Resources on Induction of labor/risk of c-section

[Labbemama]

I hope this is the right place to ask.
Looking for info about something I am wondering about. Lately ppl I know are being induced 39/40 weeks. Ages ago when I was pg. they wanted to wait until I was at minimum 38 weeks and at 38 weeks they would schedule the induction.

So was talking to sil who said her dr. said the risk of c-section is 20% at 40 weeks and 40% at 39 weeks and that's why they are waiting til her due date to induce her. (And I'm hoping she just goes into labor on her own and all for anything that reduces complications in delivering)

So was just curious why the risk would be less at 40 wks is that because your body is "ripe" for induction. Was induced myself at 38 and 39 weeks and one time it did not "Take" and I got sent home! Not looking for medical advice, just curious trying to understand in retrospect. Had everything but a c-section and I was wondering if that could be related to the timing of induction.

[mamatolevi]

Actually the risk of c/s has more to do with the bishop's score (how ready her cervix is and other factors) than how many weeks along a mother is. theoretically, she'd be more ripe at 40 than 38, but still....

ICAN is a a great resource for risks of induction and risk of c/s. I have always heard that in any induction, the risk of a c/s is 50% higher than if the mother goes into labor on her own.

If your friend wants to avoid a c/s she should avoid the induction. However, if her bishop's score is at least a 6 (I think, I know mine was an 8 at my vba2c induction) she has a good chance of succeeding for a vaginal birth. Is there some reason she's being pressured into an induction?

[clovergirl33]

Keep in mind that the factors that make your body "ready" to start labor are many and not fully understood. Even if the cervix is ripe, that doesn't mean that mom's body or baby are ready to deliver.

In the past several years, they have made recommendations that there should be no inductions earlier than 39 weeks without clear, medical indication. That is because the risks of complications for the baby (particularly respiratory) increase significantly before 39 weeks. You have to remember that the "due date" is actually a 2 week bell curve, so your 37 week induction might actually be 35 weeks gestation.

Just some stuff to think about. I don't know the stats on sections...

[Labbemama]

Thank you for your replies.

Why the push for induction? My SIL had broke her pelvis about two years ago and they don't want baby to be too big. They took measurements last week. Baby is a boy between 6 and 8 pounds at 38 weeks with two weeks left to go.
(My experience has been that they tend to underestimate the size of babies and I am a little worried. My brother is a big guy. We've had large circumphrence head babies in my family.) But she doesn't look that big yet.


She also had gestational diabetes and some high blood pressure that was treated with some bedrest, but went down after her wedding was over with.

Personally, I think she is headed for a c-section but I'm hoping for the best.

Back in my delivery day the rule was 38 weeks but it makes total sense to me that baby might not be ready yet and maybe just maybe it's a good idea to leave things well enough alone and wait to go into labor. Having been thru two very LONG inductions at 38 and 39 weeks I would say wait it out. But that's easier said when you aren't the pregnant one.

She has not been any bit effaced or dilated yet.

[mamatolevi]

I forgot to say that I'm not a BP. sorry.

Anyway, your sister needs to look at spinningbabies.com for some great info on optimal fetal positioning. Could be useful given her history of a broken pelvis. A chiropractor may be able to help her open up her pelvis as well if that's a concern and something she is comfortable with.

don't worry about the large head - baby heads mold and the pelvis expands during labor to make room.

The reports I hear of u/s and size is that drs tend to exaggerate the size of the baby. U/S can be up to 2# off in either direction. It sounds like her dr is being honest when saying 6-8# - rather than just saying "OMG he's 8# now!" and giving her the big baby scare. It's also reassuring that they are waiting till 39/40w to induce.

The next batch of questions might need to be how would they do the induction? foley catheter to start? low doses of pit? or active management of labor (higher doses with more frequent increases) and AROM? when would they give up and recommend c/s? will she be able to walk around or will she be tethered to the bed b/c of monitors? does her hospital have telemetry monitors? The more she walks and is upright the more gravity does the work of labor for her. Also, what if she decides not to induce? consequences? risks? benefits of waiting?

[OMama]

80% of inductions are not medically necessary.

Encourage her to keep talking to her provider about what is truly medically necessary. Also remind her that pelvises are designed to move and open in labor, especially if she is in a more upright position. A woman's pelvis is at its smallest when she is laying on her back. Squatting I think it is about 28% wider or something along those lines. I don't remember the exact number. There is also a smaller chance of it fracturing if she is pushing in a upright position or a position that she had chosen.

And inductions due increase the chances of a host of other problems.

As for books that you might want to look at Ina May's Guide to Childbirth and Jennifer Block's Pushed both discuss these issues. Those were just two off the top of my head.

[Youngfrankenstein]

Originally Posted by Labbemama

to be too big. They took measurements last week. Baby is a boy between 6 and 8 pounds at 38 weeks with two weeks left to go.
(My experience has been that they tend to underestimate the size of babies and I am a little worried. My brother is a big guy. We've had large circumphrence head babies in my family.)

I think you'll find that the same amount of people had the total opposite experience-babies who were said to be huge and were much, much smaller.

[Labbemama]

Probably so on the estimations not being too exact. (Gosh, I hope some scientists are working on that.)

Oh my sil is all for the induction. There is no dilation or effacement at this point. Induction on the 13th.

Does it matter that there is no dilation to start an induction of labor?

[OMama]

Dilation is one of the factors taken into consideration when trying to calculate how effective an induction will be. I did a quick search and found this article.

http://www.amazingpregnancy.com/preg...icles/173.html

I don't remember how many weeks you said she was now, or will be on the 13th, but since it sounds like they are definitely going to induce her, you could also encourage her to think about some alternative ways to induce: nipple stimulation, sex, acupressure, evening primrose oil, and even castor oil. She (or you) should research these, especially anything taken internally and ask her doctor if there is any reason she shouldn't try them. Doctors rarely say they are going to work, but if something won't do any harm, why not at least try? Also, they could try sweeping her membranes too.That has some risks (i.e. risk of breaking her water) as well but it sounds like they are going to go ahead no matter what.

[Labbemama]

Yeah, I had thought about mentioning all the things ppl told me to do, have intercourse, consume pizza/various other foods, walk. I have already told her about the first one and she was mortified at the suggestion when we were discussing getting married and the honeymoon. LOL.

My mom said they are just doing it with pitocin.

I may see her on Saturday for her shower. Don't know if I'll get a private moment to talk to her or if it will come up. It will be her and some "old school" grandmas one of whom brought up castor oil on her facebook and her friends young women with no kids. I don't know if I'll have a chance to bring it up.

We are really not close and I don't think she appreciates any advice I have to give her but I feel like I'd want to prevent her any unnecessary pain and suffering if she would take a moment to consider it.

[mamatolevi]

Leave some printouts on induction risks on her table with a note saying why you are leaving them - that you want to make sure she has all the information about induction so she can make a truly informed decision and that it be HER decision not a hospital's policy or dr's preference. I think if she can tell that you are giving her this information not out of judgment but out of concern for her well being, it won't go over poorly. If she's not adult enough to see it that way and your information does go over poorly, it's not your problem.