What You Need To Know About Inductions And Due Dates

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Induction Overkill

Over the last few years there has been a dramatic increase in the number of births that are being induced.  Some as early as 34 weeks, many more as late as 41 weeks.  Why have inductions become so rampant?

1. Many doctors are working on their timeline, not on your baby’s.

Birth rates are much higher at the end of the week for a reason.  Many doctors are inducing labor so that they can still make their weekend retreats.

On the other hand, some women are afraid of going into labor while their regular doctor is out of town, so many women will ask to be induced to ensure they do not have to birth under another’s care.

2. Many doctors give into the mother’s complaints of discomfort.

Discomfort at the end of pregnancy is to be expected.  In our day and time of modern medicine we have the ability to pop a pill for every ailment and pain.  As a culture, we have gotten very acclimated to not feeling discomfort.

At the end of pregnancy when the going gets tough many women beg their practitioners to help move things along in order to end the discomfort more quickly, and the doctors abide by their patient’s wishes.

3. Many doctors deal in fear mongering.

The modern medical community seems to forget that for the average pregnant woman, the body will take care of itself.  Labor and delivery is a normal and natural process, which should be allowed to just happen, and not intervened and interrupted.

• Being pregnant with twins does not necessitate an induction or c-section.
• A breeched baby can usually be delivered naturally with little to no complications.
• An ultrasound showing a larger baby should not be a warning sign to jump to an early induction or c-section.
• For more fear mongering signals from doctors that should be warnings to patients to look elsewhere for a more qualified physician click here.

4. Many doctors are ill informed about natural pregnancy and birth.

Doctors will not enjoy hearing this, especially considering their years of education and even experience dealing with pregnancy and birth.  However, doctors are meant for sick people.  They are taught to fix and heal.

The average pregnant woman needs no fixing nor healing.  The average pregnant woman left to herself will birth her baby with little to no help at all.  Doctors seem to have a very hard time just sitting back and allowing nature to take its course though.

Doctors today are trained mainly for medicated births, for epidurals, IV’s, inductions, interventions, and surgery.  They are trained for complications.  Ask many unmedicated birthing mothers who have hospital births and ask for little to no intervention, many of these women endure a lot of frustration due to the medical staff’s incessant badgering.

If one is in need of medical care, then doctors are wonderful allies, but the patient must always take responsibility for self education.  Doctors are fallible just like the rest of us.

Types of Medical Inductions

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Chemical:

1.) Pitocin – This is an artificial version of the hormone oxytocin which is responsible for naturally inducing labor and contractions.  The artificial version does not act like the natural.

Your body’s natural production of oxytocin will spur labor at the pace your body and baby are prepared to follow.  The average labor begins slowly, even many days before active labor begins.  The cervix will slowly efface and dilate.  The mother will often experience spurts of early labor where she will contract regularly for an hour or two at a time and then the contractions will cease.  This may happen regularly up until actual active labor begins.  This is the natural method the body uses to amp up for the real thing.  The body slowly but surely will open up and make way for baby to enter the world.

On the other hand when pitocin is given before the body or baby are ready many times a snowball effect occurs.  Pitocin brings contractions on hard and fast.  An epidural is often needed to be able to bear the immense pain by the type of contractions that pitocin induces.  The administration of pitocin often precipitates many other interventions particularly in first time moms.  Because contractions are hard and fast before the body is ripe for birth, baby often experiences elevated heart rate.  Mother cannot help baby’s elevated heart rate with movement because of her epidural.  Contractions agitate and distress baby.  When medical staff detects elevated heart rate that they are unable to bring back down, often a c-section is imminent.

2.) Cytotek – This drug is not approved by the FDA for use in the induction of labor.  However, it is used off label regularly.  For most women it works very efficiently at ripening the cervix.  Many times it is paired with pitocin to induce more contractions.  For those women that it does not work very efficiently for it can be DEADLY.  This drug is very dangerous and has been linked with both maternal and fetal deaths.  Read more on this here.

3.) Gels/ Suppositories – These can be placed right by the cervix to help with effacement.  There can be a few different side effects such as nausea or headaches.  Many times your medical institution will not allow you to leave once drug has been administered.

Gels and suppositories can take quite a while to prove effective so a long wait at the hospital might not be favorable.  Also if the gels and suppositories do not work on your doctor’s timeline he might push for stronger methods of induction such as pitocin.

Procedures

1.) Breaking the Bag of Water – A small, long, hooked tool is inserted past the cervix to make a small tear in the bag of waters.  Once the bag of waters is broken most medical institutions require that a woman give birth within twenty-four hours for fear that infection might occur.  If the woman’s body is not ripe and labor does not turn active or increase with this procedure then other induction methods will be pursued by your physician.

2.) Stripping or Sweeping Membranes – Many times this method of induction is done right in the doctor’s office.  Your physician will insert his fingers into your vagina as if checking the dilation of cervix and gently sweep the membranes that separate the amniotic sac from the cervix.  This stripping will also release the hormone prostaglandins which may also induce labor naturally.

If the body is not ripe for labor, sweeping of the membranes may not induce labor, but may in fact, open a door for infection because the protective membranes are no longer there to keep infection at bay.

3.) Foley Balloon Catheter – A foley balloom catheter is placed in the cervix and filled with saline.  The purpose is to help the cervix dilate.  Testimonials seem to concur that this is a very uncomfortable and even painful experience.  To help the cervix dilate medical staff may tug on the catheter a few times each hour to help move things along.

This method of induction does not have an extensive amount of side effects.  However, there is some research out there correlating the use of the foley balloon catheter and uterine rupture, but this is rare.  If the foley balloon catheter method of labor induction is used, and labor is not induced, there is a possibility that infection could be introduced to the cervix that could be dangerous if labor does not begin soon.

If this method of induction does not prove effective then your physician will more than likely pursue another method of induction such as gels, suppositories, or pitocin.

A Word On Due Dates

It is important to remember that a due date is not an expiration date, but an estimated date as to when your baby might come around.  According to ACOG an average pregnancy lasts anywhere from 37 weeks to 42 weeks.  The idea of an average pregnancy being only 9 months is a complete fallacy.  Most pregnancies are at least 9.5 months if not 10 months.  This is completely normal!

It is hard to watch your due date come and go.  I know, as I have been there.  However, it is important to remember that in the same way that not every baby develops the same once outside the womb, not every baby will develop the same inside the womb.  A pregnancy is not a one-size-fits-all deal.

There are many ways to ease discomforts in late pregnancy such as physical therapy, chiropractic care, and accuptuncture.  It is highly important to remember that you baby will arrive when he or she is ready to arrive.  Pushing baby to arrive any earlier than absolutely necessary can be harmful even if not immediately.  Babies that come before their time are more susceptible to many risks.

To read more on the problems and hazards of labor induction click here.

Going Post Dates

ACOG states that a true post dates pregnancy is uncommon, and usually if a woman passes 42 weeks of pregnancy it is usually due to a miscalculation in dates.  However, ACOG does make a point to say that a woman who is pregnant for the very first time or a woman who has had a post term pregnancy before in particular is much more likely to go post term again.  In fact ACOG say that this should be “expected.” (ACOG)

For pregnancies that truly do last past 42 weeks, there are a few concerns that ACOG lists, but nothing that cannot be monitored closely without probability of intervention.  Certain rare risks include:

1.) Placental Failure

2.) Decrease in Amniotic Fluid

3.) Risks to Baby: Dysmaturity Syndrome, Macrosomia, Meconium Aspiration

4.) Increased Risk of C-Section

These risks sound scary initially, but all of these can be easily monitored by ultrasound and even by less invasive tests such as kick counts and non-stress tests.  Many doctors act as though these risks become high the moment you reach 42weeks or even before.  This is just not true.  ACOG itself does not support these actions by doctors unless absolutely necessary for a legitimate medical reason. (ACOG)

Click here for encouragement for those going overdue or post dates.

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How To Naturally Induce Labor

There are many ways to naturally induce labor.  It is important to educate yourself and to consult with your medical provider or midwife, although sometimes medical physicians might be less than excited about some natural methods of induction.

Natural methods of induction are definitely preferred to medical, but should only be used if there is a true medical reason necessitating induction.  Remember that your baby will come at his or her own time and your body will work accordingly!

1.) Essential Oils such as primrose oil and clary sage oil are safe to use well after your due date to help with natural induction.  Check this online FREE webinar out by Modern Wellness on essential oils for pregnancy, birth, and beyond to learn more about how to use essential oils properly.

2.) Chiropractic Care is a great way to stay comfortable at the end of pregnancy and will also keep the body in prime condition to begin labor all on its own.  Chiropractic care can even aid breeches and back labor.

3.) Acupuncture for induction is very effective.  Acupuncture has been used for ages, is not painful, and works!  I went 2.5 weeks overdue with my third child and acupuncture did the trick overnight.  Many times your acupuncturist will book you for three separate consecutive sessions after your due date.  If these sessions do not induce labor then your body is not ripe and it would behoove you to wait a week or so before attempting again to allow your body to prepare for labor.

4.) Sex is the most natural and fun way to induce labor.  Semen naturally effaces the cervix and the extra activity going on down there can spur contractions along as well as an orgasm in the mother.  So the same thing that got that baby cookin’ can set the timer off too!  My husband always makes the point that you might as well get all that sex in right before the baby comes because once the baby arrives it is usually a while before you are both “in the mood” again at the same time due to change in schedule, lack of sleep, and for the mom some healing time.

Conclusion

It is very important to let go of our preconceived notions that due dates are expiration dates and pregnancy is only a nine month commitment.  Our commitment is to our baby and to his or her best health.

There are some medical conditions that might necessitate a medical induction but it is very important to self educate on the risks and benefits to early induction.  Going overdue is not a reason to induce labor.  Going past your due date is quite normal and should even be expected, particularly in first time mothers.  Allow your body to work for your baby.  Your baby will come when he or she is ready.  Hurrying that process along is only inviting complications and further interventions.

Pursing natural methods of induction is preferred if you must.  There are many ways to naturally induce labor but this should be done only after thorough self education and consultation with your midwife or medical physician.

What Is Your Induction Story?