The truth behind inductions

by Rachel on January 12, 2010

Induction, induction, induction. Everywhere I go I hear the word induction. Just moments ago, walking through the hall in my office I heard a woman say that someone she knew would be induced if the baby did not come by the due date. I have a hard time biting my tongue in certain situations, but well that’s why I have my blog, so I can say what ever I want!

Why do I hate the word induction? I have found that since I had Connor I have been hyperaware to those who are pregnant or have just had their own children. More and more I hear that doctors are telling women that they can be induced on xx day. Some women may think, “wow, what a wonderful thing, I can have my baby on the date of my choice and I won’t have to play the waiting game,” but ladies, it’s just not that simple.

Why do doctors schedule inductions? Often times, for convenience. The doctor will tell her patient that she can promise to be the attending doctor if an induction is scheduled on a day when she’s in the hospital. The doctor may schedule an induction if the baby does not come by xx-days before the due date. Pregnant women get antsy, and would love to have the whole pregnancy over with, knowing that date will be before the “due date” will ease her concerns. Last, but not least (as the list goes on), a pregnant woman may be scheduled for an induction because the baby is “too big!”

Now, why do I think all of this is a bunch of nonsense? Babies will come when they are ready. Inductions have proven to be unnecessary and unsafe. Due dates can be off (they are just a guesstimate of course) and if a mother is induced that baby may be born “too early.” Our babies need to incubate in the womb as long as possible. Babies born early often times have trouble breathing, as their lungs are not fully developed. This will often necessitate the trip to the infant NICU at birth. Brain development is another reason that women should let labor begin on its own. The last few weeks of pregnancy provide critical brain development so much that if a baby is born early the family could be burden with a lifetime of developmental issues.

Did you know that the average pregnancy is 41.5 weeks? We all have our focus on that magic due date, but that doesn’t mean baby has the same date in mind. A baby will come when he/she is ready and no one can predict that date for you. What if my baby is too big? This is another inaccurate measurement taken to convince mom that she cannot possible vaginally deliver a big baby. Measurements of baby’s weight by ultrasound can be 1-2 pounds off. Besides, your baby will grow the perfect size to fit your body and cannot be too big! Only in cases of gestational diabetes, that is not properly controlled, will the baby grow larger than he/she should in the womb.

I happen to think that it is completely unethical for a doctor to unnecessarily induce a woman simply for convenience. Although the doctor wouldn’t admit that you are being induced for convenience and may explain that it is completely necessary.

Not only can induction lead to the birth of a pre-term baby, but complications can arise during the birth itself. Inductions begin by administering pitocin, a synthetic hormone to mimic oxytocin (the natural hormone that causes labor to begin). The synthetic hormone will cause contractions that are much more intense than the contractions a woman will have when labor begins naturally. For women planning a natural birth, this may cause them to feel otherwise because of the intense pain. This is not to say a woman still cannot deliver naturally, but it is much more of an intense pain that she must go through. If a woman chooses the epidural for pain relief, the drug can slow down labor that was brought on so quickly by pitocin and in worst case scenario can cause, what the doctor may refer to as “failure to progress” and an emergency c-section will be ordered. But, of course that’s for another blog post.

My point is that only you can stop the unnecessary rate of inductions in this country. You don’t have to do what your doctor suggests. It is just that, a suggestion. If the doctor is pushy, switch providers. It is never too late to find someone you are more comfortable with to have deliver your baby. Know that you have a choice, it is your baby and your body, you can say “no” to a suggestion of a scheduled induction.

I would love to hear from those of you who have had an experience with induction, either for yourself, a family member or friend you know who was induced. What do you think about the topic?

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14 comments

  • Maria W.

    I have had 2 Inductions. First off i agree that it being done for convenience should never happen! My first son was due on feb 2 and I was not induced until feb 16th. we simply had to because if a baby stays to long it become dangerous for both the mother and the baby. The amniotic fluids start to diminish after a time which starts to make the womb an inhabitable environment for the baby. Other then the pitocin i delivered him naturally. That labor did not go well at all and it was do to the fact that they set the iv pump to increase the pitocin way to quickly they told me that it would only increase by like a half a cc every 20 min. well WRONG!!! (both my husband and I can read IV pumps because we both have worked in his fathers Veterinarian hospital and we have been responsible to check iv pumps and alert him is something was wrong.) 20 min after they gave me the pitocin i was up to something like 15 cc’s. It is supposed to be a long process with the pitocin but 1.5 hours after the gave the the pitocin i had a baby and a bad Hemorrhaging problem! Long story short I had major lase rations in my uterus and on my cervix, the docs told me that they stopped counting stitches after 12 dozen I had to have 2 units of blood replaced and I was told if the bleeding did not stop they would have to take my uterus in order to try and save me.

    Everything turned out fine My self and my first son are completely healthy.

    3 yeas latter I find out that i am Pregnant again, I had the copper T IUD in and it was in place so there was only a .01 % chance that i would ever get pregnant with that. 9 months latter, 4 days before my first sons 4thBirthday I was due to have my second son. after talking to my now new doc (not the one that delivered my first, I had my first in NY where i grew up and i moved to MD while i was pregnant for my 2nd)we dicided that I should be induced I had explained to her my reservations on why i wasn’t sure of doing it but again we were worried for the safty of my son.

    This time around i knew exactly when i conceived because I figured it out 2 days after i conceived I just know my body that well and was able to tell. I went in to the doc 2 days latter cuz the IUD was still in and they ultra sounded an took the IUD out and because they couldn’t even see the little cluster of cells that first start to develop they made me take a blood test to triple confirm i was pregnant.

    Any ways I walked like crazy! and did everything to doc told me to do to try and induce naturally and still nothing. Not even a twinge of pain. So in I went again for an Induction. I had a great delivery this time everything went smoothly and i was no little to no pain.(probably because I was not panicked that time). My second son was born on his due date weighing 8 lbs 13oz and at that wait they are concerned about the child having diabetes and have to do blood testing. (he did/dose not have diabetes)

    So yes going to long in a pregnancy can be a problem and the baby weighing to much also can be a problem.

    • http://www.greenbabiesblog.org Rachel McFadden

      Maria,

      Thank you for sharing. I really appreciate you taking the time to tell your stories. It is amazing to me that you had no pain meds, since I don’t know from experience, but have heard that it is extremely painful.

      I want to clarify that I do agree with you, inductions were created for a reason, just like the epidural and cesarean sections were created for a reason. The use of both should be done sparingly. It is important to have these procedures when it means that we can save the lives of mother/baby, The issue is that they are being overused and as women we need to understand when they are necessary and when to choose not to have these interventions. I still stress that finding a provider that will be inline with your wishes is of the utmost importance!

    • http://jabberwocky-jessica.tumblr.com Jessica

      “My second son was born on his due date weighing 8 lbs 13oz and at that wait they are concerned about the child having diabetes and have to do blood testing. (he did/dose not have diabetes)”

      Really? My son was 8 lbs 15 oz and his doctors were never concerned about diabetes. Maybe it’s different in each state…

  • Maria W.

    No I agree that they are being over used. I know of a few people who have had their labors induced or have opped to have C-sections. Which I completely don’t agree with (I don’t under stand why some one would want to have those muscles that are so important to your body cut willingly for any reason other then to save their baby) I the big reason I posted such a long response is because when people hear that both my kids were induced labors people just assume that I did it for convenience reasons. Also so many think that oh the baby is late or to big is just a lame excuse. Those things can be real problems. But yes i agree oh the baby is a day late got to induce is lame if there is no reason to suspect that anything else is wrong.
    I am pregnant with my third child right now and am due in July. I would love to go into labor with out being induced this time. I do fear that i am in capable of going into labor on my own (it is rare but can be a possibility)

    Thanks for letting me vent

  • http://jabberwocky-jessica.tumblr.com Jessica

    I was induced with my son. My OB felt that he was growing too quickly and that he was going to be too big, so she suggested I be induced the day before my due date. I had not done any research, but I was an antsy pregnant lady so I went along with it. Boy do I regret that decision! I was in labor for 20 hours because I also opted for an epidural (something I do not plan on getting for future pregnancies) and it slowed everything down. I was stuck at 7cm for about 10 hours before they finally took me off the epidural. I was in a tremendous amount of pain. What I forgot to mention was that every time I had a contraction the babies heart rate would plummet. The nurse blamed me saying that I needed to take deeper breaths when contracting. Turned out the cord was wrapped around his neck. Wrapped so tightly, in fact, that when his head was out they had to clamp the cord and cut it right there before they delivered the rest of his body. He was rushed to the NICU (thankfully not before my mother forced them to let me hold him for a few seconds). Needless to say, I will be opting out of an induction for any future pregnancies.

  • http://marlieandmommy.blogspot.com Teresha@ Marlie and Me

    I’m all for women having the right to choose how they give birth, even if I don’t personally agree with their choice. I just wish some of the decisions, like induction, weren’t made so casually.

  • http://countrygirlcitylife.com Kati

    Hi! I am a nurse.. specializing in L&D.. and while I admire the fact that you did your research on the topic.. there is ALOT more to consider when it comes to inductions.

    Yes, doctors may suggest induction for their convenience, however they also do so with the health of the baby in mind. As you stated, a due date is a “rough estimate” of when the baby is full term. Because of that.. many doctors will NOT induce until the due date or later with the exception of other medical conditions that warrant such a procedure. Also, doctors take into consideration how far progressed your body is into the early stages of labor. It is almost always required that you have begun to dilate and well as being nearly completely effaced, otherwise medications such as Cervidil, will not work. Cervidil is the most commonly given medication when an induction is started, even before the pitocin. It is like a small disk with a string, similar to a tampon, that is inserted. The goal is to thin and dilate the cervix which allows contractions to do their job more easily.

    Inductions are risky.. and causing a “premature baby” is not usually the reason why. Medicine in the US is advance practice, and doctors and medical testing is becoming more and more accurate. The odds of having a premature baby because of a needless induction is really really rare. Inductions can go smoothly and within hours of entering the hospital you can be holding your little, but this is not always the case.

    As I stated above one of the most commonly used drugs, based on your dilation and effacement state is cervidil. Sometimes this works and sometimes is does not. Pitocin is also given to for contractions. Note that pitocin is given to a vast majority of women who go into labor naturally as well even when it is not necessarily needed. It does in fact give you stronger, more intense contractions, but a large number of women who birth in a hospital receive an epidural, which slows labor as well as contraction production. The pitocin is often used to counteract that.

    While it can literally take days to have a baby with an induction, but that should not be ruled out with that it can take days to have a baby without an induction. Either way, doctors keep a close eye on the heart rate and other stats of the baby, and yes, if it seems like there will be complications, a cesarean may be ordered.

  • http://lilmouse.blogsite.org Jill

    I was induced because my water broke 3 weeks early and I didn’t go into labor. I wanted to have an all natural birth. The nurses turned up the pitocin about 10 hours in to ‘final stage’ labor type of contractors for 5 hours. You know the final stage that is supposed to be 20 minutes to 2 hours of back to back contractions? I was having back to back to back contractions with no relief, for 5 hours in the middle of labor, and then the nurse said ‘oops I had you up too far’. Yeah. Nice. 20 hours without drugs (after being awake all day mind you, my water broke at 8 pm) I took some of the sleepy stuff to try and rest, but it woke me up every minute to contract, then ended up with an epidural, which didn’t take at first, and they didn’t believe me. Then by the time they finally got it working, it had been 4 more hours since the first sleepy stuff, and I pushed for 4 hours, yes 4 before the doctor would come in. Not sure what in the heck took so long, a previous lamaze class and all the books say it is UNSAFE to go 24 hours without delivering because of possible infection, but here I was at hour 28, doctor finally comes in and says, oh by the way, your baby is upside down, you have to have a C section. Just like that. Right before midnight. Why would you choose to wait that long? Anyway, apparently, they tried to turn her, but I don’t remember it. I don’t remember anything other than them saying ‘tell her what we have dad’ and finding out I had a girl and then seeing her on my chest and then in my husband’s arms and that’s about it. I was so exhausted from the unnecessary ‘too high’ labor so early on. So yeah, if I’m forced to be induced again, I’ll get the epidural as soon as possible, because it’s stupid to go through all that pain when you’re going to have that kind of experience again, most likely. I also felt like I had let everyone down by not going through labor naturally, even with ALL the circumstances that went wrong. I was upset for weeks, months really about it until I realized it was all out of my control. Even my mom thought I CHOSE to have a c-section for almost a year, like it was something I planned. Her longest labor was about 15 hours and natural of course. Everyone thought I had wimped out and it was very soul crushing. I would NEVER EVER choose to be induced again.

  • Jessica

    I think a lot of this really depends on your doctor and how much you trust him\her. I knew I really liked my practice when I learned that before the pregnancy is over they will schedule a 41 week appointments in case you go late. Other practices that I have heard will ask you at your 40 week appointment when you want to schedule an induction. I was with midwives for my first, but due to complications with my second I had to switch to a doctor that the midwives were associated with. Due to IUGR and concerns about the placenta, the specialist we were seeing recommended that we be induced at 37 weeks for our little girl’s safety. The doctor I had was amazing. He understood that I wanted to go naturally during the induction (but he did not use cervadil due to the risk of c-section since they really had no idea how my little girl would tolerate labor. He wanted to be able to control the labor if she started having problems.) So he slowly increased the pitocin over the day and waited to break my water till labor was well established to minimize the pain and help me to go naturally. I would have been able to go naturally if I had listened to my body. I did get an epidural at the end, thinking that I still had hours to go and blamed all the pain on the induction…but as soon as it went in I had to push. I guess next time I’ll believe myself when I think I’m in transition! If you don’t trust your doctor, really look around for a new practice. You don’t want to have to second guess him when you’re in labor or they “recommend” something that you disagree with but don’t know who to trust.

  • http://jent-manyblessings.blogspot.com JenT

    Well, I touched on induction in my post about my birth experiences. I would never voluntarily go through that again. Having experienced natural deliveries, I can compare the pain and say that induced labor pain is far more intense and painful.

  • Rebecca

    Oh, boy. I don’t think I could have read this on a worse day! I just found out that I need to be induced next week. For me, the deliver date is NOT a guesstimate as we did IVF—so, it is all absolute surety. The baby is failing to grow, though. She is tiny and I only look about 7 months pregnant. The heartbeat is very strong, but my doctor is concerned that perhaps the placenta is beginning to fail. I do trust my doctor, though. I’m an all-natural girl, so this is a blow to me. I’m already dilated to a 3, and the baby’s head is completely down—doc says it can’t come any further without contractions, so my body is definitely ready to go. When I’m induced, I’ll be 37 1/2 weeks from known-conception.

  • http://thehardesthue.blogspot.com Maggie

    To Rebecca: You can do it! The best thing is to try not to worry. Trust your body. I will join the chorus saying inductions are performed too casually and are too common, but they are also an important medical tool. If you trust your doctor, feel good that you are making the best decision for your baby. My midwives decided to induce me because of high blood pressure. I was disappointed, but it turned out to be a wonderful birth. I have my birth story on my blog if you want to read it.
    http://thehardesthue.blogspot.com/2009/04/adahs-birth-story.html
    I hope that’s okay to post that here. I don’t want to spam anyone. I just discovered Happy Green Babies recently and I love it!

  • http://www.jenandjoeygreen.blogspot.com Jen

    I was induced at 42w. I am thankful that my midwives let me go the full 42w. I really hated the idea of an induction (threw our plans of a homebirth out the window) and after experiencing it I can say that I think it is the worst kind of labour ever. Ofcourse I have nothing to compare it to but it is like going from 0-100 in no time flat. After 10 hours and when problems started to arise they gave me an epidural to prepare for a c-section. My contractions stopped as soon as they turned the oxytocin off. My midwife said it meant my body never really was in labour..it was all the drugs causing the contractions.

  • Amy

    I was induced because of my skyrocketing blood pressures…it was done to save the lives of both mother and baby. Not all inductions are unnecessary although I do agree that the contractions were much more intense and painful than with my first baby (all natural). My little angel arrived into the world safely and I believe the doctor’s made the best decision in my case and to wait it out would have been dangerous and foolish. I still think I would prefer induction over having a C-section given the choice….just my two-cents.

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