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To Induce or Not to Induce

5/21/2010

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“Induction of labor is like pushing a parked car up a hill. It requires a lot of help, hands and/or machine (tow truck). ”

There are many reasons a woman may be admitted to the hospital for an induction; past expected due date, pregnancy-induced hypertension, spontaneous rupture of membranes without labor and just because. As you can see most of these reasons are perfectly valid and are most likely for the best interest of the mother and baby. However, there are 2 reasons in particular I have seen take place for convenience or according to the doctors or hospital policy, not necessarily because the mother and baby were in any danger.

The Estimated Due Date Myth

Most women do not know when they ovulated, therefore conceived so the common method is based on your LMP (last menstrual period). The problem with this method  is you may have been told that you ovulate or are most fertile on day 14 of your menstrual cycle, mid-cycle or even 14 days before your period is expected. These are myths. While this may be the case for some women, it may not be true for you, even if your cycles are regular. Your own fertility pattern is unique to you and unless you observe and chart your cycles your estimated due date can be off by as much as 2-3 weeks.

When we are given a due date (even on the basis of it being just an estimate) we hold on to it as if it is in stone. We watch the calendar and check days off and the closer we get to it with no sign of labor starting we panic. Not to mention the annoying phone calls, emails and now texts from well meaning and loving family and friends asking, “Have you had the baby yet?” If you happen to have a doctor who has a vacation coming up or who “doesn’t like to see their patients so uncomfortable”, that’s a lot of pressure for an expectant mother.

“One of the biggest obstacles to natural birth is misunderstanding your "due date." A due date does not mean there is only one safe day for your baby to be born. It is meant to establish a range of time that your baby is mature and safe to be born. Because modern obstetrics narrows this to a specific day, unnecessary interventions, like inducing labor, come into practice.” Mothers Naturally

“Is this baby ever going to come?”

These words and thoughts may start to be uttered days before the estimated due date. But we have forgotten one thing, it’s an estimation.

Sometime we are literally evicting the baby before he/she is ready. There are many things that need to come together for true labor to begin. It is not just about jump starting contractions. When we begin to play with nature and its timing there is no wonder the snowball effect of interventions begin. It’s almost like our bodies are saying, “I wasn’t ready but since you are trying to make it happen you are going to have to finish it”. That is exactly what happens.

 “Pitocin is like normal contractions on steroids”

Oxytocin is a natural hormone produced by a woman's body that cause uterine contractions, when her body and baby are ready. Pitocin is the synthetic form of oxytocin. Pitocin is generally used in two ways: 1) to induce labor, and 2) to augment (speed up) labor. Pitocin is supposed to be used to induce labor or increase the strength or duration of contractions for the health of mother or baby.

Oxytocin, your body's natural hormone, is secreted in bursts. However, when you are given pitocin you are placed on a regulated intravenous pump, to regulate the amount of pitocin to a steady flow. Therefore, pitocin induced contractions are different from your body's natural contractions, in strength and effect. (For more detailed information on Pitocin FAQ )

This domino effect, I have unfortunately seen more than once, has a higher chance of ending with a c-section. The mother wonders; how did I get to this point, what went wrong, did my body fail me? I have been in these moments; it can break your heart to witness.

Are there times when inductions are needed? Absolutely, and when they are done during those times can give a mother and child the best outcome. However, similar to c-sections, it can be a matter of convenience and control and less about a woman’s ability to labor successfully on her own.  “In a well-nourished, low risk pregnancy it is normal for your baby to be born between 37 and 42 weeks gestation*. Many natural events take place within your body during the last weeks of pregnancy to prepare you for labor. Allow time for the natural process to occur.”

I would like to encourage mothers to-be and their providers to 1) allow nature to take its course which will require some patience, 2) if assistance is needed to consider all the options, pros and cons of induction, 3) consider alternatives to start and augment labor.

To induce labor:

  • Walking
  • Nipple Stimulation
  • Intercourse (Only if the bag of water is intact.)
  • Enemas
  • Castor Oil
Augmenting Labor:

  • Walking
  • Change positions
  • Avoid exhaustion
  • Nipple stimulation
  • Employ a professional labor support person
Do not be afraid or intimated.

Ask questions about what is being suggested. Ask why, are there any alternatives and what are the pros and cons. When we want someone to do something we tend to glorify the benefits and downplay the risks. This is a time you want to know (equally) both sides of the coin. If your doctor seems impatient or acts as if your questions are stupid or annoying (I’ve seen it) in the middle of labor (especially an induced one) is not the best time to address your concerns. You may feel vulnerable, afraid and as if you do not have any choices, or that you can’t make the right one.

 

Resources:

Childbirth.org

The Doula Book

mothersnaturally.com


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​At the heart & soul of A Woman's Design is the belief that every mother has the inner wisdom to make the best choices for herself and her baby in pregnancy, childbirth and early parenting. 
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