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Risks of Induction
I think with anything in life there are risks and benefits. But when it comes to your baby's well-being I think it is safe to say that we must take extra precaution. I just came across this article from the University of Rochester Medical Center and thought I would share and get a discussion going.
http://www.urmc.rochester.edu/news/story/index.cfm?id=3120
Obviously plenty of women have given birth via induction without a problem but studies have shown the vast majority do not. Induction taxes your body (and baby's body) and even if the outcome is positive (a live baby) it doesn't mean the road to getting that baby didn't have major risks.
I'll pull a few quotes to highlight some main points but definitely go take a read. It is important to educate yourself about the birth of your baby. Trusting your doctor is all well but you must remember that only you can be an advocate for your delivery and the care of baby afterward. Unfortunately there are hidden agendas and fear of litigation that drive physicians to do great harm to women (the opposite of the oath they took when becoming a medical professional). Anyway, on to my quotes:
"In the past decade, scheduled deliveries have become commonplace, with physicians making elective inductions part of their routine obstetric care.
“As a working professional and a mother, I know how tempting it can be to schedule a delivery to try to get your life in order, but there is a reason that babies stay in the womb for the full term,” said Loralei Thornburg, M.D., an assistant professor who specializes in maternal fetal medicine. “Why put you and your newborn at risk if you don’t have to?”
"Researchers found that approximately 34 percent of women who opted for elective induction of labor ultimately had a cesarean section, while only 20 percent of women who labored naturally underwent a cesarean delivery. Like elective induction, cesarean delivery naïvely may be seen as routine and risk-free, when in fact it is a major surgery and like all surgeries increases the risk of infection, respiratory complications, the need for additional surgeries, and results in longer recovery times.
"Though elective inductions are not outside the standard of care, physicians should be cognizant of the associated risks and communicate these risks to women considering the procedure. In an effort to better address this issue at the University of Rochester Medical Center, the department of Maternal Fetal Medicine is applying for a grant to help put procedures in place that will prevent elective induction of labor before 39 weeks.
http://www.urmc.rochester.edu/news/story/index.cfm?id=3120
Obviously plenty of women have given birth via induction without a problem but studies have shown the vast majority do not. Induction taxes your body (and baby's body) and even if the outcome is positive (a live baby) it doesn't mean the road to getting that baby didn't have major risks.
I'll pull a few quotes to highlight some main points but definitely go take a read. It is important to educate yourself about the birth of your baby. Trusting your doctor is all well but you must remember that only you can be an advocate for your delivery and the care of baby afterward. Unfortunately there are hidden agendas and fear of litigation that drive physicians to do great harm to women (the opposite of the oath they took when becoming a medical professional). Anyway, on to my quotes:
"In the past decade, scheduled deliveries have become commonplace, with physicians making elective inductions part of their routine obstetric care.
“As a working professional and a mother, I know how tempting it can be to schedule a delivery to try to get your life in order, but there is a reason that babies stay in the womb for the full term,” said Loralei Thornburg, M.D., an assistant professor who specializes in maternal fetal medicine. “Why put you and your newborn at risk if you don’t have to?”
"Researchers found that approximately 34 percent of women who opted for elective induction of labor ultimately had a cesarean section, while only 20 percent of women who labored naturally underwent a cesarean delivery. Like elective induction, cesarean delivery naïvely may be seen as routine and risk-free, when in fact it is a major surgery and like all surgeries increases the risk of infection, respiratory complications, the need for additional surgeries, and results in longer recovery times.
"Though elective inductions are not outside the standard of care, physicians should be cognizant of the associated risks and communicate these risks to women considering the procedure. In an effort to better address this issue at the University of Rochester Medical Center, the department of Maternal Fetal Medicine is applying for a grant to help put procedures in place that will prevent elective induction of labor before 39 weeks.
I missed this debate as it was happening, too. But, it was quite an interesting read. I was induced with my son at 40 weeks and 2 days (depending on whose date you go by) on Dec.10. That was the date I had in my head, but my doctor dated my pregnancy based on LMP and a 28 day cycle, so she had me due on Dec. 1, even though all of my ultrasounds dated my son due between Dec. 6-8. The later dates were more accurate to me, because I usually have a 35 day cycle, and I knew when I ovulated that month because I was using OPK's.
My doctor really wanted to induce me on Dec. 3, because in her mind, he was already late, and she was worried that he'd be too big and there wouldn't be enough fluid left in there, so she made me come in to her office practically every other day between Dec. 1-10 and I did 2 extra ultrasounds and a non-stress test. She also did a membrane sweep, without telling me before doing it - which I still think is wrong, but apparently legal??
I had lost my mucus plug on Friday Dec 4, so at least I did something naturally! LOL By the time I was induced, I had been at 1 cm dialated for a few weeks, and thank God the induction went smoothly and 12 hours after checking in to the hospital, I delivered my sweet boy who is 15 months old and is just as healthy and smart as can be now.
I always think his birthday is Dec. 12, though, because I think if I'd let my body go in to labor naturally, that'd be the day that he would have come. I don't know why, but that's what I think.
I do agree that doctors push inductions too much for their convenience, and so they can be in control of the situation, and my doctor and her nurse at their office were ticked when I didn't want to induce a week early. I am glad I stood my ground and waited another week because I really think I would have ended up with an emergency c-section. If I had to induce again, I'd want to wait until after 40 weeks again, and maybe even 41 weeks, just in case my "instinct" date is correct.
I only know of two people, myself and my step-mom, who were induced and did NOT have to have an emergency c-section. A few other patients of my doctor that I know and other friends that were induced (too early in my opinion) all had emergency c-sections. That makes for a scary statistic and I was worried going into mine. Luckily I was far enough along in the pregnancy that the induction worked for me.
Well, anyways, that was my story, and I guess my opinion is that inductions and epidurals are great and do serve a purpose, as long as they aren't used out of convenience, especially the doctor's convenience. (I am of course not talking about the ladies who live hours away from the hospital - that's a completely different kind of "convenience". I'd opt for inducing instead of having my baby in a car on the side of the road too!)
Oh, and I was pleased that this was a "debate" and not an "argument" for the most part, so I'll second Ashelen and say, it's an honor to be on this board to learn and discuss important topics in a civil manner! :-)
My doctor really wanted to induce me on Dec. 3, because in her mind, he was already late, and she was worried that he'd be too big and there wouldn't be enough fluid left in there, so she made me come in to her office practically every other day between Dec. 1-10 and I did 2 extra ultrasounds and a non-stress test. She also did a membrane sweep, without telling me before doing it - which I still think is wrong, but apparently legal??
I had lost my mucus plug on Friday Dec 4, so at least I did something naturally! LOL By the time I was induced, I had been at 1 cm dialated for a few weeks, and thank God the induction went smoothly and 12 hours after checking in to the hospital, I delivered my sweet boy who is 15 months old and is just as healthy and smart as can be now.
I always think his birthday is Dec. 12, though, because I think if I'd let my body go in to labor naturally, that'd be the day that he would have come. I don't know why, but that's what I think.
I do agree that doctors push inductions too much for their convenience, and so they can be in control of the situation, and my doctor and her nurse at their office were ticked when I didn't want to induce a week early. I am glad I stood my ground and waited another week because I really think I would have ended up with an emergency c-section. If I had to induce again, I'd want to wait until after 40 weeks again, and maybe even 41 weeks, just in case my "instinct" date is correct.
I only know of two people, myself and my step-mom, who were induced and did NOT have to have an emergency c-section. A few other patients of my doctor that I know and other friends that were induced (too early in my opinion) all had emergency c-sections. That makes for a scary statistic and I was worried going into mine. Luckily I was far enough along in the pregnancy that the induction worked for me.
Well, anyways, that was my story, and I guess my opinion is that inductions and epidurals are great and do serve a purpose, as long as they aren't used out of convenience, especially the doctor's convenience. (I am of course not talking about the ladies who live hours away from the hospital - that's a completely different kind of "convenience". I'd opt for inducing instead of having my baby in a car on the side of the road too!)
Oh, and I was pleased that this was a "debate" and not an "argument" for the most part, so I'll second Ashelen and say, it's an honor to be on this board to learn and discuss important topics in a civil manner! :-)
This was a very interesting debate and I'm sorry I wasn't here for it, lol.
I was induced for medical reasons 3 days before my son's due date, and the induction was easy, healthy, and the most amazing experience ever....but I had a very clear medical reason. I do not believe inductions should be elective before 38wks. period. but I believe that for medical reasons inductions can truly be a life-saver.
I do not agree with elective inductions for convenience any more than I agree with elective c-sections for convenience...there is nothing "convenient" about bringing a life into this world in a healthy manner, and there's no way to force that scenario onto childbirth.
but it has worked and does work for some people...and elective inductions for a good cause, like I said, can be truly a Godsend for some women and babies. (when I say convenience, btw, I don't mean "I live 4 hours from the hospital and need to be induced for convenience"...that's a completely different scenario and I totally understand that).
However...I have and always will support any woman on this board who chooses to induce. I may gently suggest that they wait until the last possible day to do it, but I would never belittle or berate someone for their choice because clearly I do not live their life.
I do want to say, Joy....yes, home births are considered safe for low-risk women. However...very often, you don't discover that a woman is high-risk until an emergency has arisen and mom or baby's life is in danger...like what happened with my first delivery. I was a perfect candidate for home birth and in fact considered it...and if I had gone along with it, I would have bled to death...but there was absolutely no way to predict it. I'm all for midwives...but in a medical setting "just in case".
Anyway...good job debating calmly and respectfully ladies. I'm so proud to be a part of this board!
I was induced for medical reasons 3 days before my son's due date, and the induction was easy, healthy, and the most amazing experience ever....but I had a very clear medical reason. I do not believe inductions should be elective before 38wks. period. but I believe that for medical reasons inductions can truly be a life-saver.
I do not agree with elective inductions for convenience any more than I agree with elective c-sections for convenience...there is nothing "convenient" about bringing a life into this world in a healthy manner, and there's no way to force that scenario onto childbirth.
but it has worked and does work for some people...and elective inductions for a good cause, like I said, can be truly a Godsend for some women and babies. (when I say convenience, btw, I don't mean "I live 4 hours from the hospital and need to be induced for convenience"...that's a completely different scenario and I totally understand that).
However...I have and always will support any woman on this board who chooses to induce. I may gently suggest that they wait until the last possible day to do it, but I would never belittle or berate someone for their choice because clearly I do not live their life.
I do want to say, Joy....yes, home births are considered safe for low-risk women. However...very often, you don't discover that a woman is high-risk until an emergency has arisen and mom or baby's life is in danger...like what happened with my first delivery. I was a perfect candidate for home birth and in fact considered it...and if I had gone along with it, I would have bled to death...but there was absolutely no way to predict it. I'm all for midwives...but in a medical setting "just in case".
Anyway...good job debating calmly and respectfully ladies. I'm so proud to be a part of this board!
re: "home birth has been proven to be safer than hospital birth for low-risk women who have a medical professional present (in those cases a CNM or CPM). "
This is based on faulty research. When you compare the same population (i.e low risk women) there is a higher incidence of adverse outcomes (deaths, birth injury) with home births with CNM as compared to physician assisted hospital births.
The studies that show lower risks with CNM compare ALL populations (including high risk women). Once you compare the SAME low risk population, the numbers change dramatically.
I did a lot of research on the subject when my husband and I first started talking about having another child and I seriously considered a home birth because I believe that natural is better and physicians tend to interfere where they are not needed. I am in nursing school and did my Maternal Child rotation in December 2010. Most of the interventions done seem to me to be so the HOSPITAL/doctor can hurry things along and free up a bed for another customer...since they only get paid for the delivery once...so better it only take 9 hours instead of a day or so.
I don't even agree with artificial rupture of membranes (pretty much NO medical reason for it and increases risk of a prolapsed cord and infection) which is now pretty much standard practice.
Btw you can probably guess I am not in favor of elective inductions :) I think God schedules things for a reason and we are asking for problems when we decide we know better...I really wish the Tulsa, Oklahoma area had a birthing center. Here you have a choice between home and hospital :(
Christine
PS My own birth experiences have been 2 deliveries. First was spontaneous labor complicated by a BAD reaction to Demerol. Vaginal delivery, no epidural. Second was scheduled to be induced because he was post term and NST showed some distress. They admitted me the night before and put gel on my cervix to ripen it. I went into labor overnight and delivered vaginally, no iv meds or epidural, 41 minutes after my membranes spontaneously ruptured.
Both times I told my doctor/nurses absolutely NO artifcial rupture or membranes. The only personal experience I had with AROM was when my aunt had to have an emergency c-section due to a prolapsed cord right after AROM...so I admit to strong bias in that area.
This is based on faulty research. When you compare the same population (i.e low risk women) there is a higher incidence of adverse outcomes (deaths, birth injury) with home births with CNM as compared to physician assisted hospital births.
The studies that show lower risks with CNM compare ALL populations (including high risk women). Once you compare the SAME low risk population, the numbers change dramatically.
I did a lot of research on the subject when my husband and I first started talking about having another child and I seriously considered a home birth because I believe that natural is better and physicians tend to interfere where they are not needed. I am in nursing school and did my Maternal Child rotation in December 2010. Most of the interventions done seem to me to be so the HOSPITAL/doctor can hurry things along and free up a bed for another customer...since they only get paid for the delivery once...so better it only take 9 hours instead of a day or so.
I don't even agree with artificial rupture of membranes (pretty much NO medical reason for it and increases risk of a prolapsed cord and infection) which is now pretty much standard practice.
Btw you can probably guess I am not in favor of elective inductions :) I think God schedules things for a reason and we are asking for problems when we decide we know better...I really wish the Tulsa, Oklahoma area had a birthing center. Here you have a choice between home and hospital :(
Christine
PS My own birth experiences have been 2 deliveries. First was spontaneous labor complicated by a BAD reaction to Demerol. Vaginal delivery, no epidural. Second was scheduled to be induced because he was post term and NST showed some distress. They admitted me the night before and put gel on my cervix to ripen it. I went into labor overnight and delivered vaginally, no iv meds or epidural, 41 minutes after my membranes spontaneously ruptured.
Both times I told my doctor/nurses absolutely NO artifcial rupture or membranes. The only personal experience I had with AROM was when my aunt had to have an emergency c-section due to a prolapsed cord right after AROM...so I admit to strong bias in that area.
Would it be possible for you to post some info on ''more natural ways of induction'' as im totally confused about nautral ways ( be it pineapple or sex or whatever else might help) to the more sever induction that cause these problems.
as i have said before the ob is way to offreing with me about telling me what hes going to do without telling me what he CAN do instead...
I wasnt aware of the diffrence between doing a sweep or what ever else they do?
Im going to go to the idwifes in a few days and im going to have a huge chat about what is done and what the options are.. They say its to early for me to be thinking about that but i believe the more i think about it and the more info i get on it it will help me make the right choice for me and the baby....
as i have said before the ob is way to offreing with me about telling me what hes going to do without telling me what he CAN do instead...
I wasnt aware of the diffrence between doing a sweep or what ever else they do?
Im going to go to the idwifes in a few days and im going to have a huge chat about what is done and what the options are.. They say its to early for me to be thinking about that but i believe the more i think about it and the more info i get on it it will help me make the right choice for me and the baby....
I wasn't making a blanket statement that at home birth is unsafe. I was not considered high-risk in my first two births, but they had complications at birth that required immediately be taken away for not breathing and neither were induced. I am not naive to know that women have given birth away from hospitals since the beginning of time. I was merely saying that I was glad to have been at a hospital and that it is something to consider. And I have seen a midwife in the past and she was not as knowledgeable as the OBs and REs that I have seen. I left her practice. Maybe she was a bad lemon, but I know I made the right choice for me. My other doctors have always been forthright with me and told me of the risks of procedures and risks of not having procedures. I try to educate myself either way. I think it sounds like a matter of finding a medical professional that you trust no matter the type.
I totally respect you for sharing, I was just confused because I got the impression I offended you to the point of needing to defend yourself. I am actually sitting here crying because I feel absolutely horrible if I have made anyone feel badly and I will most likely delete this post to not cause anymore hurt or fear. That definitely was NOT my intention whatsoever. I just wanted to HELP but I think I just made things worse.
I am definitely not anti-doctor. But I am definitely for people advocating for themselves and working together with their doctor, rather than just taking everything they say as the law. Does that make sense? My own mom died because she had a lump she failed to get checked out for a long time. Was that a doctor's fault? No, she should have been a voice for herself and gotten checked out right away. People have to be a voice for their own care. People die, people live whether they choose a more holistic approach or a more medicalized approach. Each and every case is so different. I only meant to share, not make anyone feel bad. And for that I'm truly, truly sorry.
I am definitely not anti-doctor. But I am definitely for people advocating for themselves and working together with their doctor, rather than just taking everything they say as the law. Does that make sense? My own mom died because she had a lump she failed to get checked out for a long time. Was that a doctor's fault? No, she should have been a voice for herself and gotten checked out right away. People have to be a voice for their own care. People die, people live whether they choose a more holistic approach or a more medicalized approach. Each and every case is so different. I only meant to share, not make anyone feel bad. And for that I'm truly, truly sorry.
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