To Induce or Not To Induce?
I was born on July 19. My original due date was June 28. My poor mother suffered for three extra weeks during an incredibly hot summer, waiting for me to decide to be born.
These days, very few women would be allowed to be pregnant for 43 weeks. Recently, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) redefined a full term pregnancy as a baby born between 39 weeks and 40 weeks, 6 days. This gives a baby the best chance at being healthy.
However, once a woman reaches full term, her doctor may begin to discuss an induction with her. There are various ways to induce labor. Manually breaking a woman’s amniotic sac is one option. Another is ripening the cervix with synthetic prostaglandins or a foley bulb. A final option is Pitocin, or the synthetic version of oxytocin, given through an IV.
Unfortunately, inductions are not always positive experiences for women. Some are successful, while some end in traumatic, emergency C-sections.
I asked peers and other friends to share with me their experiences with induction and got a lot of fantastic responses.
“Size was a deciding factor. My doctor gave me to option of an induction. It was successful, but a more challenging labor [than my first]. I scheduled it for when it worked for me, but I managed my pain better when I was not induced.”
“I was induced because my blood pressure was high and I was 38 weeks. It went great. The labor and delivery was very easy as well as the recovery.”
“The induction went very smoothly and it was my easiest labor. I’m grateful I was inducted. I trusted my OB and knew she wouldn’t have suggested it if she didn’t think it was necessary.”
“My doctor and I agreed if I didn’t go into labor naturally a few days after my due date that I would get induced. It was a really good experience. My body reacted well to the Pitocin and I progressed on schedule.”
“I was blessedly, happily induced at 38 weeks because they don’t let you go over that usually with twins. I had an overnight Pitocin drip which resulted in my first of my first boy.”
“I was induced for all four of my pregnancies because of high blood pressure. I had a pretty quick turnaround for each of them: a few hours of contractions followed by just a few pushes.”
“They scheduled the induction before my due date and said they don’t generally let people exceed 41 weeks. I didn’t fight it but they didn’t really give me a choice or talk about waiting as an option.”
“My water broke 8 weeks early. I asked if Pitocin was necessary [after 2 more weeks of bedrest] and the doctor told me, “Do you want to have your baby today or do you want a dead baby?” I was put on a drip. Things progressed slowly and painfully.”
“My induction was not medically necessary and was without my consent. It was also unsuccessful. I did not progress, was sent home in extreme pain and didn’t have my daughter for another two days. I learned so much after that and was very well educated for #2….and went many lengths to avoid induction.”
“They said at 15 days late the baby could get too big and/or the risk of baby dying inside me went up. They scared my husband so much that he begged me to get induced. I had no idea that it could mean not just Pitocin but then that horrible inflated ball inside me that pushed the baby and sent me into back labor. Then the pain was so bad I got an epidural and couldn’t move which stalled the labor [leading to a] stuck baby with head swelling and a C-section.”
“I was induced two weeks before my due date. Baby was not ready and was breech. This doctor broke my water so there was no going home. I was rushed into an emergency C-section. I later found out he induced many of his patients for his own scheduling convenience. Lesson learned to question every doctor and always get a second opinion.”
Education and Alternatives
“I did not want to be medically induced because of the horrific medical domino effect that is statistically very likely to follow such medical interventions. I induced with acupuncture. Two 45 minute visits worked! [Second time] I asked the doctor if we could push back inducement as long as we did a sonogram, non-stress test every week and as long as my blood pressure was fine. I referred to this very interesting website for many of my concerns and questions.”
A Medical Opinion
“I am not an OBGYN [but as a doctor in the UK] I know about the potentially devastating consequences of waiting just too long. I appreciate that a good birth is important to many women, but to me, my baby being out and both of us alive and healthy was pretty much the only consideration. I was induced with my first. It ended with an emergency C-section, but I wouldn’t have changed my decision to have the induction at all. I chose an elective C-section at 39 weeks with my second. I wouldn’t necessarily advise this course of action for patients, as obviously inductions/C-sections are not without risk, but personally speaking once I get to term, they need to come out as soon as and as safely as possible. I get frustrated when I read so much about not letting your medical team ‘pressure’ you with induction, when all they are trying to do is get your baby out before you risk losing it. Thankfully. in the western world our rates of stillbirth are relatively low, but that is because things like induction exist and I see far too much advice for new mums to dismiss this in the misguided belief that our bodies know better, when in fact many mothers and children died in childbirth before we had the benefit of modern medicine.”
“There is a really fine balance between facilitating the best possible birth for mum and baby and balancing it with knowledge of the risks. I’m not sure the medical profession gets that balance right sometimes and I think there is a huge need for better communication so women feel more empowered.”
Education is the best way to feel empowered. Take the time to read and research about childbirth and prepare yourself for the different situations that could occur once you hit your due date.
Communicate your birth plan with your provider but remain open to the various possibilities that could arise.
Personally, I was determined to avoid Pitocin and planned to labor at home as long as possible. However, a diagnosis of group-strep b raised the risk of infecting the baby. My doctor said that Pitocin was the best option for a safe and healthy delivery, which I agreed to. Fortunately, I progressed quickly on Pitocin and my daughter was born within 24 hours of my water breaking.
Hiring a doula, and advocating for and educating myself and open communication with my doctor helped me to achieve a birth of a healthy daughter that was a positive experience for me.