Induction is on the lips of almost every OB, but is it safe and how do you say no?
By Danielle, contributing writer
If I have heard it once, I have heard it two hundred times. “My doctor says she won’t let me go past 40 weeks…”
First, your doctor is providing you with a service. Your doctor doesn’t permit or allow you to do anything. They are working for you. Your baby knows when it’s time to come out, and starting labor before that time without just cause can be risky for the baby’s health.
Though induction has fallen into vogue in developed countries, it by no means equals a healthier birth. The last weeks of pregnancy are important for so many reasons. Learn more about the risks of induction and how to say “let’s wait” for your birth.
Why Are We Inducing?
Let’s first look at why we would induce birth to begin with. If we are honest, we are inducing because of these reasons:
- Physicians like to plan birth.It is easier to book a birth between the physician’s business hours, so they may induce you to get birth going on their clock.
- Mothers like to plan birth. You may be tempted to get that bun out of the oven, especially when you haven’t seen your toes in months.
- We are concerned with going over due.There are real concerns with babies staying in longer than 42 weeks, and babies who don’t seem to know when it’s time to come out. After 42 weeks, often monitoring should be done to evaluate the baby’s health. However, doctors are inducing at 37, 38, 39, 40 and 41 weeks for no good reason. This often endangers baby’s health and adding more pain to mama’s labor.
- We no longer understand that all pregnancies vary in length, nor how to date conception. Understanding fertility and a woman’s monthly cycle is a thing of the past. Now, it is replaced by metal instruments and pharma-funded textbooks. Not all women ovulate on the same day of their cycle, and not all gestation dating methods are accurate. Your due date may be up to two weeks off, making the doctor’s guestimate date less than a legitimate reason to induce.
The CDC’s most recent estimate says that only 18.4 percent of births are induced between 37-38 weeks, down from 20 percent in 1990. Based on that, induction is a downward trend. I would say that’s a low statistic. I still often hear murmurs of inducing from nearly every OB patient past 40 weeks.
There are four main ways to begin labor unnaturally:
1. Using medication to cause the cervix to ripen (or efface).
2. Using medication to cause the cervix to contract.
- Misoprostol (Cytotec) is a pill taken orally or vaginally that may be used to efface or contract, however, it is only approved for treating ulcers and is not safe for use during pregnancy and birth.
- Oxytocin (Pitocin) is used intravenously to cause effacement and contraction. It causes more painful, quicker and harder contractions than natural uterine contraction. It may also increase the baby’s heart rate and fetal distress, however, it is the most common induction medication.
- Dinoprostone (such as Cervidil or Prepidil Gel) is inserted vaginally to cause the cervix to open.
3. Sweeping the membranes (breaking the bag of waters).
4. Using a balloon catheter to help the cervix open.
- A balloon catheter is inserted into the cervix and blown up until the cervix opens to 3 centimeters.
Recent studies show that the birth process begins when the baby’s lung cells signal that they are ready. The biggest risk of preterm babies because of induction or other means is immature lungs — a baby born before their lungs are ready to breathe on their own. Inducing may mean that your baby’s lung are not ready to work yet earth-side.
Real risks are involved with induction. Here are some of the most common risks:
- Birth regret. Induction leads to riskier outcomes, such as c-sections. Many mothers feel robbed of their ideal birth if they cannot deliver naturally, and induction makes those outcomes more likely.
- Low heart rate. Because of the numerous medications used to induce birth, and subsequently squash pain, the baby is more likely to be born with a low heart rate.
- Premature lungs. Since the lung cells signal to the mother’s body to begin labor, if they have not signaled yet, it may mean the baby’s lungs are not ready. Lungs that are not ready to pump air earthside are one of the most common side effects of premature birth.
- Failed induction. About 25% of women who are induced end up birthing via c-section because the induction medication simply could not overwrite the body saying it’s not ready to deliver. This is a real likelihood for all inductions.
- Uterine rupture. Uterine rupture is a serious and possibly fatal condition where the uterus tears. This is more likely for mothers who have had previous c-section births, but possible in mothers who have only delivered vaginally. Because the induction medication forces the uterus to contract more and harder than usual, a tear is more likely.
- Bleeding post delivery. Your body knows to contract after birth to stop bleeding and to expel the placenta. If you induce unnaturally, your body may struggle to work through the medication to accomplish this important task. You may experience more bleeding post delivery or even a postpartum hemorrhage.
How to Induce Naturally
If the baby reaches 42 weeks and is still showing no signs of making his appearance, there are natural means which can start the process. Check with your doula and provider on which methods are safe for you.
Some natural induction methods include:
- Sex or nipple simulation
- Moderate exercise
- Riding on a bumpy road
- Spicy food
- Castor oil
- Acupressure (foot)
- Evening primrose oil
- Red raspberry leaf tea
Induction has become a norm in our society, but it’s not safe and you don’t have to be induced, no matter what your doctor says. Plan a natural birth and use these natural induction methods if need be.