I've seen it time and time again — well meaning (mostly) doctors who encourage mothers to choose an induction… only to wind up in a cascade of interventions that ultimately end up in an "emergency" C-section.
40 weeks or bust
Perhaps you may have guessed this already, but here's the thing:
I'm not a fan of inductions, especially inductions for first-time mothers.
Although it might sound nice and convenient — getting to choose your baby's birthday, finally being done with pregnancy, snuggling your little one in your arms on your schedule — it's not always a pretty picture. And while inductions can absolutely be a necessary intervention for stubborn babies who are more at risk in-utero, I do also think it's very important that mothers considering an induction (especially at their doctor's urging) know what they are getting into.
Know the reason for your induction
This may sound horrible, but the truth is, I've witnessed a lot of doctors proclaiming that a mother "should" have an induction or that a mother "needs" an induction, when the reality is, the doctor needs the induction to happen. Payment plans for doctors depend on their association with the hospital they work for, but if they aren't directly hired with the hospital and work independently, they may not get the money for delivery if you happen to deliver when they are not working. (And delivery equals big bucks.) So an induction might be a way for them ensure that they are the ones who deliver your baby — and pocket the change.
The bottom line? Don't be afraid to be blunt, direct and expect an honest answer from your doctor when you ask if your induction is 100 percent medically necessary.
Understand your due date is just an estimate
I know you've probably heard this one before, but do you really know why that 40-week deadline is just an estimate? It's honestly just an average for pregnant women. The reality is that your dates may be off, even if you're pretty confident of conception. A woman is considered four-weeks pregnant by the time she misses her first period, even though technically, conception only usually occurred two weeks prior. This gives room for error in case ovulation happened before or after the 14-day "range" in a woman's cycle. Hence, the assumption that the 40 weeks is plus or minus two weeks.
It's also important to understand that as long as babies are healthy, there is no reason to induce labor. Babies show clear signs of distress in the womb and if you're overdue, your care provider should be closely monitoring for a problem.
First-time inductions are usually the most difficult
Again, first-time inductions are the ones I have the most problem with, simply because they are often a lot harder on both Mom and Baby. When I worked as a labor and delivery nurse, I would always tell my patients to think of induction as trying to get a car started — labor won't happen until you really get that first spark going. And sometimes, it takes a while to get that engine going.
Many first-time parents come in for an induction that they don't really need, fully expecting to have a baby by lunchtime, and then are assaulted by two or three days of long, drawn-out labor. The medications that they are given often cause very intense contractions that don't always cause "real" labor. (Women can contract without those contractions necessarily affecting her dilation.) Hospital policy usually means that she can't eat, so she's starving and if she's on Pitocin, she won't be allowed to walk at all, so she'll also be confined to bed, which prolongs labor even more. Frankly, the whole experience is often exhausting for everyone and she becomes tired, mentally and physically.
Inductions have risk
So what's the result of that long, exhausting labor and relentless contractions, combined with a mother who's hungry and confined to bed? You guessed it — it's the "emergency" C-section for a tired-out baby or a "stalled" labor.
In fact, some studies have shown that an induction carries the risk of doubling the chance for a C-section. And along with an increased risk for a C-section, inductions can lead to:
- Vacuum or forceps-assisted vaginal birth
- Problems during labor such as fever, fetal heart rate changes and shoulder dystocia
- Low birth weight
- Increased incidence of admission to the NICU
- Increased length of hospital stay
But because I'm not all doom and gloom, although I think it's important for women to know the facts about induction, I will also freely say that I have seen many mothers happily choose an induction and in fact, be holding their newborns by lunchtime. Every woman and every labor is different, but what's most important is to be fully informed to make the best birth choice possible for you.