An Induction Discussion: When is it NOT a Good Idea?

Induction (the process of starting labor using artificial means instead of allowing it to begin on its own) is very common in some obstetric practices. You can read more about what it is and how it is done here.  Some possible reasons providers may give for a medical induction may include:

• Preeclampsia
• Hypertension
• Bleeding
• Gestational diabetes
• Various concerns for the baby/mom
• Infection
• Mom is "overdue" 
• Mom's age
• The size of mom's pelvis
• Baby's size
• Convenience
• Low fluid

NOTE:  While there are definitely times when induction is medically necessary, it is (sadly) fairly commonplace for some obstetric practices to push for an induction when it isn't actually in the best interests of mom and baby.  I am not a doctor and I will not make medical suggestions to my clients as a doula or to readers on this blog, but I do believe knowledge is power and recommend everyone inform themselves of the risks and benefits and seek out the best evidence before making a decision for themselves and their babies.  I also realize that sometimes induction (even when not medically necessary) can be the best choice for some moms for their own personal reasons.  This post is not intended to heap judgment or shame upon the reader but rather be a source of information to consider for themselves!  

That being said, here are a few common, non-medical reasons moms begin to entertain the idea of induction and some things to know to make a decision that's best for you:

"I'm sick of being pregnant and just want this baby OUT already!"
This is such a common sentiment late in pregnancy.  Around the last month (or earlier), many moms begin to get very impatient and, understandably, they just want to meet their babies.  They begin to dialogue with their doctor about this, and many will agree that induction could get them from point A to point B much faster.  Pretty soon, a date is scheduled for induction and mom knows the (approximate) day that baby will be born.
What to know:  Before beginning an induction, it's a really wise idea to ask your provider what your Bishop Score is.  This number is calculated after an exam and cervical check is done and can be a good indicator of how "successful" the induction would be.  The lower the number, the less chance mom has of birthing vaginally, and the higher the risk of needing a cesarean (or surgical) birth.

"It would be so much easier if I could just plan the date baby is born!" 
Of course it would!  Yet...the only thing predictable about birth is that it's unpredictable, and this includes the timing.  It's usually never very convenient for anyone.  Couples are usually very concerned (and rightly so!) about work schedules, care for the other children in the home (if applicable), time off once baby comes, how much leave they have from work, traveling mothers or in-laws coming long distances to help out and their availability, etc.  This is especially hard for type-A, "high D" personalities that live by their planner and a very well thought out and organized schedule.  But when it comes to babies, these things simply can't be predicted and that's one of the hardest parts for many moms.  
What to know:  The key to this issue is taking one day (or minute!) at a time, having several contingency plans depending on the day/week, and then doing your best and waiting patiently for the day baby is to be born.  It's also important to note that it's the baby, and not mom, that is the decision-maker for when labor begins. When your baby is ready to be born, he or she will secrete a hormone called CRH (cortico-releasing hormone) which sends a chemical signal to your placenta. When your placenta receives the chemical signal from baby, it will release estrogen and cortisol, two hormones that will help your baby's lung's mature.  This, in effect, is what "kicks off" labor and is actually quite critical to your baby being able to survive life outside the womb with strong, healthy lungs! 

"My baby is just too big.  I'm not sure he/she is going to fit!"
For many moms, the thought of delivering a full-term baby is daunting and even downright terrifying.  Unfortunately, our culture doesn't help much with this.  Women sometimes scare one another with their stories and for the pregnant woman (especially if this is her first baby), this can only add fuel to the fear she may be already feeling.  After all, she may be asking, how can something that large be ejected from such a small opening?  And so doubt begins to creep in.
What to know:  It is so incredibly important to surround yourself with people who will instill confidence and not fear into you.  If your provider says "your baby is too big," just bear in mind that there is truly no sure-fire way to know the exact weight of your baby, not even through ultrasound.  In fact, they can be off by a pound either direction!  It's also really crucial to remember that if your body made the baby, your body can birth the baby.  For more information on this topic, read this!

These are just a few of the non-medical reasons for induction I hear most commonly that I wanted to address, but I hope it's been helpful.  Let me encourage you...it's your body, your baby, and your birth.  You have the right to ask questions, seek counsel, and know what the evidence and research points to in terms of success rates for inductions.  I strongly recommend that you find out the risks of induction and learn about the intervention spiral that often results.   When we interfere with birth, it negatively impacts the beautiful hormone cocktail of oxytocin in birth, breastfeeding, mother/baby bonding, the way baby adjusts to life outside the womb, and even increases risk of postpartum depression.

Knowledge is power!  Know your facts and do what is best for you and your baby!  

And as always, thanks for reading!

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