Induction is one of the most common birth interventions in our modern world. App.1/4 of births in Queensland are medically induced and app. 20% of the remaining women, who go into labour spontaneously, have medication to speed up their labour. This is an awful lot of women having one medication or another to make labour come quicker or happen faster. This is a very busy world 🙂
Our talks at BaBs are never about whether it is right or wrong to choose a particular intervention or type of birth, but it is a lot about making sure you all know that you have a choice and to question routine procedures as they are often not evidence based.
Where there is some medical reasons for induction, the most common reason is post dates. A baby is full term anywhere between 37 weeks and 42 weeks, but lots of women go longer than that. After 42 weeks there is a slight increase in the percentage of babies, who would be better off out than in. If pregnancy goes on for more than 42 weeks it is possible to have regular check ups to be aware of whether your baby is OK in there and whether there is another reason that you are not going into labour other than that your baby isn’t ready. It is common belief these days that it is the baby who initiates labour, so we have to ask ourselves how many babies are born prematurely and with that having more breathing issues and babies going off the special care, being separated from their mother.
The reason given to women by the Obstetricians to explain why they need induction now they are past dates is most commonly that her placenta will shut down and stop working. But there is apparently no medical evidence to support this notion. It is purely a theory. On the other hand there is a lot of evidence suggesting that induction is very risky business, but not many women are given this information. Most women think they don’t have a choice about induction. “They won’t let me go any longer” is something I think we have all heard a woman say, but in fact it is your choice.
Some risk factors for induction are:
• Foetal distress, as the contraction made from synthetic hormones are harsher and unpredictable in nature – i.e. hard to control for both mother and caregiver
• Uterine rupture, yes even in first time women, but particularly if you have had a caesarean before
• Placenta abruption – placenta coming away from the uterine wall before baby is born and thereby cutting the oxygen supply
• The cascade of intervention, induction contractions can lead to the need for an epidural, which can lead to more synthetic hormone to speed labour up, which can lead to foetal distress
• Caesarean and all the risks associated with major surgery
So to summarise our Monday meeting there seems to be an awful lot of women induced and having very medicalised births as a result, without a good medical reason for the intervention in the first place. We can say no, if we feel that it is not the right choice for us and we can have regular check ups to make sure baby is ok while we are waiting.
As women we can’t count on interventions in hospital being necessary and if you want to avoid unnecessary intervention you need to do your own research and ask lots of questions to make sure you have enough information before you make up you mind.
These are some good questions to have in your back pocket:
TREATMENTS, DRUGS & INTERVENTIONS:
How will this be helpful?
What are the advantages?
What are the *RISKS?
What are the *ALTERNATIVES to this?
Does it need to be done *NOW?
What might happen if we wait an hour? A week? Or do nothing?
As we talked about the different issues around induction some women reported very difficult experiences with induction – they were completely overwhelmed with the intensity and the speed of labour contractions, leading them to epidurals, more monitoring, assisted deliveries and caesareans amongst other things. Other women had the minimum dose and carried on labouring by themselves from there. This seems to have to do with how ready or close to birth you are in the first place.
So women remember, you have a choice. Trust your gut instinct and gather information through questions and check ups to make your very personal decision. I believe women often know whether their baby is better off in than out, if they can sift through the fear. Hospital staff always want to give you the best possible care, but are restricted in so many ways under hospital policies created to protect themselves in liability cases. Keep taking charge of your birth!