"Many women have described their experiences of childbirth as being associated with a spiritual uplifting, the power of which they have never previously been aware...To such a woman childbirth is a monument of joy within her memory. She turns to it in thought to seek again an ecstasy which passed too soon."

Grantly Dick-Read

Sunday, January 24, 2010

saying "no" to elective induction

i just came across a great article called "saying 'no' to induction." what a read! PLEASE read it!

here are some excerpts that i really liked:

"Women are between a rock and a hard place. It is so easy to be seduced into believing that the baby is ready for birth. It is also frightening to hear the physician talk about a too-large baby or a possible medical problem. In the first instance, potential problems are brushed aside; in the second instance, problems are suggested where none are likely to exist. In both cases, pregnant women do not have the full information required for making a truly informed decision.

"To make an informed decision—either informed consent or informed refusal—women need to know the value of waiting for labor to start on its own. The last days and weeks of pregnancy are vitally important for both the mother and her baby. The end of pregnancy is as miraculous as its beginning. It's a lot easier to say “no” to induction if the mother knows the essential and amazing things that are happening to prepare her body and her baby for birth."

"Induction of labor alters the process of labor and birth in significant ways. The cervix often needs to be softened before pitocin (synthetic oxytocin) will be effective. Pitocin causes contractions that both peak and become stronger more quickly than naturally occurring contractions. The result is a labor that is more difficult to manage. In addition, the uterine muscle never totally relaxes between contractions, increasing stress on both the uterus and the baby. Because of the increased potential risks for the uterus and the baby, continuous electronic fetal monitoring is indicated. The fetal monitor and intravenous line make movement more difficult. The hormonal orchestration of labor is disrupted. Pitocin does not cross the blood-brain barrier; therefore, endorphins are not released in response to the increasingly strong and painful uterine contractions. Laboring women do not experience the benefits of endorphins as they try to manage their contractions. Additionally, without the help of endorphins, they are likely to require an epidural. The epidural alters the course of labor, prolonging the length of both first- and second-stage labor and increasing the need for the use of instruments at birth. Without high levels of naturally occurring oxytocin and endorphins, catecholamine levels do not surge at the time of birth, and the mother and her baby are less alert and able to interact in the moments after birth."

"Nature is not perfect. However, when it comes to babies and birth, unless there is a clear medical indication that induction of labor will do more good than harm, nature beats science hands down. For both mothers and babies, it is safe and wise to wait patiently until labor begins on its own.

"In our childbirth education classes, it would be wonderful if we could help women reframe the last days and weeks of pregnancy and begin to look on this time as important for their babies and for themselves. As each day passes—even if the days are well past the due date—what if pregnant women delighted in the steady maturing of their baby and appreciated the slow preparation of their body for labor? We can help women to think of this time as important psychologically and emotionally, as well as physically, providing an opportunity to rest, to think, and to complete the final preparations for the baby. At a time when we are most likely to meet women, we can also help them approach the end of pregnancy in wonder at the beauty and wisdom of nature's plan."

"Saying “no” to induction and to other interventions that are becoming routine takes courage and confidence, as well as the knowledge that women have the right to informed refusal. What women learn from you about nature's plan for labor and birth, including the beauty of waiting for labor to start on its own and the risks of interfering without clear medical indication, will insure that the women you teach will have the information they need to confidently say “no” to routine induction."

elective inductions are, sadly, on the rise. how many women do you know (or perhaps, you yourself) has had labor induced for a non-medical reason? yes, when you are 40 weeks pregnant (or "over" due) you just want your baby out! but knowing that your baby is still inside you for a reason can really help. i know several women who have had their labors induced for various reasons (and by all means, if there truly is a medical need -which one of my friends was in that category - induce labor and make sure mom and baby are safe! if there is not a medical need, trust in your body and let your body do what it was made to do!). one of my friends had her labor induced because her baby would be "too big." guess how big her baby was? 7 pounds. not too big at all. thankfully her induction went well and did not end in an "emergency" c-section, but the doctor was not right at all about the baby being too big thing (which is often the case). plus, your body is not going to grow a baby that is too big to come out...that would be counter productive!

at the end of my first pregnancy, i just wanted my baby to come! i was so excited for him and tired of being pregnant. although at the beginning of my pregnancy i was adamant about not being induced, as my due date approached i was much more willing to be induced because i was so anxious for him to come! the only reason i was against being induced was because i had heard how much harder labor is when it's induced and i just really wanted everything to happen on its own. i didn't even know how important each week and day is for the baby's growth and development. the second time i got pregnant, because i had gained much more knowledge on just how important it is for the baby to be as near 40 weeks as possible and to let nature run its course, i told my husband to remind me what i knew as my due date approached. i can honestly say that that change in perspective and attitude helped me tremendously. instead of focusing on how much i wanted my baby out or how much i wanted to just sleep on my stomach (!), i focused on how good it was for her to be growing inside me and trusted that my body would know when it is time.

gain all the knowledge you can - knowledge is power! and trust in your body - your baby will come when it is time. you are beautiful and your body is miraculous! now i'll step down from my soapbox. :)

6 comments:

  1. I was induced two weeks early because they didn't think I had enough amniotic fluid. They considered sending me home to drink lots of water over the weekend (it was a Friday) then to get retested, but decided it would be "safer" to just get induced that night. And I was with midwives! (With a consultation with a doctor.) Cytotec , Pitocin, stripping my membranes, and 22 hours of induced labor later, my body still wasn't cooperating or going into labor on its own. Finally they broke my water and about 3 times the amount of water they thought I had in me came gushing out.

    I was still able to birth naturally (though, I seriously changed my mind at one point, but by then it was too late. So I toughed it out.) and all was well. My biggest regret of that entire ordeal has been that I didn't question the order to induce more. I should have asked more questions. I should have pressed to go home and drink water over the weekend. But as it was something I hadn't expected, and since I was with midwives, I just accepted it without question. Just tears.

    It was interesting to read that article. My baby had a lot of trouble nursing for several weeks (I had to use tube-on-breast for a week and a shield until she was about 3 months old!) and was jaundiced for 10 days. It's interesting to think that her early induction might have caused that.

    Now, I'm not saying to refuse induction if you need it, but I definitely will be asking more questions if it happens again.

    Sorry for the epic comment, but this really touched home. Thanks for taking the time to do this blog! I'm loving it!

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  2. tianna, thanks for your comment! i admire you SO much for going naturally, even with the pitocin. i have heard that is extremely difficult to do and don't know that i could do that!

    i think you are very right about just needing to ask more questions. it is so easy to just do what our doctors/midwives suggest - because after all, they know best right? but it is so important that we take charge of our health and ask questions, then make an informed decision. thank you so much for sharing your story! i'm so glad you like my blog :) that makes me happy!

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  3. Very rarely, a baby can be grown that is too big to physically fit through the mother's birth canal. My friend was one such case- she attempted to deliver her son vaginally but he was so big compared to her pelvic ring, she actually ended up breaking her pelvis and her tailbone and having to have him removed via c-section when she still couldn't get him out. Ouch!

    But how often do situations like that (and other serious medical emergencies) occur in relation to how often deliveries are just induced? I agree, if there is real need an induction should be done. But it's all about making sure you have correct information. We do need to remember that "due" dates are really educated GUESSES. My mom held out for three and a half WEEKS after my "due" date. The doctors were begging her to be induced, but she knew through much prayer that I needed more time. We can only guess what complications I might have had had she allowed herself to be induced almost a month before I was ready to come.

    P.S. did you know about the recent trend sweeping Hollywood the last several years? Women have been actually electing for pre-term C-sections so they can avoid stretch marks and such. How disgusting is that?! And how detrimental to those pre-mature babies!!

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  4. wow jaclyn, props to your mom for being so strong and trusting in her body and the power of prayer! and as for babies being too big...i do know that there are some women whose pelvises are small and truly cannot birth their babies - i was just generalizing in saying that most women can successfully deliver their babies.

    and that trend...yikes. that is just really sad and scary. very selfish.

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  5. Wow, Kami. Love this new blog and the thoughts you so openly share. In a few, rare cases induction is a great tool. However, most times our bodies know exactly what needs to happen with the precious baby growing at its own pace. My first baby came 3 weeks early. She was healthy and strong and 7 pounds even. My second baby came 4 days late. He was healthy and strong and 9 pounds 14 oz. My labor was WONDERFUL with him and he came with 2 minutes of pushing. Even though I experienced nearly an extra MONTH of pregnancy the second time around, (and I was sooo anxious to get him out) I realized then what different timelines babies can have. Many people have balked at his size and wondered how in the world it was such an easy birth. I am such a believer that our body is simply and wonderfully equipped to deliver the baby it has created. And when we wait until the right time, all things work together in a great "symphony" making it a healthy experience.

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  6. This was a really interesting read, Kami. Thank you! It is silly, but this subject feels very personal to me. I would have given anything to be able to keep Micah growing in my womb as long as he needed, no matter how long that would have been. I know there is occasionally a medical need for induction, like you said, and that the practice of induction started in response to a medical need. It's so unfortunate that it is used without need so often lately. It makes me sick to hear of those women who are electing to have pre-term c-sections to avoid perceived imperfections. I can't think of anything more selfish.

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