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Inductions?

Posted by on Apr. 19, 2010 at 10:57 AM
  • 28 Replies

I am due today and still no baby yet. The doctor is saying if I make it until Friday he is going to schedule an induction. I have never had this before. My first son was born at 38 weeks and my second son was born at 38 weeks 6 days. Do any of you ladies know if there are any risks involved in an induction and will it cause more complications? I am so nervous and want more information! Thanks ladies!!!

by on Apr. 19, 2010 at 10:57 AM
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Replies (1-10):
meam4444
by Emerald Member on Apr. 19, 2010 at 11:03 AM

Did you doctor say how he is going to induce?  If you are uncertain with the induction, you have every right to deny it too.  You may want to ask him to sweep your membranes which may help labor come on too (I had it done with my last baby and it worked).  Good luck momma.

doulala
by on Apr. 19, 2010 at 11:04 AM

No way to *know* if it will cause complications~   but it does add risks.

So I would guess you will want to make sure you have a medical reason...     Because it adds risks to a healthy pregnancy, moms want to be sure the choice to induce is because baby is safer on the outside than in.

 

The due date is the mid-point in the due period (38-42 weeks).   It is an average, not a deadline.     I can offer info, absolutely!

;-)

doulala
by on Apr. 19, 2010 at 11:06 AM

Please be sure that you fully understand your risks and benefits so that you're making an informed decision.   A doctor that wants to induce a healthy mom for simply being "past the due date" is  adding risks.   You can learn more about this~


Postdates: Separating Fact from Fiction

Let the Baby Decide: The Case against Inducing Labor



The Tree and the Fruit


Birth is a process that probably lasts about a month or more, when
you think of how the baby works his/her way into position, mom's body
prepares with the uterus thickening at the top and thinning at the
bottom and the cervix prepares itself to dilate for the final pushes in
this process. It is such an amazing, divine plan and in this day and age
so easily disturbed—possibly as never before. I think induction,
possibly in any form, can disrupt this plan, interrupting the baby's
process of positioning and getting ready to be born. As Carla Hartley
says, "Birth is safe, interference is risky."


Jan Tritten, mother of Midwifery Today
magazine

abra
by on Apr. 19, 2010 at 11:09 AM

yup.

Quoting doulala:

Please be sure that you fully understand your risks and benefits so that you're making an informed decision.   A doctor that wants to induce a healthy mom for simply being "past the due date" is  adding risks.   You can learn more about this~


Postdates: Separating Fact from Fiction

Let the Baby Decide: The Case against Inducing Labor



The Tree and the Fruit


                                                    -----Wife to Bennett-----
                                      Mommy to Ophelia Grace & Mira Lorne

                                 
-------------
Due in November 2010 -------------

doulala
by on Apr. 19, 2010 at 11:12 AM

uhg--     lol

I have more info that I can not paste...       ?!?!?!

 

Anyway~    I have more to share:

 

 


 

 

 

Impact of Drugs and Procedures

Induction and Augmentation

by Dr. Sarah J. Buckley, MD 

In Australia in 2002, approximately 26 percent of women had an induction of labor, and another 19 percent have an augmentation--stimulation or speeding up of labor—through either artificial rupture of membranes or with synthetic oxytocin (Pitocin, Syntocinon).In the US in 2004, 53 percent of women reported that they had Pitocin administered in labor to strengthen or speed up contractions.36

Synthetic oxytocin administered in labor does not act like the body’s own oxytocin. First, Pitocin-induced contractions are different from natural contractions, and these differences can have significant effects on the baby. For example, waves can occur almost on top of each other when too high a dose of Pitocin is given, and it also causes the resting tone of the uterus to increase.37

Such over-stimulation (hyperstimulation) can deprive the baby from the necessary supplies of blood and oxygen, and so produce abnormal FHR patterns, fetal distress (leading to caesarean section), and even uterine rupture.38

Birth activist Doris Haire describes the effects of Pitocin on the baby:

The situation is analogous to holding an infant under the surface of the water, allowing the infant to come to the surface to gasp for air, but not to breathe.39

These effects may be partly due to the high blood levels of oxytocin that are reached when a woman labors with Pitocin. Theobald calculated that, at average levels used for induction or augmentation/acceleration, a woman’s oxytocin levels will be 130 to 570 times higher than she would naturally produce in labor.40 Direct measurements do not concur, but blood oxytocin levels are difficult to measure.41 Other researchers have suggested that continuous administration of this drug by iv infusion, which is very different to its natural pulsatile release, may also account for some of these problems.42

Second, oxytocin, synthetic or not, cannot cross from the body to the brain through the blood-brain barrier. This means that Pitocin, introduced into the body by injection or drip, does not act as the hormone of love. However, it can interfere with oxytocin’s natural effects. For example, we know that women with Pitocin infusions are at higher risk of major bleeding after the birth43 44 and that, in this situation, the uterus actually loses oxytocin receptors and so becomes unresponsive to the postpartum oxytocin peak that prevents bleeding.45 But we do not know the psychological effects of interference with the natural oxytocin that nature prescribes for all mammalian species.

As for the baby, ‘Many experts believe that through participating in this initiation of his own birth, the fetus may be training himself to secrete his own love hormone.’29 Michel Odent speaks passionately about our society’s deficits in our capacity to love self and others, and he traces these problems back to the time around birth, particularly to interference with the oxytocin system.

 

 

 

 

 

 

 

http://www.pushedbirth.com/ 

A pushed birth is one that is induced, sped up, and/or heavily medicated for no good reason, and all too often concludes with surgery, invasive instruments, an episiotomy, or a bad vaginal tear — outcomes you don’t want. Decades of research show that the healthiest birth for you and your baby — and that means your partner, your family, and your community — is a normal, vaginal birth with minimal intervention and maximum support.

If you’re like most American women, though, labor support is not what you’re going to get. Look at the numbers: 4 in 10 women today are induced. 1 in 3 give birth by major surgery, the cesarean section. 1 in 3 vaginal birthers get an episiotomy — surgical scissors cutting your vagina. And most women will put their pelvic floors at risk by lying in a bed throughout labor and pushing the baby out while while flat on their back.

Why? Because most L&D wards aren’t following best practices. They’re strapping 95% of women in for labor with continuous electronic fetal monitoring. It sounds great, but it’s actually a practice that goes against the research evidence. Time and time again, studies have shown that the machine is no better at monitoring your baby than a human being with a stethoscope, meanwhile it increases the likelihood of surgery and other unwanted outcomes because it limits your ability to move, find comfort, and help labor progress.

Labor and Delivery wards also put you on the clock, and more than half of you will be given the synthetic hormone Pitocin to speed things up. You’ll probably also have your water bag artificially broken. Once that happens, you’re on deadline: most OBs won’t allow you to labor more than 12 hours after your water has been broken. If you’re not pushing out that baby, you’re going to be pushed into the OR for a cesarean.

Or maybe you’re being told to induce labor because…your baby “looks big” on the ultrasound, or the fluid “looks low,” or it’s past your due date, or your doctor is going on vacation and you want her to deliver your baby, or you’re tired of being pregnant and, well, why not? There are compelling reasons to wait. An induced labor is not a normal, “physiological” labor. It’s more painful, it requires that you stay in bed hooked up to various tubes and machines, and it ups your chance of a C-section by two to three times. Furthermore, none of these reasons is medically valid.

Even if you’re able to go into labor on your own and progress fast enough, you’re probably going to push lying in a bed, and you’ll be told when to push, how long to push, and how hard to push. It’s a hold-your-breath-bear-down-and-count-to-ten kind of thing, and research has shown this practice to be damaging to your pelvic region and more likely to result in tearing as the baby emerges. Hello painful recovery, painful sex, and incontinence.

It sounds pretty grim, but it doesn’t have to be this way.

Can I avoid it?

In the United States, there’s a gap between what’s called “evidence-based” maternity care and normal maternity care. According to a 2006 survey, a mere 2% of women had an optimal birth experience. Instead, most women experience a host of routine medical interventions. Research shows that what a woman needs most in labor is support. Childbirth is a process that normally starts and progresses all on its own — the cervix begins to open, the uterus begins to contract, the baby begins to descend, and each of these accelerate until you can’t help but push the baby out. The body does this all by itself. Evidence-based care is essentially when the labor process is watched, supported, and protected with the least medical interference necessary.

So, in order to get optimal care, you need a provider who will provide support. Someone who will…

  • wait for labor to begin on its own and progress on its own
  • allow you to move freely during labor and help you find comfort
  • provide what’s called “intermittent” human monitoring of the baby, rather than continuous machine monitoring, so you can stay mobile.
  • protect your perineum while you’re pushing — by helping you into good positions, putting counterpressure on your bottom while you push, and most importantly not telling you how to push.
  • catch the baby from whatever position you feel best pushing: standing, squatting, hands-and-knees, kneeling, sitting (you get the picture).
  • give you the baby immediately so you can be skin-to-skin and initiate breastfeeding.

Who are these providers, you ask? Unfortunately, they’re not usually obstetricians or L&D nurses. Even midwives working in hospitals may not be able to offer intermittent monitoring and other evidence-based practices. Unfortunately, you need to do your research and be vigilant. Even if a provider has progressive ideas, hospitals are increasingly restrictive in how they manage labor (in fact, the medical term is “active management”).

Some nurse-midwifery practices (which typically work within traditional hospital maternity wards) have a great track record. Look for a low cesarean rate (below 10%). Midwives practicing outside the hospital maternity ward, in birth centers and at home births, have been shown in studies to have the most success in supporting normal, physiological birth.

Home birth — it’s not just for hippies. Two large studies following healthy women who chose to give birth outside the hospital with a trained midwife show that 95% had normal, vaginal births, meanwhile their babies did just as well as those who were born in the hospital.

If that’s not an option, there are still ways to reduce your risk of being pushed:

  • get a doula
  • labor at home with her until labor is really cooking
  • prior to your due date, have your doc or midwife write on a prescription pad “intermittent monitoring, no IV, and OK to eat and drink.” Jackie Levine, a NY doula, calls this an “Rx for a Normal Birth.”
  • during labor, have access to a shower or preferably a bathtub
  • stay mobile and avoid immobilizing anesthesia
  • avoid Pitocin, multiple vaginal exams, and artificial rupture of the bag of waters.
  • negotiate upright, active positions for pushing and delivery
  • refuse an episiotomy
doulala
by on Apr. 19, 2010 at 11:12 AM

 

Summary - Who Should Further Examine Their Due Dates?

 

If this is your first pregnancy, then your pregnancy will quite likely be longer. Usually, the first-time mom averages 8 days beyond her 40-week due date, if she is white and a private-care patient. (Women of color tend to have slightly shorter pregnancies, as do women not under private-insurance care, for whatever reason.) Your doctor will probably want to keep the traditional 40-week-from-LMP dating rather than change the date, but should be more flexible about not pressuring you into interventions before 42 weeks, assuming all is otherwise well. It is quite NORMAL for a first-time mom to go at least a week 'overdue' and pressure for interventions should probably not begin during that time! Try and sound out your health provider about when they think interventions should start to be considered; if they sound very interventionist you may wish to consider switching to a different care provider, depending on your philosophy. DON'T WAIT till you are 40 weeks along to consider the issue!

 

If your cycles are longer than 28 days, then your pregnancy may be longer. You may need to add another week or two onto your totals. Some doctors are quite good about taking this into account, but unless you can document that you KNOW when you ovulate or when you conceived, many doctors will still arbitrarily set your date according to the 28-day cycle, possibly setting you up for early interventions, a difficult labor and perhaps even a C-section (worst-case scenario). It is in your best interest to dialogue with your physician about this concern; you may be able to come up with a compromise date or use ultrasound to confirm dating. However, if your physician seem overly rigid in dating, it may be time to seek an alternate provider. Charting before future pregnancies is an excellent idea for you to consider.

 

If your cycle is quite irregular, you may have great difficulty dating your pregnancy. If you have records showing when you ovulate (either by charting or by ovulation predictor kits), then these can be used to help determine a more accurate due date. If you do not have any idea of when you typically ovulate or if it varies significantly from month to month, then your doctor will probably need to use multiple ultrasounds during the pregnancy to date your pregnancy via measurements of the fetus. These are most accurate before about 20 weeks or so. You will also probably need more testing at term to confirm whether baby is doing OK, due to the possibility that dating may be off. If you are not already pregnant, it is an excellent idea to start charting your temperature and mucus to avoid this difficult problem. If you are already pregnant, you will need to rely on your doctor's expertise and ultrasound testing to help you set a reliable due date.        http://www.plus-size-pregnancy.org/figuring.htm

doulala
by on Apr. 19, 2010 at 11:14 AM



 In his classic book Husband-Coached Childbirth, Robert Bradley, MD, compares the arrival of human babies by nature's schedule to fruit ripening on a tree. Some apples ripen early, some late, but most show up right in season. Along with Grantley Dick-Read, the father of what we now call "natural childbirth," Bradley advocated relaxation, trusting nature, and allowing babies to show up when nature intended.

The gestational age of an unborn baby is best determined by looking at a number of different factors. If you combine an accurate date of the last menstrual period with a first-trimester pelvic exam, fundal measurement (from the pubic bone to the top of the uterus), date of "quickening," and a fetal heart tone, then confirm these findings with a first-trimester ultrasound, you'll end up with a due date that is still only 85 percent accurate, plus or minus 14 days. Second-trimester ultrasounds tend to be inaccurate by plus or minus 8 days, and third-trimester ultrasounds by a whopping 22 days.

It's probably best to stick with the "late November, early December" method unless you are fortunate enough to know the exact date of conception, another way to attempt to pinpoint a due date. Medical science recognizes in vitro or artificial insemination as the only accurate means of determining conceptual age. However, if a woman was using an ovulation predictor test correctly, or her husband was home between business trips only once after her period ended (and she actually wrote this date down on a calendar), she could nail down her due date by counting forward ten lunar months from conception. Even so, she might end up with a baby who stubbornly decides to belong to that 10 percent who go beyond 40 weeks. Despite all of these calculations, an induced baby may turn out to be premature rather than postmature.


Protecting Our Unborn Babies
Labor should be induced only when medically necessary, never simply for convenience or because a woman is sick of being pregnant. The risks in these situations far outweigh the perceived benefits. Determining postmaturity or a woman's readiness to give birth are complex processes. We are just beginning to understand the long-term effects on the fetal brain of drugs such as Pitocin, and the exact long-term effects of inducing or augmenting labor are unknown. Pregnant woman wanting information on the safety of a drug can consult the Physicians' Desk Reference or call the product safety officer at the pharmaceutical company where it is manufactured.

http://www.mothering.com/articles/pregnancy_birth/birth_preparation/inducing.html






  HAZARDS OF LABOR INDUCTION
First-time mothers have approximately twice the likelihood of cesarean section with induction compared with
natural onset of labor. This risk is due to the procedure itself, not any reason that might have led to inducing
labor.


Did You know a woman who agrees to an induction if her body is not ready ..

  • is twice as likely to give birth by cesarean section if she is a first time mom?
  • by a cervical ripening agent increases her chances for birth by cesarean section 5 fold if she
    has given birth vaginally before and her cervix is not ready or 'ripe'?
  • is likely to have uterine hyper-stimulation, a painful for mom and dangerous for baby state to
    be in?
  • is often told to do so to help avoid a theoretical potentially dangerous situation for her babe,
    but by agreeing to the induction is introducing agents highly likely to cause fetal distress and
    the resulting cesarean section she was hoping to avoid in the first place?
  • can first use a tool called a Bishop's score to predict how likely it is that her induction will or
    will not work?
  • after her water breaks by using oxytocin or pitocin is 10% more likely to have an operative
    delivery and 17% more likely to use analgesia than if she simply did nothing but wait for up to
    48 hours?


Oxytocin (Pitocin)
Complications of oxytocin (Pitocin) include

  • uterine hyper stimulation,25 which can lead to fetal distress
  • twice the chance of the baby being born in poor condition;15
  • postpartum hemorrhage;25
  • greater probability of newborn jaundice.25
  • Rare, severe, maternal complications include uterine rupture and water intoxication leading to coma and death
  • Oxytocin may also cause brain damage or death in the baby.25


http://www.seattlebirthnet.com/inductlinks.html



Pitocin is pretty common these days.  But whether that's a good thing is anybody's opinion.  Henci Goer writes:

"First-time mothers are given oxytocin if they don't steadily progress at the average rate -- a rate that is probably an underestimate. At one stroke, deviation from the average has been defined as abnormal.

Studies have shown that with active management, 40% or more of first-time mothers will receive oxytocin. Telling nearly half of laboring first-time mothers their bodies are incapable of birthing a baby without help could have significant psychological consequences.

For example, the use of labor interventions, not surprisingly, links to postpartum depression. And high-dose oxytocin increases the chances of overly long, overly strong contractions, which, by depriving the baby of oxygen, can cause fetal distress and worse.

Setting arbitrary time limits on the pushing phase of labor can also lead to unnecessary and potentially risky procedures. In a study of 13,000 labors at the Dublin National Maternity Hospital, the authors reported that three babies delivered by forceps for prolonged pushing phase died of forceps injuries. In this country, doctors generally don't use forceps unless the head is low enough to make forceps relatively safe. However, faced with a "time's up" situation, they would do a cesarean instead -- not exactly an improvement!"
http://www.hencigoer.com/betterbirth/sample/



Jul. 4, 2008 at 12:05 AM about 45% of first time moms that are induced will end up with c-sections. Regardless of exactly how many labors are induced in the US today, the majority aren't medically necessary, and between 40 and 50 percent resulted in failed induction.

induction is medically required in only 3 percent of pregnancies and that therefore approximately 75 percent of all inductions put both the mother and baby at risk.

Pitocin can cause increased pain, fetal distress, neonatal jaundice, and retained placenta; and recent research suggests that exposure to Pitocin may be a factor in causing autism.

http://www.mothering.com/articles/pregnancy_birth/birth_preparation/inducing.htm


Birth is a process that probably lasts about a month or more, when
you think of how the baby works his/her way into position, mom's body
prepares with the uterus thickening at the top and thinning at the
bottom and the cervix prepares itself to dilate for the final pushes in
this process. It is such an amazing, divine plan and in this day and age
so easily disturbed—possibly as never before. I think induction,
possibly in any form, can disrupt this plan, interrupting the baby's
process of positioning and getting ready to be born. As Carla Hartley
says, "Birth is safe, interference is risky."


Jan Tritten, mother of Midwifery Today
magazine

ready_for2
by on Apr. 19, 2010 at 11:15 AM

yes it is very risky! especially when there is no reason to do it (going overdue is not a medical reason until after 42 weeks, and its rare for someone to go past that point)

its a huge risk bc there is no balancing benefit whatsoever.

you do not have to agree to an induction just bc your doctor suggests one. your baby will probably come before then anyway, if not just a few days after.

here are some risks:

-much harder on the baby than natural labor. there are greater contractions pressures over a greater period of time

-can cause uterine hyperstimulation. this is a common side effect of induction drugs

-requires an IV and electronic fetal monitoring, which have their own potential side effects

-doubles the odds of the baby being born in poor condition

-causes increased post partum blood loss and newborn jaundice

-increases the risk of c-section, which can have grave adverse side effects

and there are many more... the thing is, when there is a medical reason to induce (pre eclampsia, low fluid, etc) then you can compare the risks of leaving the baby in vs induction. however in your case, there is nothing to compare the risks to. you ONLY have these risks, and no balancing benefits

im glad you questioned this enough to ask on here and hopefully get more info!! doctors love to push inductions without really telling women about all the risks they involve

Barbiedoll137
by on Apr. 19, 2010 at 11:51 AM

 Ok ladies, so my doctor says he won't let me go past 41 weeks. What do I do?? Do I have to find another doctor??? I mean I still have a week left. Maybe I shouldn't worry yet... oh and I don't have any health risks at all!!

marynash88
by on Apr. 19, 2010 at 11:56 AM

I have heard many OB's say this exact phrase. What is he gonna do if you go past 41 weeks? Come to your house and drag you by your hair to the hospital for the induction? Nope he legally cant make you do ANYTHING. If he doesnt deliver your baby because of "refusal" then you are entitled to a refund of at least the delivery charge. Doctor tend to say that because they want to get you done and over with. Just sit down with him and say that you would prefer to wait till at least 42 weeks before looking at induction (if avoiding an induction is what you are wanting to do.)

Quoting Barbiedoll137:

 Ok ladies, so my doctor says he won't let me go past 41 weeks. What do I do?? Do I have to find another doctor??? I mean I still have a week left. Maybe I shouldn't worry yet...


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