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.”

“Labor Prep” After 35 weeks for a Spontaneous and Shortened Labor

As I prepare for my HBAC (home birth after cesarean) and continue to have bi weekly to soon weekly appointments with my LM (Licensed Midwife), I’ve been given some options of how to further prepare my body for labor in this final stretch of the last 4-6 weeks. There are a lot of myths out there, things that can actually help, and things that could cause damage as “natural” ways to encourage spontaneous labor and shorten labor. I am not putting myself on a timeline where I have to induce labor and have chosen a provider who will also not put me on a timeline except for what she has to honor in our state per law. She can only attend my birth if I go into labor between 37-42 weeks gestation in the state of California. If I go into labor before that I’d be “early term” so would need to see an OB at a hospital and post 42 weeks I’d have to do so as well because after 42 weeks is considered “postterm” according to the ACOG. BUT… going to 40 weeks, 41 weeks and some days, is definitely fine and VERY NORMAL. I can choose to do more tests at that time as I wait as well to ensure all is well as I wait. I’m not looking to try to force this baby out before the baby wants to come out. (You can read about induction which is now a “norm” in our country at EBB.) I would consider medically indicated induction if I knew for sure it was actually medically indicated, but I wouldn’t do an elective induction (obviously planning a home birth reflects those beliefs).

I’d recommend using the Evidence Based Birth website to watch videos and read articles about specific topics to see what evidence exists as you make your own choices, along with other valid sources and your midwife, OB or family doctor. That helped me. But mostly… I listen to my gut which I believe is actually the best thing I can do to prepare myself for labor. If I can stay connected to that, I will have a great birth, no matter what. My body knows best. My inner voice knows best and I will listen to that. (I’ve done lots of fact finding and gathering from other peoples’ experiences and researched what I can to help me come to these conclusions for what feels right for ME).

Things I’m doing to prepare my body for labor in addition to the all the things done so far in pregnancy (posture, Spinning Babies, weekly chiropractor, walking etc. (see earlier posts). Please research these widely known ways to improve labor outcomes to know if they are right for you. I’ll just list them here with a few links of support to get you started if you’re interested.)

POST 35 WEEKS: Natural Methods of Preparation

“The women who consumed date fruit had significantly higher mean cervical dilatation upon admission compared with the non-date fruit consumers (3.52 cm vs 2.02 cm, p < 0.0005), and a significantly higher proportion of intact membranes (83% vs 60%, p = 0.007).”

The effect of late pregnancy consumption of date fruit on labour and delivery.
  • Spending more time sitting on the birth ball, moving hips/pelvis and keeping the good posture for baby’s optimal positioning to hopefully avoid any posterior presentation and keep baby head down. (He’s been head down since around 27 weeks thanks to all the things done the whole pregnancy.)
  • Drinking Red Raspberry Leaf Tea everyday (I’ve been doing this since 20 weeks). I may increase to 2 cups a day now in the last month. (Study “Raspberry leaf and its effect on labour: safety and efficacy.”)
  • Weekly Acupuncture after 35 weeks! (it’s supposed to shorten early labor by 2-3 hours)
  • Positive Affirmations (my own as well as Hypnobirthing audio) and listening to my prenatal yoga playlists that I’ve been listening to most of the pregnancy.
  • Staying connected to the belief that I “Trust my inner knowing.”

What I’m choosing NOT to do/take:

  • I won’t take castor oil near 40 weeks in hopes of inducing labor (there is a lot of bad evidence about this method that some people use to “naturally” induce labor).
  • My midwife offered me an herbal “Labor Prep” syrup to be taken in the last 4-5 weeks of pregnancy to naturally help prepare the uterus and cervix for labor. (It has the same ingredients as this one found on Amazon which are: Blue cohosh, squaw vine, false unicorn, and black haw. I personally trust her and trust that is has helped many women’s labors BUT, it just didn’t sit right with me so I decided not to take it after I tried it. After doing some research on some of the herbs in the mixture, I further solidified my choice. This was one of those… just trusting my gut kind of things. It may be fine to take for many women, but I’d prefer to just take some vitamins and have some herbal tea as opposed to 3 times a day herbal syrup. The EBB video about blue cohosh solidified it for me. I haven’t regularly take herbal supplements so it’s just not something I feel comfortable with with this particular product.