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The Startling Truth About Inductions

While the induction rate was just 9.5 percent in 1990, it rose to an astounding 23.3 percent by 2012. They are becoming so common, that women think they are normal. Those two words — common and normal — are often used synonymously. But wait, they hardly mean the same thing.

Something is only common because it occurs frequently. Just because induction is occurring a lot doesn’t mean it’s normal. In fact, there’s nothing normal or natural about it. The process has one benefit: delivering the baby when the risk of keeping the baby where they are becomes greater than the risk of having the baby before it reaches maturity.

In truth, the baby plays a big role in when it’s time to be born. When a baby’s lungs reach maturity, they release surfactant. That substance alerts the body to start the process of labor by triggering a release of oxytocin. When we induce labor, we are removing the opportunity for the baby to reach full maturity.

Thus, we should only be venturing into the world of induction when it is absolutely necessary for the health of the baby and/or Mom.

More and more women are waking up to the realities of induction. The medical industry has become a little too induction-happy for many expectant mothers. They are educating themselves on what situations warrant needing induced, and which can be safely waited out. Often, women are encouraged to push things along for less than kosher reasons.

Some of the truth behind the induction culture is quite shocking. 

14 Ouch! The Pain!

Many women who have undergone inductions can attest to the reality of childbirth that is forced with drugs and other induction methods. The truth is, it can be more painful to birth a baby when induced. It’s tough on the body to pump it full of synthetic oxytocin or rupture the membranes before it was ready for it.

Contractions that are brought on with Pitocin are often harder on the body and the baby than natural contractions would be. Rupturing the bag of waters removes the cushion that the baby had — and that Mom had — from the intensity of contractions, too.

Still, childbirth is completely bearable and doable even in light of induction. But women should be prepared and know that their birth experience may be more intense with the addition of induction interventions. Likewise, adding drugs to the experience may delay labor further and further increase the risk of more adverse outcomes.

13 More Side Effects

The side effects that come with inducing are numerous. The doctors are under no obligation to list them all to you before they recommend it, either. How many women who get induced are asking for the package inserts for drugs like Pitocin before consenting to them? Very few.

This is unfortunate, because had they been informed first with the knowledge of what lies in those inserts, they may have made other choices.

For instance, Pitocin comes with many side effects, too. Such as, postpartum hemorrhage, cardiac arrhythmia, pelvic hematoma, hypertension, premature ventricular contractions, and much more.

By no means are we saying you should never consent to an induction. As previously mentioned, there are certainly reasons to go ahead with one. That being said, every woman deserves informed consent. It’s the law, after all. In light of that, when they give consent, they should actually be informed.

12 It Won’t Always Work

Unfortunately, induction is not a given that a baby will be born the day it is attempted or the way that we hope. Often, women get their hopes up that the uncomfortable days of pregnancy will soon be over with an induction that relives them of their hip pain and back ache.

Then they get up early, head to the hospital and get hooked up to an IV drip of Pitocin waiting for labor to happen, and it never does.

This is a reality for a lot of expectant mommas. When an induction doesn’t take, women often feel let down like their bodies have failed them. The truth is, a failed induction is a sign that the body is working well and doing its job to stay pregnant until the baby is mature.

Still, when it’s necessary, a failed induction then equates either another attempt on another day or jumping to a Cesarean section if the risks of staying pregnant another day or two are too high.

11 Inductions, Forceps, And Vacuums… Oh My!

Forceps and vacuum-assisted deliveries are much more common for women with induced labors than those who go into labor spontaneously on their own. A lot of mommies think that forceps and vacuums are needed for babies who are too large to fit through the birth canal and crown on their own. This isn’t true at all, though.

The need for assistance during delivery usually stems from the baby being in a poor position or mom being exhausted. Both of these scenarios are more likely to occur in cases of induction. Maternal exhaustion is particularly common during Pitocin inductions, which can produce strong contractions that are very close together and easily wear Mom down.

Some women may not pause at the thought of having an assisted delivery. After all, what harm can come from forceps and vacuums? Glad you asked. Skull fractures, hemorrhaging, and temporary paralysis of facial muscles are just a few.

 

10 Making A C-Section Necessary

The past few decades have marked this period in modern medicine as the era of unnecesareans. C-sections are rising all on their own. Many women are led to believe they can’t birth a baby vaginally because of its estimated size (not true), or that they must have a C-section this time because they did last time (also not true).

Some women are simply terrified of birthing vaginally and opt for a C-section by choice!

But there are a lot of C-section mommas out there who earned their scar by way of induction. They planned on a vaginal delivery all along. They got to the finish line and it was there that things went awry. Whether it’s via fetal distress because of Pitocin or a failed AROM that left a mom on the clock and at risk of infection as her labor didn’t progress, it is much more likely your provider will push for a C-section if you are induced than if you aren’t.

Among women who are induced by choice, 23.8 percent end up sporting the scar, and 23.4 percent of moms who need an induction for medical reasons do, compared to just 12 percent of moms who go into labor on their own.

The Countdown From AROM

Speaking of being on the clock, that’s exactly how it feels after you’ve consented to having your bag of waters manually ruptured by your provider. Get ready for a gush! Contrary to what you’ve likely seen in movies all your life, it’s not likely that your water will break in your favorite restaurant on your due date.

Instead, you might see a slow trickle, but most women won’t have their water break until they’re fully in labor. A special few will deliver the baby en caul — still in the amniotic sac.

Then the bag of waters breaks, the body typically starts contracting. Still, this doesn’t always happen if the body isn’t primed and ready for labor. When inducing, it’s very risky to let your provider break your water, because the risk of infection increases after the waters are broken.

Likewise, if contractions don’t start within a certain time frame following AROM — artificial rupture of membranes — then, you can bet your provider will be urging you to use Pitocin or opt for a C-section to get the show on the road.

Scary Fetal Distress

Induction immediately ups the risk of fetal distress. What does this mean exactly? Most of the time, it means there are decelerations or irregularities in the baby’s heart rate during labor. If this happens too often, your provider will encourage Cesarean deeming it necessary to get the baby out safely as soon as possible.

This is most common with Pitocin, since it makes contractions so much more intense for the majority of women who it is administered to. Fetal distress can deprive the baby of oxygen. It can also cause them to expel meconium in the womb, which increases the risk of meconium aspiration.

To determine whether or not that is fetal distress, women must be monitored. Most providers are pretty adamant about needing continuous fetal monitoring during inductions for this reason. This means Mom must be hooked up to uncomfortable monitors the whole time. It also means there’s more technologic exposure to the baby.

Elective Inductions On The Rise

In case you missed it above, it’s not wise to induce labor when there isn’t a medical need for it. There is literally zero research that supports this practice. Hospitals and doctors that are engaging in it are known as not practicing evidence-based care. They have that right, and you have the right to choose a provider that does better — even if it means switching late in pregnancy.

Elective inductions have become a trend as doctors continue to offer women the option to schedule their baby’s birth date. This sure does tend to make things easier. Women can plan to have their loved ones in town when they deliver. Doctors can be home for dinner on time that evening. It’s a win-win, right?

Sure. Except for the baby who is being deprived of the vital time he or she needs to fully develop inutero. The baby’s lungs and brain are the last to reach maturity. Again, when the lungs are mature, they release a protein known as surfactant. That substance triggers oxytocin to produce, and then, labor starts.

When this hasn’t happened yet, that means you can reason that fetal lung maturity hasn’t been reached. Should we really be playing with this just out of the sake of wanting control over something Mother Nature never intended we have control over?

Lack Of Evidence For Inductions

Piggy-backing on elective inductions, even medical inductions are sometimes a stretch. Sadly, many providers offer up reasons for inductions to mommies that aren’t medically support by research. Yes, there are absolutely reasons to induce. When a condition arises that makes it more dangerous for a woman to stay pregnant than give birth, it’s time to get the baby out.

However, women are often told incorrect information to try to push them into consenting, and it’s both ethically and medically wrong. For instance, some women are told they are too thin and/or their baby is too big. Others are told gestational diabetes always produces larger babies that can’t be birthed if they go to their due date.

Some women are even told it’s unsafe to stay pregnant beyond 40 to 41 weeks. None of this is true.

While each case must be weighed individually, there is no reason that women should be coerced into thinking they are doing what is best for their baby and themselves when they could be making a decision that is just the opposite.

Bishop’s Score Is Going Under Used

Many doctors and midwives neglect the Bishop’s score, named after Dr. Edward H. Bishop, an OBG from a few decades ago. Likewise, many mommies-to-be have never even heard of it. This is ludicrous, because it’s the very mechanism that should be dictating whether or not a woman should opt for induction.

In layman’s terms, this is a score for your cervix. It assesses how likely spontaneous labor is and how well an induction might take and produce a vaginal birth.

The score is derived from calculating certain factors together. A posterior cervix would give a woman zero points, while a mid-way cervix is one point and an anterior cervix is two points. Cervical consistency, effacement, dilation, and fetal station are all computed, as well.

When combined, the total will be between zero and 13. The higher the score, the more likely an induction will produce a vaginal birth. The Bishop’s score has been used for decades to assess this likelihood. Women who are not at risk by remaining pregnant that have a low score should consider waiting longer to pursue induction, if at all.

The American Way Seems To Be Medical Inductions

As has been noted here, doctors will push inductions for many reasons. Unfortunately, it’s not always about what is best for the patient. Of course most doctors are never trying to put their patients in harm’s way. However, these doctors often see patient after patient leave the labor and delivery ward with healthy babies.

So, they have come to assume that induction is totally fine because it’s not harming most moms and babies.

What we must reconsider is what we define as harm. While the doctor’s only obligation is to make sure both parties are in good physical health, most mommies are just as invested in their journey to motherhood from an emotional standpoint, too. Just ask any momma who has been coerced into an induction with mistruths and ended up having a C-section because of it.

Many of them come out on the other side feeling robbed of the vaginal birth experience.

The Doctor’s Agenda

As has been noted here, doctors will push inductions for many reasons. Unfortunately, it’s not always about what is best for the patient. Of course most doctors are never trying to put their patients in harm’s way. However, these doctors often see patient after patient leave the labor and delivery ward with healthy babies.

So, they have come to assume that induction is totally fine because it’s not harming most moms and babies.

What we must reconsider is what we define as harm. While the doctor’s only obligation is to make sure both parties are in good physical health, most mommies are just as invested in their journey to motherhood from an emotional standpoint, too. Just ask any momma who has been coerced into an induction with mistruths and ended up having a C-section because of it.

Many of them come out on the other side feeling robbed of the vaginal birth experience.

This in particular is why inductions increase so much around holidays — especially Thanksgiving, Christmas and New Year’s.

This isn’t an attempt to bash all the well-meaning doctors out there, but our country needs a wake-up call in the maternity ward. We are often encouraging doctors to coax women into inductions that their bodies and their babies don’t need.

Per the research, this process should be reserved for women who would suffer medical risks if they stayed pregnant and babies who are in danger as long as they stay inutero. There are no loopholes. It really is that cut and dry.

What Is “Term”?

In 1990, only 2 percent of pregnant women were induced when they were 37 to 38 weeks along. Fast-forward to 2012, and the rate is now 8 percent — and term isn’t even the same anymore. Part of the confusion about this comes from the fact that what term is has changed. Once 37 weeks, it is not recognized as being 39 weeks.

Does this mean all babies should be born by then? No. Not at all. It simply means babies born after 39 weeks are most likely to have reached fetal maturity, but it’s not a given for all.

Furthermore, other nations still refer to term as 37 weeks. To add to the confusion, a lot of women are told they cannot go overdue, which is beyond 40 weeks. Some doctors even want to induce at 39 weeks! But the truth is, there are no added risks of staying pregnant until 42 weeks.

Even at that point, the increased risk of stillbirth past 42 weeks is negligible when monitoring is in place, such as NSTs.

Off Label Drugs

Cytotec is often used off-label to help ripen the cervix. However, it’s not FDA approved for use in this manner, and it is linked to uterine rupture. Yikes! This is yet another concern that pregnant women are entitled to know about, but very few providers are relaying the information on.

This again reinforces the need for informed consent and draws into question whether or not women are truly being given that opportunity by their doctors and midwives. Is leaving out vital information that could harm a mom or her baby the same as lying? The medical industry doesn’t seem to see it as such.

It is up to these mothers to educate themselves on the risks and stop relying solely on their providers to give them the whole story.

The following warning is taken from the insert for Cytotec: “Cytotec (Misoprostol) administration to women who are pregnant can cause abortion, premature birth, or birth defects. Uterine rupture has been reported when Cytotec was administered in pregnant women to induce labor or to induce abortion beyond the eighth week of pregnancy.” Any questions?

Sources: National Center for Health Statistics, Fit Pregnancy

 

 

 

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