WHY are there so many inductions? Especially before the due date?

[brown eyed girls]

I've been homebirthing for too long I guess. All my friends homebirth, too, at least most of them... but I'm feeling out of touch I guess. I used to teach CBE classes and stopped about 5 years ago, and just recently was asked to volunteer to teach again at a pregnancy center.... but suddenly I feel so out of touch with what's going on in OBs today. I have 2 clients in my class at the pregnancy center, both induced early-- before their due dates. The doc started talking about scheduling inductioni as soon as they hit their 34th week... they both were induced around 37-38 weeks.... And yes, both of them ended up having way too much interventions and have trouble breastfeeding now because of it.

Now I am seeing so many ladies HERE at MOTHERING being induced. I am so shocked and surprised! I mean, Mothering has had GOOD information about the dangers of induction, and supports natural childbirth.... so I have to assume that ladies in the MOTHERING community have the right *info* they need about induction. So what's going on that so many are still induced before due dates? Is it pressure from friends, family, OBs??? Or are you truly ASKING to be induced because you want it? I just feel like I need to know.... my ladies at the PRC just assumed they were supposed to, the OB started talking about it and they had heard in class about induction, but the OB scheduled it..... and if you are a first-time mom of only 19 or 20 years old, I guess the OB has more influence on you than a mom of almost 7 who teaches your class at the pregnancy center.

I guess I just don't get it--- so many moms who let their babies have the bottle rather than wean them because "they aren't ready".... or won't potty train "they aren't ready".... give bottle instead of breast because "he didn't want to, he liked the bottle better"..... I hear these things, but then the same woman says "we're inducing labor at 38 weeks whether he's ready or not, because I'm tired of being pregnant." Why the push to get baby out?

I'm due May 10-- today!-- and I've had prodromal labor since April 23. I spent all day Monday with early labor ctx, and all day yesterday with ctx that also leaked fluid because I had what MWs call a "high leak"... it sealed, I'm no longer leaking and no more ctx. I may or may not have this baby this week... although I hope. A lady at church was due the same day as me.... but she was scheduled to be induced last Wednesday, the 3rd, at 39 weeks. The induction failed and she got a c-section. Last year a mom at our church was induced at 39 weeks with CYTOTEC and her uterus ruptured (and this was her FIRST labor/pregnancy) and she had to have an ER c-section and her baby spent a week in special care nursery with "wet lung syndrome".....

There is a new report out in the news, about how the U.S.A. is second-to-last in developed countries for infant mortality rates. About 5 out of every 1000 U.S. babies are dying. Over 98% of U. S. babies are born in hospitals with OBs attending and all the latest technology available. 2% of U.S. babies are born out of hospital, with MWs... the stats for MWs is that they only lose about .3 out of every 1000 babies. Why? Why is a homebirthed baby so much likelier to live through infancy? Is induction influencing this?

I'm really really wondering if MY thinking is really SO out there... I mean, when my first child was born, I never knew ANYONE who got induced. Two years later, I knew ONE lady got induced on her due date, because it was her 4th child and she needed to plan childcare and talked her doc into doing it... I had the same doc for #3 and he induced me too, for "prodromal labor" and to "make it easy" since my MIL already had my kids that day. (My induction was a total emergency afterwards, the birth itself went OK but afterwards I bled, baby was too early, it was a disaster.) But now it's only 12 years later, and I don't know hardly anyone else besides me who is NOT being induced, and before the due date! I mean, I have known quite a few being induced at 42 weeks .... but now everyone is being induced at 37, 38, 39 weeks.

I guess I'm rambling now... I want to try to understand, and know what CBEs are supposed to be doing to help women know their choices in childbirth and what's healthiest for the baby.....

[Darcy37]

My last 2 babies came on there own one 8 days early one 7 days early and I have type 2 Diabetes and so I will be induced at 39 weeks because of the Diabetes but if my 4th is like my last 2 I will go before I can be induced.So I have never had to be induced but my last 2 babies came a week early.

[Peppamint]

I was lucky.... I was that 20yo first-time mom who was induced with dd. The OB scheduled it and I honestly thought it was necessary... she called it PIH but now I know better. I'm fortunate that my body was ready for labor already and it went pretty well considering. It wasn't my dream birth but it could've been waaay worse. My dd (38w1d) was not really ready to be born- a really sleepy nurser and just not "ready" IMO.

As crazy as I am going today (my due date too!) since this is the longest I've been pregnant, I just keep reminding myself it will be worth it in the end. All the prodromal labor makes for a nice, short, manageable labor later down the road and I'm not going to deal with all the risks associated with being induced or even 'naturally' inducing labor.

Did you see the BabyCenter report that the average pg is now 39 weeks? That would be because of the large amount of scheduled inductions and c/s around 39 weeks.

[Throkmorton]

Perhaps more OBs just need to be reminded of what my OB keeps saying to me "It's a due date, not an expiry date"

Sometimes an early induction is indicated, but not nearly as much as I see it being done in the US. Up here, I know of no one who was induced that early without good reason. The thing I am currently horrified about is the doctors scheduling elective repeat c-sections at 38 weeks, instead of making sure that the baby is really ready and waiting until closer to 40.

[KatSG]

I hear you. I worry about moms who get scheduled too early and end up with c-sections because of it. I have several friends who were induced, but they were all for medically-neccesary reasons and were able to deliver vaginally. Still, I'm always concerned about the choices that were made during the pregnancy that lead to that medically-neccesary induction.

I can't believe someone used CYTOTEC. Isn't that an off-label usage, and aren't the disasters widely known, now, at least by medical professionals? I wish MDs would just keep semen on hand from a sperm bank (no, I'm serious!) to use to ripen a cervix, if that's really neccesary.

As for the stats, remember that the mortality rate for OBs will likely always be higher because they have the high risk cases that MWs won't/can't attend. What's more useful is to compare intervention rates and their outcomes.

I know it's hard to understand why people make the choices they do. I've just accepted that there are some people out there who will always take a doctor's advice at face value. And I will always be the one who is viewed as a little kooky, though respected for what I do know, because I take responsibility for my and my family's healthcare.

[unalmas]

Originally Posted by busybusymomma

I was lucky.... I was that 20yo first-time mom who was induced with dd. The OB scheduled it and I honestly thought it was necessary... she called it PIH but now I know better. I'm fortunate that my body was ready for labor already and it went pretty well considering. It wasn't my dream birth but it could've been waaay worse.

That makes two of us. That's exactly what happened with my daughter. Thank you for speaking up! It makes me feel better to know it wasn't just me.

[Peppamint]

Originally Posted by Throkmorton

Perhaps more OBs just need to be reminded of what my OB keeps saying to me "It's a due date, not an expiry date"

Are you absolutely sure that babies don't "turn" like milk on their "expiration" date.

Originally Posted by unalmas

That makes two of us. That's exactly what happened with my daughter. Thank you for speaking up! It makes me feel better to know it wasn't just me.

I certainly regret it, but it's another part of my motherhood journey. It's a big part of why I've chosen the birth choices I have since then. I was angry for a long time, but my last birth was very healing and empowering.

[JayGee]

I am absolutely amazed by how many women have asked me "when" (not even "if") I'm being induced. I'm not even 39 weeks yet!!!! At DS's preschool, all the Moms are asking. Granted, the last few weeks of pregnancy are no picnic, but I'd much rather wait than increase my risk for another c-section.

I was induced with my DS (12 days past my due date, PIH, very unripe cervix) and it failed. After the horror show that was my induction and c-section, I vowed to just let nature take its course with my subsequent pregnancies.

DD was born after a natural, non-induced labor ~ wonderful VBAC.

Baby #3 is due a week from tomorrow and he or she will come when the time is right. Besides the fact that I'd NEVER induce a VBAC anyway.

[Peppamint]

It does seem like most people think "when", not "if". Dh and I were at the credit union the other day taking care of business and the woman there asked me on the way out if I had a date to go in to the hospital or if was going natural. It's sad that so many women do seem to be having scheduled inductions and c/s... and they're early too, at 38-39 weeks.

I totally wouldn't have minded a 38-weeker who came from spontaneous labor but my 38w1d induced baby was not ready. She did okay but she wasn't "done". (oops, sorry I think I said that in a previous post ).

[turtlemama77]

Not in your ddc, but I was induced for dd#1 (water broke...I didn't know better that I could wait a bit longer than the nurses said I could...I know better now!!)...it was within days of my due date, but never again. There will have to be a pretty dire emergency before I'll ever be induced. It was awful.

A mom at storytime just found out she's pregnant and is due the week of Thanksgiving. She's already planning a scheduled c-section the week before so birth doesn't interfere with the holiday. I didn't even know what to say to her. So sad.

[provocativa]

Really, you wouldn't want having a baby to interfere with an OB's tee time, would you?

[flowmom]

Brown-eyed girls - I am with you in being dismayed. I guess I'm cynical and feel that it has a lot to do with control. When care providers encourage women to induce, they get a lot of control over timing and the induction process also usually means that they get women on their own turf (hospital/birth centre/office) where they are in charge. There really aren't many situations where inductions are medically defensible.

[Sydnee]

I had my membranes stripped with DD# 2 & 3, and don't regret it one bit. It put me into labor immediately, so I know we were ready. Everyone is different, and I don't think we need to look down on those of us that made decisions some of you might not agree with.

[Mom2Adam]

I have also been amazed at all the inductions...especially before due date. Unless there is a medical reason, I am not really sure why?

My Mom asked me today how long the mw would let me go before induction (I am due 5/14)...I said, wellllllllll....it could be as long as 42 weeks before a baby comes, and as long as heart rate is good and amniotic fluid is good, why fool with it. She just said "Hmmm". Not really sure what she means by that!

I understand the need/want to see baby, hold baby, have baby...but I want it to be the right thing for baby too.

Everyone is different, and I don't think we need to look down on those of us that made decisions some of you might not agree with.

Syndee - I don't think anybody is making a judgement call on the decision to induce...I think it is comes from trying to understand the why's behind it. I am glad it worked out well for you, but it doesn't for so many others (resulting in too early baby, c/s etc) and I think that it is important to educate mothers about this.

[strawberryprincess]

The other evening i was with a bunch of neighbor ladies (i'm on a bunco league ) of course *everyone* asked me when the "big day" was, (i hate that so many poeple assume baby will come right on time...even women who've had late babies) and were surprised when i said that I'm due this week, but it could easily be another two weeks or more before he arrives. one said, "oh, my doctor let me choose the day" (very proudly) the mother of one of the ladies is a midwife, and she was telling me how one of her mother's patients is due in a couple weeks, but m/w is leaving for a conference around the same time. so she is doing everything to help induce labor...stripping membranes, etc. and, next week she plans on doing cytotec...she feels she can justify this. it made me sick to think that a midwife was being so nonchalant about inducing someone weeks before her due date, for no other reason than convenience. i couldn't say anything to this chick, i didn't want to say anything cruel or offensive about her mother....

there are some very good, justifiable reasons to be induced. just being tired of being pregnant is not a good reason IMO. i really want to hold my baby too, but for him to choose his own birthday is more important to me right now, and to have the birth go as nature has planned...not as an OB has planned.

[littlemama06]

I am from June's due date club but i have also been wondering this myself. Induction is why i left my OB and went with my midwife who i love I was just 20 weeks and she mentioned induction after 38 weeks if i wanted to ..
I can understand if a mom or baby are in danger but if i am going to trust my body to birth my child, i also need to trust my body/baby to know when the time is right.But i don't want to judge someone else and their choices,i just want to understand.

kaitlin

[KatSG]

Originally Posted by Sydnee

I had my membranes stripped with DD# 2 & 3, and don't regret it one bit. It put me into labor immediately, so I know we were ready. Everyone is different, and I don't think we need to look down on those of us that made decisions some of you might not agree with.

I hear you, Sydnee. I'm feeling a little worried about the moms who are getting induced on the DDC because I'm sure I haven't kept good track of their details. I hope no one is taking this as a personal judgement. Like I said, the two friends that I have that were induced really did need it and the outcomes were good and they got good care. I know that sometimes we have to look hard at a situation and be glad that we do all have options should we need them.

Stripping membranes is pretty benign, IMO, on the spectrum of induction techniques. That is a far cry, I'm sure you would agree, from putting a date on the schedule 5 months in advance!

[Sydnee]

Stripping membranes is pretty benign, IMO, on the spectrum of induction techniques. That is a far cry, I'm sure you would agree, from putting a date on the schedule 5 months in advance![/QUOTE]

I agree with you on that, at my 38 week visit, my nurse asked if my doc and I had discussed being induced.: Crazy how quick they are to get that going. With rachel, my water broke at noon on a Tuesday, and finally at 10:30 that night, contractions started. I did great at getting through them, but then at 5:00 the next morning, they started pitocin to speed things up, THAT was horrendous. All I can say, is God Bless the women who are induced and go without pain meds, because is was the worst feeling I've ever experienced.

[Throkmorton]

I was also going to say that I find stripping membranes to be fairly benign. It either works if you're ready, or doesn't if you aren't.
WHen I was talking about early inductions, I was referring to cervadil/pitocin/etc inductions

[zaksma]

As someone who was induced prior to my due date, I feel the need to speak up with my reasons why I was induced. First of all, my DH travels for work and we're not talking about an hour away or anything- we're talking about being on the other side of the country type of traveling. Second, I have fairly quick labors- my first was 6 hours long so chances are that any subsequent labors are going to be shorter. So in order for us to insure that my DH would be present for the labor, we chose to induce both my 2nd and 3rd pregnancies. With Alden, I was 3 cm dialated when we induced plus I had bronchitis for my entire 3rd trimester. And while you may not think that it is decent enough reason to look into induction, it's hard to take care of yourself and your other child when you are getting less than 3 hours of sleep a night plus working full time time all while coughing your head off. I literally coughed all the time and nothing helped. So when I asked my OB about induction, he was fast to go over all the possible complications, etc with me before even talking about the other details. I had a very easy labor- started around 8:00 or so and I had Alden 4 hours later with no unnecessary complications. With this pregnancy, it was the same scenario minus the bronchitis. DH still travelling and I was dialated more and more with every visit to the dr. So I was induced (by my request but I would have gone early anyway) at 38w6d with Eleanor. When I got to the hospital for my induction, I was already 5 cm and my labor (from breaking my water to actual delivery) was 2 hours long.

I know that many people here at MDC will look down on me and my decisions to induce but I am fine with those choices. I made them based on information from my OB and knew all the possible complications going into them both. Assuming that someone who chooses to induce is uninformed really gets to me- not everyone who makes that choice is going into it blindly.