These days it’s incredibly normal for a care provider to induce labour. Living in a country where a complicated pregnancy can be brought to conclusion in a controlled environment, is a great privilege, but with great privilege, must come great responsibility. When as many as one in four women (more in many places) are being advised to augment or induce labour, we have to question how responsible the use of induction is!
So let’s talk in more depth about why you might want to reconsider any recommendation to induce labour, assuming you and your baby are healthy, of course.
1. Because according to multiple studies, when you induce labour you increase the likelihood of a caesarean: Several studies have even found that the rate of caesarean from induction is as high, or higher than 1 in 2. Caesareans are major surgery, and can alter the gut flora of babies irreparably – google the microbiome. Not only this, but mothering a newborn with a giant incision can be hard work! Surgery hurts, and should be saved for when it’s truly lifesaving, or necessary for mental and emotional well being, not as the end result of an induction that wasn’t even necessary. An Australian study of more than 28,000 women found that:
“Compared with women who entered labour spontaneously, induction for non-recognised reasons was associated with a 67% increased chance of requiring a caesarean section.
It also significantly increased the chance of the newborn infant requiring nursery care in a Special Care Baby Unit (an increased risk of 64%) or requiring treatment (an increased risk of 44%) compared with infants born following spontaneous onset of labour.”
2. Because your body will go into labour: No one ever, in the history of the human race, has ever been pregnant forever. And this isn’t because of induction, it’s because all mammals go into labour. You don’t see elephants being induced, or million dollar race horses, in fact google will tell you that it’s exceedingly rare for another mammal to be induced or augmented. How did humans come to be the most successful creature on the planet, if our method of birth is so faulty that it has only worked properly for many of us, since synthetic hormones became commonplace? We’ve come to believe that we have a very short time in which we must labour and give birth if it’s to be safe, but what if we asked our providers to focus on our health, instead of short windows. What if we used induction when there were complications, and we ceased to view time as one of those complications.
Following is information from PetMD that discusses the process of labour induction or augmentation for dogs. What you’ll note is that the use of drugs is not the first port of call, as it is in many hospitals, for women. You will also note that a dog’s mental health is taken into consideration.
“The initial physical examination will include evaluating your dog’s mental and physical health and placing her in a quiet space in the hopes of restarting her labor so that it can progress normally…….
If time and resources allow, your veterinarian will have the blood sample checked for hormonal levels, notably progesterone. If serum progesterone levels remain low, this finding will help in establishing the diagnosis. Your veterinarian will also take abdominal X-rays and/or ultrasound to assess the number and position of the fetuses, and to check their heart rate. Depending on the findings from the examination, your veterinarian may be able to use labor inducing drugs, or may find it necessary to perform a cesarean surgery to remove the puppies. “
3. Because the synthetic hormones used in induction often lead to maternal and foetal distress: Which is why many inductions end in caesarean. The synthetic form of the hormone oxytocin – called syntocinon or pitocin – causes contractions. There the similarity between it and its natural counterpart ends. None of the other hormones that help women to labour are released, in fact the synthetic variety can even block the release of the good hormones which help keep you calm, and ease the intensity of contractions. So synthetic hormones used to induce labour often lead to very distressed mothers! But babies as well, and that’s dangerous. Babies become distressed because the intensity of the contractions is far greater than those produced by natural oxytocin, and they are often closer together as well, which means that the baby has less time to recover in between. According to The Mayo Clinic the risks your baby may face if you induce labour are:
- Premature birth. Inducing labor too early might result in a premature birth. This poses risks for the baby, such as difficulty breathing.
- Low heart rate. The medication used to induce labor — oxytocin or a prostaglandin — might provoke too many contractions, which can diminish your baby’s oxygen supply and lower your baby’s heart rate.
- Infection. Labor induction increases the risk of infection for both mother and baby.
- Umbilical cord problems. Labor induction increases the risk of the umbilical cord slipping into the vagina before delivery (umbilical cord prolapse), which might compress the cord and decrease the baby’s oxygen supply.
4. Because you are healthy: Is there any medicines you take that you don’t need to take? Ones that aren’t indicated by your health? Induction is taking medication. That’s great if there’s a medical need for it, but simply being heavily pregnant isn’t a medical reason to take drugs. It’s a medical reason to watch closely and ensure that you and your baby are healthy, but it’s not a medical reason for induction, because induction is not a way to avoid risk. Induction swaps one set of risks for another set, but it isn’t the risk free option it’s often sold as. By the time you are heavily pregnant there isn’t any risk free option. Natural vaginal birth has risks, caesarean surgery has risks, and induction has risks. Which risks are YOU most comfortable with?
According to Sam McCulloch, on the well respected website and pregnancy resource, Belly Belly, if you induce labour:
“Induction essentially replaces the natural process that happens over weeks, and forces your body to go through it in a few hours. Your cervix is artificially softened and your bloodstream is flooded with synthetic hormones. Contractions are forced to happen quickly and the tempo of labour increases over a short space of time. This makes the pain much harder to manage.”
5. Because you don’t want to induce: By the time a woman is 41 or more weeks pregnant the odds are good that she will face some pressure to induce. Many women don’t realise that they can decline a medical induction with synthetic hormones, and ask that their care provider simply pay close attention to their health, and the health of their baby until labour begins on its own. Hospital policy can be metered out by pushy midwives, nurses, or obstetricians without them actually mentioning that women are NOT subject to rules. Women don’t earn any money for being induced, doctors earn money for providing a service to pregnant women, and women get to dictate what that service constitutes. The law says so. ACOG has just released a very stern Committee Opinion paper on the coercion of women under obstetric care. It stated:
“The use of coercion is not only ethically impermissible but also medically inadvisable because of the realities of prognostic uncertainty and the limitations of medical knowledge. As such, it is never acceptable for obstetrician–gynecologists to attempt to influence patients toward a clinical decision using coercion. Obstetrician–gynecologists are discouraged in the strongest possible terms from the use of duress, manipulation, coercion, physical force, or threats, including threats to involve the courts or child protective services, to motivate women toward a specific clinical decision.”
As with any medical procedure there may be benefits, but there are also risks. In modern maternity care, so many care providers routinely induce labour, we tend to view it as normal. We view pregnancy as dangerous and medical intervention as risk free. Many women genuinely believe that without induction they will never go into labour, but this is untrue. The truth is that everyone will go into labour, it’s just a question of whether or not the pregnancy will remain healthy in the mean time. If the woman or baby become unwell then induction is a smart option, and it’s a relief to live in a place where it’s available, but we must not become complacent with our health care. Induction is a serious medical procedure, it isn’t a garden party. It should only be used when the benefits of inducing, outweigh the risks of remaining pregnant.
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