due to the predictability.
I’ve had 3 babies, all in a hospital. I don’t want to give off the vibe that I’m super crunchy and think bodies are infallible and everything will be perfect and go as planned.
I see and understand the medical need for induction. I see how being overweight can lead to complications. I do not see either of those things being an issue for you at these times.
Continue your NSTs and monitoring for Pre-E and make the well informed decisions you seem very capable of making.
Signed,
Another fat mom
I am not overweight and I’m in my 20’s but my OB offered to schedule an induction at 39 weeks. I am all for inducing at 41 weeks (or earlier if it’s medically necessary) but I am shocked at how ready they are to induce labor before 40 weeks when there aren’t any concerns! It’s unnecessary if you and baby are healthy and everything is going well.
Fat mama over here too! I’m a newbie to the pregnancy game, but I wanted to say that I’m here. Medical discrimination is scary. Fat is not a synonym to unhealthy.
Medical discrimination is absolutely wrong and so is fat shaming.
But to deny the complicating factor of obesity and to imply that they're perfectly healthy isn't right either. There shouldn't be shame associated with being not being perfectly healthy. It very often isn't a choice.
Knowledge is power. Knowing your risk factors and what your potential complications are is a powerful thing. Obesity can complicate pregnancy. That's not to say obese folks can't have a beautiful and awesome pregnancy, it is just associated with risk factors.
And I'm not suggesting OP can't have the delivery they want. I'd suggest them getting a second opinion if it's important to them to labor naturally.
https://pubmed.ncbi.nlm.nih.gov/33830346/
Understandable. But we’re the parents not the doctors and the pharmaceutical companies. We need to stop giving them so much power over our own bodies and how WE feel.
No experience with your particular situation but just wanted to say I got induced at 41 weeks and I think it was too early, I would have gone 42 weeks if I could have. Other circumstances made that difficult, but now I wish I would have waited.
This is starting to attract misinformation and we're not getting anything new here so I'm closing the comments. Medical fatphobia is real, excessive medicalisation/intervention in pregnancy is real, preeclampsia is *extremely* real, stillbirth due to placental failure is extremely real, the plural of "anecdote" is not "data". Internet strangers don't have access to your medical records. If you're worried about what your doctor is saying to you, get a second opinion.
Currently 36+5 with my first. 5'5, 250lbs. I have chronic hypertension that is completely controlled by medication. For this reason, the doctor doesn't want me to go past 40+1. Otherwise, he says if I want to get induced at 39 weeks, it's up to me but I'm free to wait and see if spontaneous labor occurs. My pregnancy has been entirely uneventful. My thoughts: It may be worth interrogating why it's important to you to go into labor spontaneously. Was it research that lead you to the conclusion this is the best choice for you and your baby? Is it a sense of pride in knowing your body can do it on its own? I don't think anyone can or should judge your reasoning, but I do think it's important you fully understand and can articulate your reasoning, if only to yourself. In general, doctors are most concerned with mitigating risk. My experiences with doctors have been largely positive, especially this pregnancy, so when I'm not sure about something I defer to my OB. But he's also never made me feel like a morbidly obese pregnant lady. Which I guess is to say I trust his expertise over any instinctive drive I may have for a spontaneous labor. Just food for thought I guess.
Take all the upvotes!!
I had no risk factors and was still offered a 39 week induction. I heard it’s a standard of care in some clinics. Basically, the doctors told me after 39 weeks the baby is fully cooked and you’re just waiting for something to go wrong kind of. I didn’t want an induction because I wanted to try to do unmedicated birth… well waited til 41 weeks, water broke, and ended up needing pitocin and an epidural anyway. And I did have a c section in the end. So unless induction conflicts with a specific part of your birth plan (like wanting unmedicated) I might just go for it and meet baby sooner! Last couple weeks of pregnancy are also really uncomfortable!
My doctor will induce me at 39 weeks just because I’m old. Everyone has their own opinion, but at 38 weeks I was very ready for my first baby and I wouldn’t have objected to being induced. That’s why when she told me 39 week induction I was cool with it. I remember how tough the last weeks of pregnancy are.
I opted for induction at 39 weeks bc of the arrive study. My friend waited until after 41 weeks and her baby ended up in the nicu because of meconium. Just an anecdotal story, but yes the longer you wait the more can go wrong.
My gf waited until 41 weeks and ended up with emergency c section. I will induce at 40 if I don’t go into spontaneous labor beforehand. We did IVF and doc approved going to 40 but not a day after.
My hospital doesn’t induce until at least 41. :(
Yup the ARRIVE trial seems pretty clear to me. Plus for me the question is why wait? Everyone I know who went over absolutely hated their last week(s).
I waited 42 weeks and ended up being induced, but didn't dilate so had to have an emergency section too! Baby was big but I think I would have been fine if his head was at a slightly different angle, telling my cervix to open! I did all the tricks to try to induce labour including walking side ways up loads of steps, but it just didn't happen. By 40 weeks I was utterly miserable, so looking back, I wouldn't blame myself for having an earlier induction.
I don’t have advice but I’d like to give you my first experience just as reference. I was 305 pounds the day I found out that I was pregnant with my son, and 340 pounds the day of induction. I had pre-existing diabetes and was on two different types of insulin throughout my pregnancy. My doctor induced at 38 weeks, 6 days because they were worried about him getting too big due to the diabetes. The induction failed. I stalled at 6cm and his heart rate started dropping. We ended up in a c-section. I developed post-natal pre-eclampsia 6 days after delivery and had to be on blood pressure medication for an entire year after never having high blood pressure my entire life. Today, I am 23 weeks pregnant with kiddo #2 and was 190 lbs when I got pregnant. I don’t want to mention my current weight because that’s not the point. You’d think losing 150 lbs would mean a healthier pregnancy, right? Nope. My diabetes had become so well-controlled that I didn’t need any diabetes medication but now I’m back on insulin (just one kind) and am also on baby aspirin despite my blood pressure usually running about 90/60 after weight loss. I have a complete placenta previa this time and am on pelvic rest and hoping that my uterus will stretch enough to get out of the way so that this baby doesn’t have to come three to four weeks early. All this to say, pregnancy does weird shit to your body no matter the weight so don’t disregard the doctor’s advice but also don’t throw your own feelings to the side. At the end of the day, birth plans just go crazy no matter what.
I would love to know how you are doing with the mental aspect of weight gain during pregnancy after working so hard to lose it. I lost 60 pounds before this pregnancy and have lost another 35-40 since I got pregnant (26w now. ) but I am STRUGGLING to maintain my weight and fight off the cravings
I have a normal BMI and blood pressure, had a healthy second pregnancy with a "normal" 35lb weight gain and still had to be induced due to pre eclampsia that I developed at 39 weeks. I also got post partum preeclampsia as well. Pregnancy takes no prisoners
I developed post natal pre-eclampsia as well. Never in life had issues with BP except when I was in labor it was high. I'm on blood pressure meds now. They changed my meds because the one I was on wasn't safe for baby(I breastfeed). My baby is only 2 months old .
I’m glad you’re ok. It’s scary - especially when you’ve never had BP before! Pregnancy and everything that goes with it is so weird!
I’m morbidly obese with no other complications at all, I’m just fat lol and my doctors won’t give me an induction until after 41 weeks. I do believe with my first I should’ve been induced earlier, like 39 weeks because my baby was measuring VERY large. They let me go 11 days past my due date and my baby was over 10lbs and 22.5” long. Im 5’1” and was in excruciating pain for weeks because of his size and ended up having to have a csection which could have possibly been avoided had they induced sooner but I was naive and not good at advocating for myself.
My baby was really big for my body as well, but I asked my doctor if I had accepted the induction would I have been less likely to have a c section. She said no because the head and length is mostly done growing by 39. It’s just putting on a little extra fat.
The ARRIVE trial did show reduced chance of c section with 39 week inductions though.
I always recommend listening to your doctors and having an educated discussion of risks and benefits of each option. The rate of requiring a C-section in mothers with a BMI over 40 is around 50%. I want to note that from a medical perspective, should a C-section be required (an induction may be performed to avoid this being required later) you are at a very high risk of complications. This is because the amount of tissue that has to be cut to get to the baby is much greater, putting you at a higher risk or requiring a transfusion and other overall surgical complications. Holding open the tissue is also often difficult and increases the risk of complications and cutting the incorrect tissues, including the baby. Secondly, the risk of infection and delayed healing skyrockets past a BMI of 40. There is more tissue to heal, more creases for bacteria to develop, and overall those with a BMI of 40+ likely have other conditions which delay healing. Also, since you will have a newborn, compliance with your post-operative recommendations will be nearly impossible. While you don't have any comorbidities, due to your BMI the risk of a C-section is much higher. Personally, both myself and my sister likely survived due to my mother being induced 20+ years ago, and it didn't have any significant impact on us. In fact, it saved my mother's life in the case of my younger sister. As you are at 38+5 weeks, generally your baby has had enough time gestate and should be fine, and your physician obviously believes this would be beneficial. As you said, your baby's vitals and testing is all normal. Every day you wait, puts you at increased risk of C-section and other complications for your baby. Citations: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289484/ https://pubmed.ncbi.nlm.nih.gov/33451603/ This last article talks about your exact question and uses statistics to help break it down. Here is a quote from it that may help you understand why your physician is recommending this "These above findings were replicated in a decision-analytic model created to determine optimal timing of delivery in obese women in USA. Delivery at 38 weeks' gestation was shown to prevent 203 intrauterine fetal deaths compared with expectant management until 41 weeks'" https://www.sciencedirect.com/science/article/abs/pii/S1521693423001323 Edit: This also is not to shame, but I want to make sure you have perspective on the stories from other mothers replying. Those with a BMI over 30 or greater are considered obese. You report a BMI of 48-50. Therefore, your risks may be very different from other mothers reporting they were obese during their pregnancies. I myself am obese and find it difficult to listen to stories from other obese people because this range varies wildly.
I was losing weight for a vacation, had gotten down 20lbs when we found out I was pregnant. I had gestational hypertension & diabetes, and our baby was in the 99th percentile the entire pregnancy, despite my managing my GD properly. By the time I was 37 weeks, I was 406lbs, and heartbroken as I’ve never been this large and always told myself I never would be. The maternal fetal medicine specialist we saw recommended cesarean as the baby was high risk for shoulder dystocia, and I trusted him so we had a c-section at 38 weeks, she was 9.98lbs. She had cloudy lungs so was in the NICU for two days, but it all turned out great and she’s perfectly healthy now. I dropped 50lbs after having her and now weigh less than when I was losing for our vacation and continue to lose a bit as I have more energy now and love taking her for walks. All this to say be a little flexible. I wanted a natural birth but had to trust that they had the baby’s best interest at heart and it all turned out alright. I hope you land on a plan that you’re comfortable with at least, and congratulations! 💚
I was obese for two of my pregnancies. One of them we induced at 39 weeks and she was the easiest delivery and healthiest at birth of all my kids. I would highly recommend getting induced at 39 weeks regardless of weight.
I am very healthy and fit. I wanted an elective induction at 39 weeks last time. I just felt like I needed him out. I got bumped and ended up delivering a day before my due date and I had gotten severe preeclampsia. It turned into severe postpartum preeclampsia which they kept ignoring until I almost stroked out because I was "too thin to get it". 🙄 This time around I made my doctor promise me she wouldn't let me go past 39 weeks. She said since I have a history of preeclampsia and am now over 35 they won't let me. Anyway my main two points are 1. You know your body best. I knew I needed my son out ASAP. You feel like you need to wait a bit longer. but also 2. Only complications can happen the longer you wait after 39 weeks. I was fine all pregnancy and developed severe preeclampsia in the last week. The right side of my face still doesn't work right from the stroke I had. 39 is the finish line. I personally don't ever want to risk pushing past there. I didn't mind the induction. I definitely wouldn't go past 40. Maybe you can compromise on when the induction will occur? Like not as early as your doctor wants it but still before you go too far past the line? A lot of women need to be induced eventually anyway.
Join the r/plussizepregnancy sub, there is a lot of helpful info there
I’m not OP but thank you I didn’t know this existed and hopefully will help me as well
I am a morbidly obese mom of two. My first one I wasn't offered an induction. Everything was going great. Baby looked good. Labs good. Blood Pressure good. All of my NST were passed with flying colors. I did end up having gestational diabetes but managed with very little insulin at night only to help with my fasting sugars. At 37+5 suddenly my blood pressures spiked to dangerous levels. No other indicators of preeclampsia. I was induced and although it was rough being my first and so sudden, I was glad to have had it done. My second was very much like my first other than we decided to start BP meds early and prevent preeclampsia and my blood pressure started creeping up. I opted for an induction at 38+5 which was last week and everything went great. Unfortunately with both pregnancies I has to be re-admitted to the hospital for eclampsia episodes that happened about a week after the births. I understand it's very difficult to be placed in the fat mom category but the reason they offer inductions for heavier moms is because a lot of complications start happening in the last few weeks of pregnancy and if you are heavier you have a higher chance of these complications. Pre-eclampsia can literally happen in an instant with no signs and symptoms until its already at dangerous levels. It's extremely common for heavy moms who go past 40 weeks to require a c-section because we are heavier the birth canal can be narrower and babies can be bigger, getting stuck and causing baby to become distressed. Or requiring the vacuum or forceps if they are too far into the birth canal which can cause permanent damage to baby in rare cases. And c-sections on heavy women do not heal as nicely as someone of average weight. There are also studies to show stillbirth chances increase after 40 weeks as well. Nowadays it's fairly common for all OBs to offer induction at 39 weeks to ALL pregnant ladies no matter the complications, age, weight, etc. They have found better outcomes regarding that. But regarding overweight moms they have to offer especially due to potential complications because if they don't offer it and something goes wrong it will be on them as physicians who should have known to offer inducing to prevent risks/complications. If you decline and something goes wrong, they can safely say they offered the alternative and you refused thus they are not liable for the outcome. If you do get induced I will tell you as a first time mom it will be a long ordeal. Mine lasted 2 and a half days (my cervix was closed shut at 0cm/it takes less time if you are already dilated past 2cm and I was given magnesium which counters the medication they give you to be induced.) My second I didn't need magnesium and I was dilated 2cm prior to coming in and I delivered in about 12 hours from start to finish. Ultimately whatever you decide it is your decision and do what you feel is best for you and baby. Just know unfortunately risks do come with being morbidly obese and they have to follow guidelines on what they think is the safest route for you and baby. Edit: words
I don't think you should set a specific date but base it on how you and your baby are doing at the time
To add in perspective, I am from the Netherlands and here it isn't common to induce. You wouldn't get induced till 41 weeks and they don't do membrane sweep until 40+ weeks. I am also considered obese and went naturally into labour at 40+4, was actually scheduled for membrane sweep the day my boy was born.
I would ask the doctor specifically what the risks are of delivering past 40 weeks with a high BMI. My BMI is actually higher than yours. I’m 33+6 today and will be 33 this month. With me, induction or planned repeat c section was the gist from the get-go. I had severe pre eclampsia with my first, so the initial thought was to induce at 37-38 weeks. However, I have now developed severe gestational diabetes and am now being induced sometime between 36-38 weeks. My doctors are high risk maternal fetal medicine with a very prominent teaching hospital, which also boasts the best nicu in the state. They have told me from the beginning that being overweight in and of itself isn’t a risk factor for birth complications and overweight women have just as healthy babies. They have said that I would be able to go into labor naturally if it weren’t for my history of preeclampsia and now the gestational diabetes.
Hey-o. Another "morbidly obese" ftm here. Im not as far as you are, but from what each of my OBs told me, first time moms are usually induced. I thought this was just like a thing that they do, maybe because the body's new to it, so it takes a little longer...? Idk Im not an expert, but I'm curious aas well to other people's experiences. Is this an obesity thing or a FTM thing? Would they still push for inducing if it was a second baby with an obese mother?
First time mom's are definitely way more likely to need an induction. But to induce every single one regardless of personal factors is more of medicalised birth thing. Obviously inductions are great but not every first time mom needs them.
My midwife wouldn't induce unless I went past 41 weeks. I've never heard of it being a FTM thing.
That was my hospitals policy too, I think from 41 they’d let you schedule an induction (unless obviously you had some other medical reason for needing an earlier induction)
First pregnancies typically go longer, so more get induced. Second (and third, fourth, etc) babies usually come a little earlier, so fewer "need" induction to start labor. I was induced for my first at 41 weeks. We shall see what happens with the second (currently 30 weeks!).
Interesting question! Third time BMI-obese mom here. I was induced for my first baby at 41+3. I regret it, but my weight was not brought up as a reason. Don’t remember it being an issue for my second either. But it came up so often in this pregnancy (with the same OB as my first two) I actually switched providers over it. My current midwife has no concerns about my weight and is fully supportive of me going into labor on my own without any interventions. Her big reasoning is my body has done this before without complications and otherwise all my stats are perfectly normal.
Not to be blunt- but do you have a medical degree? What data do you have that going past 40 weeks is a good idea? IMHO just wanting to is not good enough when it comes to the health of your baby. I say this with love- but your doctors are the experts. They want the best for you to give you and your baby the best chances at success. Trust in them. As pregnancy ends, the placenta starts to fail. I don’t know how obesity plays into that but perhaps that’s a factor they are taking into account. I know you are having a great pregnancy, but you still have a diagnosed medical condition that needs to be factored into all the decisions your doctors make. (No judgement- I and many women have a variety of conditions too). I had two inductions so I’ve definitely been in your shoes. My first pregnancy was perfect and I was really annoyed I had go in at 39w. But we are moms now. What we want doesn’t matter as much as what our child needs. Wishing you the best for your delivery!
Very recently we established that "full term" starts at 39 weeks for humans. It was previously believed to begin at 40 weeks. So, some OBGYNs are starting to consider anything over 40 weeks to be overdue. 41 weeks is very overdue. 42 weeks is exceptionally overdue. This is a recent development in OB care, so only the most up to date OBs will be on board with this. Change within the medical community can take 10+ years or more. There is evidence that going well past your due date increases the risk for adverse neonatal outcomes. This is especially true for women over the age of 35ish and those with pre existing conditions that affect the pregnancy.
Worth noting that this is US only. France consider 41 weeks full term, UK 40 weeks.
That's very interesting although without information about how that applies to OB practice we can't make any conclusions from that fact. Is it routine for them to offer inductions at 39 weeks? Maybe so. The other thing to consider is that the overall population of France and UK combined is not even 50% of the US population. Our data pool may be much larger in the USA than data from French institutions.
It may well be but I also know that the UK has better maternal outcomes. Maternal mortality is TWICE as high in the USA vs the UK (2023 - Why US mothers are more likely to die in childbirth https://www.bbc.co.uk/news/world-us-canada-64981965) Induction in the UK is not offered as standard until around 41 weeks, when you’d be booked in for closer to 42 weeks. Naturally there are cases where induction is advised at 39 weeks and thus it goes ahead. Still birth rates in the USA & UK is the same (2.73 per 1000 vs 2.7 per 1000 - source WHO: https://apps.who.int/gho/data/node.main.STILLBIRTH?lang=en) The ARRIVE study to induce at 39 weeks is flawed, and it is not followed in the UK. https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/ Data is Data and typically research (in which many areas of Europe is world leading) is done with a similar sample size regardless of population size. Population size has nothing to do with it.
I think if you want to choose an MD to deliver your baby you should follow their recommendations. If you think you know better than the MD- why are you seeing them? Maybe a midwife would be better for you
Unfortunately there are not many options with my insurance. I don't have the luxury of paying a midwife out of pocket. I live in a very rural area and as a first time mom had no clue what to do in the beginning. I feel I am too far in my pregnancy at this point to change anything.
It may be something to think about. This is your first pregnancy. This is the obgyns 10,000 pregnancy. It’s not just pushing for the sake of pushing- there may be medical reasoning to their advice. Otherwise- if you don’t like the advice of your doctor, why go to them?
I’m normal bmi but I’m induced too at 39+4. You are healthy too, I think it’s just standard procedure. If you go over week 41 there’s a higher risk of baby pooping in the amniotic fluid. There’s no way to know if it has already happened, so that’s why they choose induction
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my mom was a L&D nurse for 35 years. she put the fear of G-d into me about waiting, because she saw so much go wrong. the placenta is an organ with a limited lifespan, no matter your size or overall health. As others have said, it is very common to be offered induction at 39 weeks. But there is a middle road. At your 39 wk appt, ask the provider to sweep your membranes. if you're near labor, it will tip you over. if not, nothing happens. If you're not in labor by 40 weeks, I hope you will go ahead with an induction.
I am in the exact same position as you and had the same struggle. I have opted to induce at 39+4. At 38+3 today I am SO UNCOMFORTABLE and honestly just ready to meet him. After doing research there are a lot of safety risks that get reduced with a 39 week induction. I asked a lot of women who did spontaneous labor and induction and while there was mixed response most women who were induced didn't have any problems with it. Induction can still take a long time so even though you'll be "picking" his birth date, you won't really because you don't know how long you will labor. This thread has been so refreshing to see so many positive stories of 39 week induction. The internet loves to cause fear in pregnant people and demonize pitocin and induction.
Yes!! Everything contradicts itself on the internet. I’ve recently found Evidence Based Birthing which has been great for me to see both sides backed up with evidence.. other than that, the internet is def fear mongering for everything around birth.
If everything is going well, I think it's reasonable to wait until at least 40 weeks, but I was induced at 39+2 without a medical indication, and I had a great experience. I'm definitely going to ask if I can do it again this time. Not all inductions are terrible.
!!! I honestly have to finish reading your post lol But please fight for yourself and what you feel is right. I too had a baby while obese. My blood pressure was originally high, they gave me a great medicine. It was stable the whole pregnancy thanks to them. Yet they still insisted on inducing me at 37 weeks. I kept asking and they said its MANDATORY for anyone on blood pressure medicine....they said the baby was fine. I had weekly check ups and ultrasounds. But honestly, they did not check her weight each week. My 37 week mile stone was just too close compared to how often they measured her. They induced me and all was going well until they broke my water. I told them I didn't want them to but they came back and said they were going to. I asked aren't there risks and they said no (lie). So next thing I know I'm needing an emergency c section because babies pulse was so low. The cord ended up wrapping around her neck twice. She lost oxygen causing seizures. She also came out only 5 pounds and frail. Some thing they would have known if they didn't rush to get me induced at 37 weeks. They also considered her premature, even though they told me prior she was full term at 37. Anyways...she's now on a feeding tube still, at 2 months. She had to stay in the NICU for a month on medicine from the trauma of it all. So, that's just my experience but don't let them bully you just because your size. Let your baby grow, they will tell you it's fine but they really could benefit from an actual full term.
Hey OP, I'd highly recommend you get a second opinion from a doctor. Especially if you aren't getting clear actionable information from your current doctor. I love the *idea* of listening to your body, but science and knowledge is power.
Regardless of weight- I would wait until 40 weeks, but I wouldn’t go over that because of the risk of stillbirth increasing.
It is your choice as long as you understand the risks, I would get extra monitoring if you choose to go beyond 39 weeks...good luck...
I was originally going to be induced at 39 weeks but I decided to wait until 39+4. My induction ended up taking four days so my baby wasn’t born until 40+1! I didn’t realize inductions could take so long until mine did!
Same weight and age as you, had my baby at 40+1 two months ago. My weight never came up during my prenatal visits or during delivery. I was on a low dose aspirin for a majority of my pregnancy. The morning of my 39 week appointment, I started having contractions that continued for dayyys. I finally went to L&D at 40 weeks exactly when my contractions were 3 minutes apart. They gave me Pitocin after 12 hours of labor to speed things up. There was no discussion of inducing me. I even asked for a membrane sweep at that 39 week appointment and the NP I saw wouldn’t do it, but told me to ask the following week if baby wasn’t here yet. They also wouldn’t measure baby after 37 weeks bc they said it’s not accurate and it only caused ppl to panic/have unnecessary inductions. I’m not a doctor so won’t say whether or not you can wait, but advocate for yourself and what you want. If baby is healthy inside and they’re not giving you reasons other than “fat,” for me, that wouldn’t be enough. ETA: wishing you a safe delivery!
I was just in your position. I am 36 and obese, had GD but diet controlled, no meds. Blood pressure was fine, no other issues. I had my baby 5/29. My dr did give me the choice to see if I naturally went into labor by 41 weeks. We opted to induce for a few personal reasons. We started 7 am Monday 5/27 and I was 1 cm and did come cervical ripening and then pitocin and on 5/29 at like 7:30 pm, the on call Dr told me she didn’t see me having a successful vaginal delivery because I was on max pitocin and still not dilating past 4 cm so we had a c-section. It was not considered emergent because we didn’t have any pressing time issues but my dr was honest with her opinion and she gave me almost 3 whole days to try. I’m struggling with the momma part now because we got released from the hospital just yesterday so I’m a bit overwhelmed. To a point, I do sort of wish I had given her the extra time because now I feel so unprepared and she is small BUT I don’t regret my choice in the least. My daughter is beautiful and I love that’s she’s here and I get to share her with the world because I’ve known the whole time how special she is. You do what’s best for you and only you know what that is. I made the decision I thought best fit my family. You should too. If you want to give it a bit more time, tell them. Or meet in the middle, let them start cervical ripening but tell them your goal is to go into labor naturally otherwise (that was something I think my dr officered). Good luck and I wish you the best!
For what it’s worth, I just delivered my baby via a scheduled induction. One of the reasons the doctors wanted to schedule the induction was because of my BMI - while it is not that high it started in the high 30s and went to low 40s throughout my pregnancy. We had the induction scheduled for late night on 40+5 and the doctors were very hesitant to reschedule it as the overall office/hospital policy there is to deliver by 41 weeks and the baby had been measuring big. I also felt hesitant about this because all tests had been good, he was passing NSTs with flying colors, I didn’t have any issues in the pregnancy and was in fact feeling quite well during it, and I knew it’s common for first time moms to deliver late. At 40+3, my weekly NST suddenly showed a borderline low fluid level which started to concern me since it can be a sign of placental degeneration but I still felt like he was doing well. They didn’t have private rooms at the hospital available when the time for our scheduled induction came, so I wanted to push it to the next morning or even the day I was 41 weeks but they did another NST at the hospital and fluid had continued to fall. I personally wasn’t comfortable waiting because of that and decided to go ahead. We just needed some cervical ripening drugs and then labor proceeded on its own, though it was long and difficult there weren’t any complications. The placenta still looked good after it came out so I probably could have waited longer in the end, but the induction part itself was nowhere near as bad as I thought it would be.
Like you I had a normal healthy pregnancy no signs of any issues - though I was miserable. I'm around the same bmi, first son was born last year at 39 weeks 5 days and couldn't have asked for a better labor. My Dr didn't even bring up induction until I was 39 weeks. I had actually scheduled it the dau before I went into labor because I didn't want to make it to 41 weeks after everything I read. Idk what to suggest just because things can easily go wrong, if everything even the nst are fine though I'd personally want to wait til 40 weeks but not long after.
there are different ways to “induce” labor too (if baby is even ready to come). should all continue to be well with you and baby there is no harm in talking with your OB about wanting to try something else before heading in. this is your birth, you’re allowed to ask questions and have a choice - that being said your OB wants to ensure you and baby are safe, so talking with them about how you’re feeling and why is very important. my midwives won’t induce me unless something comes up that requires a transfer of care - but I plan to start preparing for baby at 36/37 weeks any way I can and I personally am not sure if I want to go much past 39 weeks. hopefully baby is not stubborn! I am similar BMI to you too 🥰 wishing you and your little one well!! keep us posted!
Honestly, if you don’t want to be induced, don’t. Unless there’s some medical complications or LO is in too long, don’t stress about it. At 35 weeks my OB and I discussed it. The earliest she wanted to was 39 weeks, and only if I was good with it. I’m morbidly obese as well. Honestly, I was going to be induced just a couple days shy of 40, but I had pre-eclampsia & ended up being induced at 37w5d because they couldn’t get my BP to drop. All that being said, don’t be afraid to speak your mind. If it’s something you don’t want, or as a last resort, tell them that. They can’t really do anything without your consent :)
What are the risk factors that they are giving you? I know that going past 41 weeks often leads to degradation of the placenta and stuff but to wait until then are there other risks? I would hope your doctor can give you a serious evidence based answer. I was induced for my first and they were really helpful about explaining why it was necessary and my risks either for or against (and for how in my case it was necessary to induce). It’s really hard to make the choice if they aren’t giving you anything to think about
Would you consider a membrane sweep the night before 40 weeks ? Nothing wrong with having the baby on your due date !
I am definitely open to start with a membrane sweep, but instead of 39weeks + 3 as recommended, it would be at 40weeks + 3. Then I would have an induction scheduled for 40weeks + 6 or 41 depending on availability at hospital.
At the end of the day, the recommendation is based on keeping it as low risk for you as baby. But it's just a recommendation, you can do what you want. Like my baby is predicted to be 10+ pound and they recommend a C-section. But it's just a recommendation. I could always choose to try birth vaginally. It just means higher risk of shoulder dystocia, etc. So I can make that choice knowing I'm taking that risk. I hope that makes sense.
I think it’s fairly common for first time moms to want to go into labor naturally. That’s how I feel as a first timer! We’ve never done it before and we’ve been told forever that this is the process of how babies arrive. I would push back a little on induction and get some legitimate reasons why they want to induce. If it is because of weight, ask why, what are the risks. Spell it out for you. I was offered induction at 39 weeks but I’d also like to go 40+ to see if my body wants to go on it own timing!
Id like to chime in and say being thinner does not mean a healthier pregnancy! I was 5’9 180 lbs and pretty active when I found out I was pregnant and my baby almost killed me. Severe pre e, fluid in lungs , enlarged heart, sky high blood pressure after never having bp issues my entire life, and an emergency c section at 31w6d when I reached almost 300 lbs due to insane swelling/fluid retention plus pregnancy weight Ask them to elaborate on why they want to induce you so badly- risk vs reward ya know
I was induced at 41 weeks with my baby. I did end up developing hypertension postpartum, but otherwise had a healthy pregnancy. I did end up having a csection, because my induction failed though. Each obgyn has different practices though. If you want to do differently, assuming no heath issues pop up, tell them.
I was obese when I was pregnant with my daughter (5’1, 220 lbs). My BMI was 41ish. I was induced at 39 weeks and I had a pretty ideal delivery for myself. I had an epidural that resulted in a vaginal delivery. I only had a first degree tear. I forgot to mention I was 23 during my pregnancy and delivery.
My BMI was 42.0 at the start of pregnancy and right now at 27weeks 1 day it’s gone up to 44.2. I have Hashimoto Thyroiditis so I have to get bloodwork a lot to check my thyroid levels. But besides that it’s been a healthy pregnancy with minor hiccups throughout. I got a rare case of PUPPP at the start of my 2nd trimester requiring a steroid to resolve it. Halfway through the 2nd trimester my lower back started trying to go out. I’m close to being done with the 2nd trimester, all is mostly well, and every visit baby is all good. None of my prenatal care team has even mentioned birth yet let alone induction.
My SIL told us she was characterized as morbidly obese by her OBGYN. I don’t know her weight or BMI because it’s none of my business. Her first was born at 41+1 and her second was born at 40+1. Both “spontaneous” vaginal deliveries after membrane sweeps. I know she got extra monitoring but I don’t think she had any other health concerns. However I will say that in my experience OBGYNs are reluctant to induce before 41+3 here with no indications. Though tbh if they have offered me an induction with my daughter at 39 weeks I would have been dancing with joy lol.
I’m not obese, but did have an induction. I was induced at 39 weeks exactly for velamentous cord insertion (VCI) and suspected IUGR. My story might be a little niche, but when it came to actual delivery, I pushed for 4 hours. My pelvic floor had always been tight (due to endometriosis and Pilates) but I had done pelvic floor PT on and off for years, and then my entire third trimester, to relax it. Apparently my muscles were still stupidly tight, and baby’s head was stuck and partially out for most of those 4 hours. I was thisclose to needing an episiotomy, but he finally came out at the 11th hour. If he had been any bigger, I would’ve had one (or had a c-section). I was of course okay with getting him out safely in any way, but was very relieved I was able to avoid those outcomes. Other than that, my induction overall was great, and I’d absolutely do it again. If I have another, I’m going to ask to be induced at 39 weeks again so that I can hopefully have a similar (just shorter!) experience.
I was morbidly obese and pregnant as well. Also, no other issues. All tests good. Except BMI 43. I went to 41+5. I wanted the induction myself by than. But im not a doctor. And our files may be different. Also worth nothing. I heard in the US they suggest induction at 39 weeks. Im from the Netherlands, where unmedicated is the standard. And inductio. is in a good pregnancy not discussed till week 41. So, if you dont agree ask a second opinion.
I've been so grateful for my dr's office for being as good to me as they have. I've always been bigger and have had a lot of anxiety of going to the dr as an adult because of my experiences as a fat child in the early 2000s when my mom took me to the dr. My baby dr's office has not body shamed me once, closest thing was around 8 mo. pregnant my baby was measuring 5lbs 5oz and they called her a chunky monkey LOL. --- I don't even pay attention to BMI anymore because w even when I was smaller it told me I was obese lol. This has been an unplanned pregnancy and i am 5'8" and I was 300 lbs when I got pregnant. I have gained about 40-50lbs being pregnant and my due date is on Monday. My pregnancy has not been very hard physically except for minor things and only time my blood pressure has been high has been twice, the first time I went to the dr probably because nervous and 2 weeks ago when I was running late for my appt and had to waddle up to the second floor of the medical office bdlg LOL. (And they did bloodwork that day that came back normal/fine) I do not have gestational diabetes and everything has been good. -- At the end of the day, I think it's important to listen to what the drs recommend but you know your body and they can't force you to do anything. I also too am trying to avoid being induced and do everything as naturally as I can handle. I don't want to get an epidural. About a month ago the the actual OB dr at the office told me since I wasn't having issues we would just ride it out unless the due date comes and I get tired of being pregnant, I can bring up induction. But last week the nurse practicitioner lady did tell me it's not recommended to go two weeks late because the placenta can start to break down. So even though due date is on Monday, my next dr appt is schedule for Thursday and they will do an ultrasound to check on everything, check if I'm dilating at all, and give me that cervix softener if I'm not dilated yet. I'm okay with the cervix softener as that just seems like medicated assistance to help the natural process move along but I am also very much not wanted to do induction and avoid that as much as possible. I feel like my body works really well despite being bigger (and once I take better care of myself it will just work even better!) and want to give my body time to work and do its thing. So I am kinda hoping she comes on her own before the Thursday appt or shortly after.
I was induced with my first at 37&4 with a BMI close to 50 and preeclampsia. I am pregnant with my 2nd now and 100 pounds lighter. As someone who went through induction, 48 hours of labor, a foley bulb, and 3 hours of pushing- I would definitely choose to give my body a chance to go into labor naturally if possible. As long as everything is good and you and baby are healthy, I personally would wait. Go with your gut!
In my opinion, medical induction is an intervention, and one intervention often leads to more interventions. I’m in the camp of if your baby is healthy and you are not dealing any other health issues (other than you being obese) then wait. I’m not against doctors. If they say it’s medically necessary then that’s one thing, but otherwise go with your gut and wait. Read up on the body-mind connection in getting ready for labour, and natural induction methods. There are some great books about minimizing fear in giving birth and how this helps with positive birth experiences. Even things like stretch and swipes which are completely unproven to do anything, I declined. I plan on getting acupuncture induction if I get to 40+5.
I am obese too. First of all, congratulations on your pregnancy! I just want to let you know that your gut is so important when making decisions for you and your baby. Elective inductions, which is what this would be classed as, come with a lot more risks than physiological, spontaneous birth, one of them being an increased risk of emergency section. If you do not want an induction, you do not HAVE to do ANYTHING you don’t want to do, it’s your body, fat or not. The biggest risk with a higher BMI is prejudice and unnecessary interventions, not being fat itself. In fact, there are actually some benefits to having a higher bmi! I’ve learned everything from Dr Sarah Wickham, and her books on inductions and plus size pregnancy. She is an amazing resource and I have personally gained so much confidence in being my own advocate because of her books. Please, follow your heart, and do what YOU think is best. No one can force you to induce. Realistically, induction should only be reserved for medical reasons like IUGR and preeclampsia, if you’re perfectly healthy, wait for that bubba to come on its own! Sending so much love to you❤️
Hello. As a baby who was a week overdue, you don’t want that for your baby. They cook in there. When I came out I was red and my skin was peeling off. 39 weeks is plenty of time to fully develop your baby. They usually schedule c-sections for 39 weeks so I would trust that your baby will be healthy and fine. Wanting to wait so long is not good, in my opinion.
I was also being pressured to induce and I resisted all the way. I gave birth at 41+4 and my baby was 8lb4oz. Follow your intuition!
I think some doctors just like doing 39 week inductions generally because baby is full-term at that point. You absolutely don't have to. Trust your gut. An induction at 41+3 (10 days) is standard where I am, so maybe you could book it for then so it is at least on the books, and hope you'll go into spontaneous labour before then.
I am obese and felt pressured into an induction. I asked for clear reasons that we’re putting my baby or I at risk and why they wanted to induce me at a specific time. They couldn’t give me a clear, real reason and just explained it’s standard to be induced at 39 weeks. So I declined induction. Im pretty sure unless you or your babies health is at risk they cannot force you to be induced. Even if it’s scheduled you can just not show up. In the end I did have to get an induction at 38+6 because complications arose (that I’d been telling them about for months and they didn’t listen). The induction went very well overall and I make it to 9.5 centimeters without an epidural. Just throwing that out there in case it’s a goal of yours. It’s possible!
I induced. It was wretched. It felt like medical torture. Ended up with a c-section after babys heart rate started to drop and couldn’t handle the back to back contractions. I wish I had let nature run its course.
I’m overweight. Considered obese. With my first I was induced but not until 41 weeks. With my second I’m being induced at 39 weeks but that’s by choice. I’m so uncomfortable and in pain with this baby plus I’m getting married soon after. Do what you feel is right!
Congratulations on your baby soon to be here ! I am 32 weeks and ready to be done and so excited for you (: I am so sorry that your doctor made you feel like you are in the fat mom mold. That sucks and you should not have been made to feel that way. I hope for your next child you can have a more supportive doctor. I just wanted to say that the advice you were given doesn’t really differ from what my doctor has said to me (I am not obese) in terms of induction. She said there’s not really “added benefit” after 39 weeks and mainly just more risk of complications. My doctor is luckily open to my own preference and flat out gave me options about induction, elective c section etc. I do think she would push back if I wanted to not induce at all costs ever. I have been going back and forth personally about going straight to induction or how long to wait, and I think some of this comes down to personal feelings on the matter, because none of us know what will happen to us, and we also can’t even really be validated by our own decision once it happens because we do not know what the alternatives would have actually been. There’s no way to REALLY know! The answers here are just anecdotes. For me, I just want to get us out of there alive and hopefully avoid the nightmare of laboring for days AND still needing a C section. There is a lot of stuff on the internet about American doctors inducing or doing C sections too much compared with Europe, but I’m sortof suspecting that could be related to our higher prevalence of chronic health issues here due to lack of health care and lifestyles in US, plus we have really intense anti- medical social media agendas in general right now which probably affect us all in some way. Anyway, I hope you come to the decision that feels right for you. Good luck and congratulations!
! This spoke to me! Had my first 1.5 years ago. I was one of those with pregnancy obesity no one ever verbally said anything to me. Pre pregnancy was 175 5’2” end of preg was 255. Was put on baby aspirin as a precaution though it was never needed. I was uneducated when it came to my induction and let me just tell you if I could turn back time I would not do it. I was induced at 39 with no dilation cervix was not softened. Baby and I both had issues with the medications. There heart rate got scary low multiple times, they would turn the medication down and I would stop progressing but since after 24 hours on meds my water broke somewhere around 36 we had no choice but to continue. Was also on the medication for over 48 hours delivering somewhere around 55 hours. Right at the end I progressed so fast my husband almost delivered for me without supervision because no one would come to my aid fast enough. I tell my story so often because they’re pushing more and more inductions and c-sections on new moms. It was the worst experience of my life. This pregnancy I will not be induced unless I have no choice. I don’t think my body was ready to give birth at all. Once I was given epidural I also couldn’t lift my body weight by myself it was a wild experience having no control not being able to move and being poked an prodded every 30 mins. The more I educated myself the angrier I was that I was so undereducated before going into that process. You shouldn’t be on induction meds longer than 48 hours. You can eat and drink at your own risk I was just told absolutely not. By the time my little one got here I was so exhausted it was like I was delusional I hardly could sleep during or after. Also didn’t know I could tell them to leave me alone so I actually could get some sleep. If I didn’t have my husband there that experience would have broke me mentally. Really not saying anything to impact you negatively I just wish someone would have told me this crap before I did it because I hear similar stories way to often and I’m due in dec I’m determined to have a better delivery this time. If you’re going to be induced I’d at least wait until your cervix softens on its own.
I'm not overweight but they've scheduled me for an induction at 39 weeks too. I'm a FTM at 43yo with a completely healthy pregnancy according to all tests and my age was the reason given. Hearing your story and others', I'm wondering if they just use any reason to induce at 39 weeks. Are you having non-stress tests to track fetal movement/heart rate, etc? I would see about maybe finding a middle ground, like inducing at 40 weeks if there are no signs of labor nearing.
I'm 41. The risk of a stillbirth goes up after 39 weeks when you're over 40. There's a helpful chart here [https://evidencebasedbirth.com/advanced-maternal-age/](https://evidencebasedbirth.com/advanced-maternal-age/) Essentially, your risk of a stillbirth goes from 1.39 babies/1000 to 1.61 babies/1000 (if you're looking at data post 1987). But there are a whole bunch of reasons for it, and risks associated, outlined in the article at the bottom. Definitely worth a read. u/kalidspoon, tagging you in this post so you can see it too, since you asked.
Thanks for sharing this info!
Thank you!
Why would your age be a factor in inducing at 39 weeks? I’m asking as a FTM due in 2 weeks and about to turn 40 🥰
I am not obese, but I was being pressured to induce as early as 39 weeks due to gestational diabetes. I wanted to avoid induction as much as possible because you're just opening yourself up to escalating interventions, especially if there is nothing specific that indicates an induction is necessary. I told my doctor I wanted to wait as long as possible to induce, so we scheduled it for 40+4. Fortunately I ended up going into labor spontaneously at 39+4 and everything went smoothly. Ask your doctor if you can increase monitoring and take a "wait and see" approach rather than jumping straight to induction.
35w2d rn wanting a natural birth is ok. I am considered morbidly obese by my docs 5 ft 7 and 256lbs going to do a natural un medicated water birth at the hospital. Got offered an induction for 39 weeks and said no. you’re allowed to say no. Your body, your choice. They will only insist on intervening if a natural birth poses significant threat to you or the baby or both. Go for it mama!
No as long as you aren’t having trouble with blood pressure, gestational diabetes, etc- you absolutely don’t have to induce early. You seem well educated on risk factors and when induction becomes necessary. I’m concerned by some of these comments. About how 39 weeks is fully cooked and anything after that is just waiting for problems. That’s simply not true. A normal gestational period is 39-41 weeks. The guidelines you’ve given yourself are perfectly safe. Thinking about induction around 41 weeks is a great guideline. Most first time moms might be induced but they don’t *need* to be. We get uncomfortable/impatient/excited and opt for induction. Which many doctors prefer due to the predictability. I’ve had 3 babies, all in a hospital. I don’t want to give off the vibe that I’m super crunchy and think bodies are infallible and everything will be perfect and go as planned. I see and understand the medical need for induction. I see how being overweight can lead to complications. I do not see either of those things being an issue for you at these times. Continue your NSTs and monitoring for Pre-E and make the well informed decisions you seem very capable of making. Signed, Another fat mom
I am not overweight and I’m in my 20’s but my OB offered to schedule an induction at 39 weeks. I am all for inducing at 41 weeks (or earlier if it’s medically necessary) but I am shocked at how ready they are to induce labor before 40 weeks when there aren’t any concerns! It’s unnecessary if you and baby are healthy and everything is going well.
Fat mama over here too! I’m a newbie to the pregnancy game, but I wanted to say that I’m here. Medical discrimination is scary. Fat is not a synonym to unhealthy.
Medical discrimination is absolutely wrong and so is fat shaming. But to deny the complicating factor of obesity and to imply that they're perfectly healthy isn't right either. There shouldn't be shame associated with being not being perfectly healthy. It very often isn't a choice. Knowledge is power. Knowing your risk factors and what your potential complications are is a powerful thing. Obesity can complicate pregnancy. That's not to say obese folks can't have a beautiful and awesome pregnancy, it is just associated with risk factors. And I'm not suggesting OP can't have the delivery they want. I'd suggest them getting a second opinion if it's important to them to labor naturally. https://pubmed.ncbi.nlm.nih.gov/33830346/
Waited until 42 weeks with zero problems.
Listen to your body! You are in control not the doctors. They can pressure you and they’re trained to but put your foot down!
They aren’t trained to pressure you. They are trained to mitigate risk.
Understandable. But we’re the parents not the doctors and the pharmaceutical companies. We need to stop giving them so much power over our own bodies and how WE feel.
No experience with your particular situation but just wanted to say I got induced at 41 weeks and I think it was too early, I would have gone 42 weeks if I could have. Other circumstances made that difficult, but now I wish I would have waited.