Tis the season...for inductions

As a doula and child birth educator I am always a bit unnerved come November, the number of inductions always seems to spike between November and December. I know that the thought of a bundle of joy arriving as the holidays arrive is lovely, but unnecessary inductions carry a lot of risks. Often it’s the OB who pushes the induction,  frequently citing reasons that aren’t founded in evidence. Risks of induced labor can include:

·        Increased risk of needing an emergency cesarean section (C-section)

·        Complications from Pitocin  

·        Respiratory complications for the baby

·        Oxygen deprivation, which can reduce your baby’s heart rate

·        Infection, uterine rupture, and excessive bleeding for the mother

·        Complications with lactation and breastfeeding

And a number of other issues. Statistically speaking women who have an induction are significantly more likely, according to the national library of medicine , to have a cesarean which carries it’s own risks including:

·        Your incision, uterus and other parts of your body, like your belly and bladder, may get infected. 

·        You may lose a lot of blood and need a transfusion.

·        Organs near the uterus, like the bladder and intestines, may get injured during surgery.

·        You may get blood clots in your legs, pelvic organs or lungs

·        You may have bad reactions to certain medicines, including anesthesia you get during surgery.

·        You may have an amniotic fluid embolism. This is a rare condition that usually happens during or right after a tough labor and birth. It happens when some of your baby’s cells, hair or amniotic fluid (fluid that surrounds your baby in the uterus) gets into your bloodstream and moves to your lungs. This can cause the arteries in your lungs to become narrow, which can cause problems like a fast heart rate, irregular heartbeat, heart attack or death.

·        Although it’s rare, you’re more likely to die during a c section than during vaginal birth

While there are many legitimate reasons to be induced in today’s modern world it is often pushed without merit. I want to address something, I am not a doctor but you do not have to be one to notice the direction our maternal healthcare is headed. In the united states we have extremely high rates of infant and maternal mortality, more than other developed nations. This is especially true for birthing people of color who are 4-6 times more likely to die during childbirth. It is impossible to talk about the overuse of inductions without mentioning the issue of maternal mortality.

So what can you do about this unfortunate trend? Well let’s talk through some common reasons that babies are induced

-baby is “big”

-“slow” labor

-multiples

-“overdue” / full term

-high blood pressure (when pre-e has been ruled out)

-“small” pelvis

-breech baby

-birthing person with gestational diabetes

-OB wants to be home for Christmas finally (yes this does happen but no it will not be what your doctor tells you is the reason)

So let’s talk about a few of these, jumping in with the myth of the “big baby” … Yes big babies happen but here’s the thing ultrasounds to predict big babies are wildly inaccurate and many women are fully capable of going into labor and delivering said big baby without induction. The failure of labor to progress on the timeline that your OB feels is best is another common reason we are induced. The supposed “slow” labor is easy to explain, sometimes person “A” will take longer to bring baby earth-side than person “B/C/D/E” ect. Okay so next on the list “full term” (let’s also talk about “overdue” as well because they go hand in hand), you know what else is wildly inaccurate? DUE DATES! Yes, as you might imagine due dates are quite hard if not impossible to guesstimate based on last menstrual period. This causes many birthing people to be pushed (no pun intended) to induce when this mystical “due date” arrives. This is why we hear stories of folks delivering at 43 +5 or whatever other hard to imagine overdue gestational date. Babies are not cakes, they do not need to be removed from the oven right at 40 weeks nor are they going to necessarily overcook if left to arrive on their own time. Finally let’s talk about the OB who wants to FINALLY be home with their family for Christmas, yes this is a hypothetical but it does happen. OBs are people and this means that they can make choices based on their own needs, not necessarily based on the needs of their patients. With how spooky-common inductions have become many OBs are happy to induce if the birthing person seems willing and they can come up with a reason. This is not meant to be an OB shaming post, many OBs are fantastic people who care for birthing people with skill and love. I do not want to come across like I think all OBs are bad so I had to make that clear.

What can you do if your doctor wants to induce you for a non-emergent reason? Well this might seem overly simple, but the answer is……… say no. You must remember you are the boss in this situation. Your body, your choice. Polices are also not laws, maybe your hospital or doctor doesn’t “like” folks to go past 40 weeks but that does not mean that you can’t. You can advocate for yourself or you can enlist the help of your partner or family member. As your doula I can help you advocate for yourself and I will always be happy to provide you with evidence based information. I want to reiterate a few things

-I’m not a doctor

-sometimes inductions are medically needed

-sometimes they aren’t

-I’m not shaming all OBs, rather I’m pointing out the issue of the overuse of induction

-you have the ultimate say in what happens to your body during pregnancy, labor and birth

-holidays are not a reason to induce

I truly hope this blog post can help folks this holiday season be able to identify when they might be being pushed towards an unnecessary induction. If you are in need of a doula, child birth educator or lactation professional please be in touch. Be sure to like my page on facebook.