Why does everyone get induced? What’s going on here?

Opinion piece here…As I’ve been on this journey of birth for a few years now, with my first son (born by cesarean in a hospital) and now awaiting the birth of my second son (planning to birth at home with a licensed midwife), I have been reading a lot and keeping my ears open to others’ experiences. I am not a “everyone should do home birth” kind of a person, I don’t know anyone who is. Nor am I judging women who choose elective induction. If that is something someone really wants, that is cool, I am pro the woman’s choice. BUT, I don’t think that women are actually given the full spectrum of information about elective induction which is the main problem AND it is being suggested by far too many medical professionals (mostly OB’s in hospitals) when, many times, it isn’t actually in the best interest of mother and baby. I think a lot less women would be saying “yes” to suggested inductions if they were given the whole picture. For example, a mother’s mental well being post baby is actually extremely important for one: the woman and two: the health of the baby. The whole “as long as you have a healthy baby, healthy mom” comment, is hardly ever referring to a woman’s postpartum health or just her mental/physical/spiritual health in general, or the baby’s. Studies show that emergency cesareans (which can rise from elective inductions) give a 15% higher chance for a woman to develop postpartum disorder. There is also the issue of clarifying when inductions are medically necessary versus elective. For example, the fear tactic of “your baby is big and you’re close to your due date so let’s induce” is NOT medically supported. (The ACOG finally just came out and admitted that ultrasounds can’t accurately predict a baby’s weight for example.)

I am just thinking of this today as literally within the past two days I’ve heard of two women I know being induced. One of which is getting induced the day after “40 weeks.” Now, to me… due dates are a joke. They aren’t accurate. A woman isn’t even considered “post term” until after 42 weeks and that is just a guideline of the ACOG. In some countries, it’s later. Unless there is a major medical reason to induce, it seems more logical to just let the body and baby go into labor when ready, so labor isn’t horrible for the mother. Induced labors in general are actually harder than spontaneous labors because the body is being forced into it. I have friends who shared with me how their kids went into distress once given pitocin. It was clear that the baby didn’t like the “force me out” method. My mom said once she was given the epidural that her labor stalled.

If someone doesn’t want a major abdominal surgery with all that comes with it (possibly not having skin to skin right away, possible problems nursing, possible problems with breathing for baby, a much higher likelihood of postpartum depression, etc.), one should really consider saying yes to any kind of induction method because of what’s called the “cascade of interventions.” Once this process is kickstarted, let’s say with being given some pitocin when the body has shown no signs or minimal signs of readiness, the woman is then typically put on a clock at that hospital for things to happen in a certain amount of time. She is also catapulted into a lot of pain (not the natural way of the body and brain chemistry working together) which leads to a need for an epidural, which can totally halt the progress of labor because a woman can not feel what is happening to intuitively breathe or push the baby down. NOT to mention, once given synthetic drugs to induce a woman is put on continuous fetal monitoring devices which also unnecessarily lead to more interventions and she is most likely stuck on her back in a bed which makes labor much harder and less efficient. (Please look at my resources page and this quick article with a caption below).

“The Listening to Mothers survey reported that almost 50% of the women surveyed had their labors induced (Declercq, Sakala, Corry, Applebaum, & Risher, 2002). Physicians are astonishingly up-front in discussing how much more efficient scheduled inductions (and scheduled cesareans) are. They claim that women will not have to worry about middle-of-the-night births and that hospital staffing and bed turnover can be better managed. Both physicians and women seem to be comfortable with “intervention-intensive” labor and birth.

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.” (“Saying No to Induction” The Journal of Perinatal Education by Judith A. Lothian, PhD, RN, LCCE, FACCE)

I remember with my first birth, the CNM saying, “Don’t worry, having the section at 39 weeks is perfectly fine. The baby is done developing.” In my gut, I had a problem with this. Although I accepted that most likely he wouldn’t turn at that point (he was frank breech), I felt it was not right to not let my body at least go into labor on it’s own and then go in for the cesarean, but I succumbed to the fear tactic and went with what they said “I had to do.” If you access the risks with either choice (c section scheduled without any indication of labor at 39 weeks vs let labor start then have the c section), I think it’s less risky go with the later and gives many benefits for baby and mother to allow body to at least start the process.

Now, that all said, with the info I have now I would’ve sought out an OB who delivered breech babies but I have also thought about how going into labor is usually better for the mom and baby. It’s not convenient for doctors or hospitals though.

If anyone out there is pregnant and hoping for a spontaneous labor with little to no interventions, I would highly suggest you ask your provider lots of questions very early and do your homework on the provider/institution in which you are planning to deliver as per their rates and policies (with a 50% induction rate going on and a 31% cesarean rate going on in the US… it is very clear that it’s actually harder for a woman to birth without interventions in hospitals than it is to have them.) Also, switch providers as many times as needed to find one that lines up with your beliefs and “gut.”

Share or not to share?

During my first trimester, I was researching, interviewing, and coming to terms in my own soul with what was right for me in terms of a provider and birth plans, I chose to not share my home birth considerations with basically anyone other than my husband and support groups online. I highly highly recommend this. During a time of decision making, it is important to not be subjected to a million opinions OR other people’s negative, traumatic experiences with birth and their own fears. I have spent a lot of time growing into a person who can stand on her own two feet and not give a shit about what other people think about me or say BUT, when in a vulnerable space such as being pregnant…and making these personal choices, I believe it’s important to protect that space spiritually and mentally. The use of DISCRETION is key. Even throughout the second trimester I chose to not tell people because…well, it didn’t feel necessary and I was still moving through some tests and things that could’ve risked me out of prepping for a home birth so I didn’t think it felt “real” enough to even share.

I’m 31 weeks pregnant and I feel differently. I made it through the decision making process of the first trimester as I gained tons of information and I spent the second trimester settling into it all myself, and in the third trimester now, I feel confident in my choices and am super excited about birth! I also want to normalize my choices (as a home birth plan is new for me given my first was a desired natural birth turned c section due to frank breech at 37 weeks). I do want to share all this info I have learned as well to other women but also know that might not be my place, or the time yet. Another place to use that lovely word DISCRETION. Other women may want a scheduled c section, an induction, etc. and that is cool, more power to you. I’m not trying to push for all women to have natural births. I just hope there is more real informed consent happening around all of it one day…for example, every women actually being told the risks of an epidural to mom and baby or how inducing labor changes labor and has a high rate of leading to c section or how our posture affects baby’s positioning the whole pregnancy.

Off on a tangent again…So, I am now openly sharing my home birth plans to people if 1. they ask specifically, and 2. I feel capable of detaching from their reactions. Being in the preparation phase for birth now, I do mostly feel able to detach from others’ reactions because I just don’t care what others think but…I’m not about to get into debates about it or try to justify my choices to skeptical, fearful people. There are still some people I won’t share it with because, well it’s a personal healthcare and family choice that really isn’t anyone’s business. But just like everything on the pregnancy journey, my perspective has now shifted and Im in the space of being excited for our plans, super happy with my provider (a home birth/birth center midwife), and wanting to normalize the process for myself, because, contrary to our culture, it is normal and I believe in physiological birth.

What are your experiences with this? Sharing or not sharing birth plans (whatever they may have been) and what worked for you?

Posture…Who would’ve thought?

Jan. 17, 2020.

I’m now almost 29 weeks pregnant with baby number two and I’ve been writing about the differences in care I’ve received this time around (because of my choices) and how I’m prepping for my vbac home birth. Today I’ve been thinking about how my previous experiences with OB’s and CNM’s in a hospital group (at great hospitals in major cities) compare with my care under a midwife now. I am not blaming previous providers as I konw to take responsibility myself to gain information now in regards to birth within our healthcare system BUT in all honestly, they were not great at teaching how to take “preventative” measures for concerns such as breech positioning or nutrition or exercise stipulations in general. Which probably doesn’t come as a shock as these are things they don’t really emphasize in their studies. This pregnancy, besides just taking responsibility myself to gather all the information I can, and I have, I have also been with a provider, a licensed midwife (LM) who practices in out of hospital births (home births or birth centers) who has put emphasis on measures to be taken EARLY to prevent the whole, “oh fuck, it’s now 37/38 weeks and baby is… or mommy is…what can we do to change it?”

Here’s a quick list of things I am now grateful to be more aware of because of both my own research being stepped up about 100 notches and my midwife’s thorough care. (She provided me with a thick binder with info to read before each appointment that carries me through to the end). Right away, first section of the binder there was an emphasis on how to achieve optimal fetal positioning for a smooth birth. FETAL POSITION DOES MATTER if you are trying to have a smooth, natural birth. It’s important even if you aren’t trying to have a natural birth but are trying to avoid an unnecessary cesarean or just a labor that might qualify as a “tough one.”

  1. POSTURE

I was never aware how much my posture and slouching in a chair or a couch could contribute to less than ideal positioning of the baby for birth. I think I was more aware of it at the very end of the pregnancy the first time but now I know it is something to consider from the beginning and one in which I believe has helped position my little guy in the optimal fetal positioning (LOA) since at least 27 weeks. I am going to keep paying attention to posture and although it feels like a pain in the butt sometimes to not just slouch into the couch, I understand and believe the importance of it now. I feel a bit awkward sometimes sitting with such good posture as everyone around me rests into the back of a chair…but hey, you gotta do what you gotta do. I do want to slouch sometimes and sometimes I do briefly, but I’ve now developed a good amount of muscle memory with good posture or choosing to stand (as I am now) so when I do slouch, I can feel it my lower back and how my hips aren’t tilting forward anymore. The Spinning Babies website labels this as “Maternal Positioning.” Which leads me to the number 2 thing I’m most grateful for being more aware of now…

2. SPINNING BABIES

The main homepage of this website says “Easier birth with fetal positioning. Use this site and videos to improve fetal position (breech, transverse, posterior) and birth. Reduce the chance of cesarean.” I won’t copy and paste their knowledge here but go to the site and read read read! In my first pregnancy, I was made aware of this website from my prenatal yoga teacher and my doula at the time. My OB’s and CNM’s never directed me to this information except at the very end the CNM’s mentioned it with trying some exercises for how to flip a breech baby. It is much more effective to just be knowledgeable and practicing some of these exercises/suggestions EARLY on in the pregnancy and throughout, and not just at the end when it’s like…”oh shit…” 🙂 Before I also didn’t take it as seriously as I do now. I thought it could be used more as a measure taken if something went wrong as opposed to just optimal health for the pregnancy.

3. Acupuncture

I have seen an acupuncturist 3 or 4 times so far and I swear it is the best stress reliever I’ve ever experienced. You’re basically forced to rest and meditate for an hour without moving much so it is super super helpful to me to get some self care rest time as I have an almost 1.5 year old AND I believe the practice really works to prepare the body for birth. My body needs to be in balance and without tight muscles and ligaments obstructing or hindering baby’s positioning for birth. It was highly suggested to seek acupuncture from numerous Licensed Midwives I’ve met on this journey. Again, it was not suggested in my experience with OB’s or CNM’s until again at the very end last time when my CNM suggested I do that to try to solve the issue. I’ve found it to be helpful as a preventative measure so far.

4. Webster Certified Chiroporactic Care

This time around I’ve been seeing a chiropractor since the beginning… before, I tried to go 2-3 times around 38 weeks…which… when your body is out of balance, super tight, etc. a few times aren’t going to help. (First pregnancy I was probably the fittest I’ve ever been leading into it and had very tight ligaments around my pelvis and abdomen (and everywhere).) I love getting these adjustments and yes, I do think they have been helping enormously.

There you have it… The top 4 things I am grateful to be aware of during this pregnancy and doing things differently.

Please follow my blog to stay tuned and please reach out if you have any questions, are in the same boat, etc etc. I’d love to hear from you!