Thoughts? Scheduling induction/c-section due to due date in middle of finals.....

We are unexpectedly pregnant with baby #4 and my due date is 3 days prior to DH's last final exam this fall. (Wonderful timing, I know.) I'm due December 10th. Finals start December 6th and end December 13th. He has 3 days- from December 3rd to December 5th- where he doesn't have to be in class. On December 3rd, I would be 39w0d. I VBAC. I've gone at 37w0d, 39w0d and 40w0d, so I've never gone over before. He is not going to be able to miss his finals for the birth of the baby and I don't want him to, but ideally I would like for him to be there. Our options are:

1) Hope I don't go into labor until 40w3d. If I do, we'd be scrambling to get my mom here (she's 3.5 hours away) and struggling to find childcare for our other 3 kids. DH might not be available to take me to the hospital, so I might have to wait for a ride, etc if I'm not in any shape to drive. DH might not be able to make it for the birth as he might be in a final or studying for one, and even if he is taking one or studying for one, he would probably be distracted knowing I'm in labor.
2) Schedule an ERCS at 39 weeks. I'd really prefer to vaginal birth because I recover a lot quicker from vaginal births (my first was a c-section, my last two have been VBACs), but if that's what has to happen, so be it. Scheduling it would give DH the assurance that he would actually be there for the birth. Also, we could schedule childcare, so we would know we had childcare. Also, I would be in the hospital until the 6th recovering, so he could stay with me the 3rd, then go in his hole and study the 4th and the 5th. My mom would come on the 6th and stay for a week which would take us through DH's finals.
3) Find a doc who would be willing to schedule an elective induction at 39w0d. I'm always very favorable from 38w on and I'm a multip so really if they AROM me and give me a whiff of pit I might just go on my own quickly. Might be difficult to find someone willing to do that though because of the March of Dimes initiative and no one wants to do "social" inductions anymore. Same benefits of scheduling as in #2.

Thoughts? Anyone have any advice or can think of alternatives we haven't thought of yet??

Thanks!

[TigerLily]

I know this probably isn't going to be popular, but I was induced at 39 weeks w DD2 because I knew DH would be able to be there and have a few days off. My OB is amazing and was willing to do it. When I asked, I told her that I understood the risks, understood that being induced sucks, and I wanted to do it anyway. I think sometimes doctors might be more willing to go outside of the norm with people in the medical community. They know that you probably actually understand, and might be more understanding of the schedule that your DH has etc...
Maybe you'll get lucky and will just go into labor naturally a little early.

[HouseofWool]

When I had my daughter in January 09, we had an elective induction set as her dad was going to be traveling for residency interviews. My OB was fine with doing setting it for anytime after 37w. He had been traveling and I had a friend stay with me while he was gone, he got home on a Wednesday and on Thursday evening my water broke at 38w0d. DD was born on Friday morning.

Honestly, have your DH talk to his professors about the possibility of taking the exams early if that would work better. Most people aren't assholes, but the system can suck.

[SoonerTexan]

Honestly, have your DH talk to his professors about the possibility of taking the exams early if that would work better. Most people aren't assholes, but the system can suck.

This. He isn't going to perform well on a test he is missing because his wife is GIVING BIRTH anyway. Our daughter was born Dec 5th and DH got permission in advance to take a final late if needed. It wasn't necessary, but nice to know. We had another med student friend whose wife went into labor 5 weeks early and he was able to miss a test with very little notice. Maybe our school is just nice about it, but I think it is worth asking. It's just a test and not even a Board Exam. I know residency is different, but a birth is important!

And CONGRATS! You'll enjoy having him home over the Christmas holidays. That was a big bonus for us.

[ladymoreta]

It's worth asking about getting advance permission to miss the test, but the March of Dimes initiative even says 39 weeks, so most OBs would probably be willing to induce then. My OB knew DH was a resident, and he brought up scheduled induction before we did.

I ended up being induced with my second baby because of her size, and it wasn't bad. Like you, I was favorable far in advance, so the by the time the contractions started hurting at all, I was at a 7 and could get an epidural immediately. I hope that's the case for you!

[MrsK]

Congratulations on your pregnancy! I'm hoping you have an easy pregnancy and can look forward to a beautiful baby.

I think it may be worth speaking to the professors about rescheduling his final. They may be reluctant to let him take it early for fear that he'll share the test with his classmates (or late for fear that they will share the exam with him). But, hopefully, there can be some accomidation.

I also think inducing sounds like it may be an option for you since it would relieve some of the pressure to find childcare for your other children. However, I don't know if your doc would be willing to induce if you've had a previous c-section. Mine said that she couldn't but my babies were close. Since your c-section was many years ago and you've successfully vbac'd twice, it may be an option for you.

[TulipsAndSunscreen]

I didn't think induction was an option with a VBAC (though I don't know for sure). Good luck with your decision though and congrats on the pregnancy!

[Michele]

I was "induced" as a VBA2C. You can't have cervadil or cytotec. But you can do a balloon/foley dilation and a pitocin drip. My water broke so the foley option was out. I got pit but never dilated so I ended up with a repeat C-section. Honestly? My scheduled c-section (2nd kid - repeat pre-e) was the best recovery. I left the hospital less than 24h post op and felt great!!! I felt pretty good after the 3rd as well but not as good as after the second. A week after the third, I walked the Dallas Zoo.

Aside from my severe allergic skin reaction to the various adhesives, I've had great post-op experiences with my C-sections. Don't get me wrong, the extremely itchy full body rash (requiring a month of pred) and the weeping wounds from the steri-strips SUCK! But the walking/recovery part was fine. I had a Belly Bandit after the third and it was super helpful!!! I think there's a thread about it somewhere.

I'm kind of skeptical about his profs budging, to be honest. There was a girl last year who had a baby in the middle of the year and they made her come to her exam less than 48 hours postpartum. She failed it, of course, and then failed out for the year (probably due to more than just that 1 exam). They aren't very flexible. But I guess it's worth a shot.

A bit of pitocin hasn't really been shown to increase uterine rupture rates in VBACers. The max pit is lower (in all of the hospitals I've worked at), but the real danger with VBACs are any prostaglandins (like cytotec). Those have been shown to dramatically increase uterine rupture rates and are a huge taboo. If my cervix is already ripe, though, there's really no need for prostaglandins anyway. No danger in AROM with VBACs. Some docs are comfortable with inducing VBACs, some aren't. My last OB (in NC) was willing to induce me (I ended up going into labor naturally), but others aren't. It just depends. I'd probably have to shop around. VBACs are already an increased liability, so it might be difficult to find someone who is comfortable with VBAC and then comfortable with inducing a VBAC. I bet I could find someone, though. The issue is whether or not I care enough about a vaginal birth to put forth the effort, lol.


I'm really glad to know others have scheduled. If I do schedule, I'll have to switch practices since I"m seeing nurse midwives. I know none of them are going to agree with my plan and will try to talk me out of scheduling it "early". I guess I do feel some guilt about it because I'm a nurse midwife myself and scheduling induction or ERCS, especially prior to 40w, seems not very "midwifey". But I'm more of a medical midwife anyway so I suppose everyone else can shove it. I know there's not any danger in it (other than dangers inherent in birth) and I really don't' see any way around it if DH's profs aren't going to give one way or the other. Plus it's just more convenient, and doesn't that count for something? Seems to me that it should. My main reason for wanting to VBAC with the other two kids was that I wanted a big family. We wanted 5 kids. This being the 4th, I wouldn't have to limit my family size based on # of c-sections. People have 3 sections all of the time.

Thanks for your input. It really does help that others have scheduled as well!

[MrsK]

Sounds like you know your stuff! No need to ask our permission but FWIW, we'll back you up whatever you decide. No one here will ever judge you for doing what you feel is best for your family.

[ms.conception]

Hmmm that's a rough one. I would opt to wait and go naturally, but that's only because I've seen a lot of inductions fail and go to section which just end up in a longer recovery. Do you have an option of hiring a post partum doula who might be able to come in and help with the kids if you go early/late? Or do you have any friends with nannies who might want to nanny share?
I'm always for letting nature take is course, while planned sections are often an easier recovery, it could be devastating if you were to hemmorage or develop a surgical infection.
What about having your mom come in a week early?

[hanginginthere]

When we adopted, our daughter's birth mom asked to be induced early- at about 2 or 3 weeks ahead of the due date. It went well! So it is something that is an option for you. Wishing you all the best whatever you choose and congratulations.