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#1 of 52 Old 12-01-2007, 04:08 PM - Thread Starter
 
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Her doctor is going to induce her this week because she's sick of being pregnant. No medical reason-at all. So 4 weeks before her due date for convenience. How freaking unethical is that? I am just enraged right now.

Can anyone recommend a good link to the dangers that isn't too crunch-tastic to send her? She is 100% mainstream and she would be turned off by anything with midwives, I can guarantee you. Please?

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#2 of 52 Old 12-01-2007, 04:20 PM
 
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http://www.motherfriendly.org/Downlo...fact-sheet.pdf

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#3 of 52 Old 12-01-2007, 04:28 PM - Thread Starter
 
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Thank you!

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#4 of 52 Old 12-01-2007, 05:52 PM
 
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You're welcome

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#5 of 52 Old 12-01-2007, 07:07 PM
 
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4 weeks before her due date?! The baby won't even be "term" (37 wks among most obstetricians). I can't believe her doctor would even allow that with no medical reason.
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#6 of 52 Old 12-02-2007, 06:05 AM
 
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"Sick of being pregnant"? I bet her baby's going to be sick of the NICU before even half of those four weeks go by.
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#7 of 52 Old 12-02-2007, 09:44 AM
 
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Wow--this just makes me sooooooo sad....so puzzled and sad. :

Not only has medical science reduced women to mere machines-- baby -producing machines which can be freely manipulated according to the will of the 'operator'--now even women have reduced their sense of themselves to being merely machines. Now, even the women have been persuaded to know themselves as machines replaceable by other machines, and their babies as objects whose health/wellbeing is as safely in the hands of the doctors and the NICUs of the world, as in the bodies of their mothers. We have had so very much stolen from us. And now women give our gifts of Life away with both hands, not seeing what those gifts are, having no idea of their value to ourselves, our babies or our society-- or how pathetic an imitation of Life is a doctor or an NICU.

Does she realize that if her original edd was Jan 6, then they are actually running the risk of producing a premie of 35wks gestational age--or less? Does she realize that u/s edd estimates can NEVER be considered 100% accurate, even in the first 6-9wks? Does she know that weight estimations can also be off by quite a bit?
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#8 of 52 Old 12-02-2007, 09:50 AM
 
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Are you sure you are aware of all the facts? Inducing this early, for no medical reason, just seems so unbelievable to me. Maybe there is some medical reason that SIL is not comfortable discussing?
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#9 of 52 Old 12-02-2007, 11:29 AM
 
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I'm with the PP's...I just can't wrap my head around that. :

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#10 of 52 Old 12-03-2007, 12:35 AM
 
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Just no words to express how sad this is.

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#11 of 52 Old 12-04-2007, 01:07 AM
 
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I just want to thank the person who posted that link. It is a great one. I am currently at 41 weeks and sometimes get tempted to induce. But my gut is telling me that my baby just needs a little more time to prepare to enter this world. My pregnancy has been a healthy one. It is truly insane how prevelent induction is these days. Luckily I have a really nice midwife who took the time to explain to me the additional risks, and that in an otherwise healthy pregnancy "elective induction" is not really worth it.

I for one, am just 'over' the whole emphasis on due dates. So many people act just shocked that my baby is 6 days 'late'. Library books are late, not people! I myself was induced. Maybe I just needed a little more time! ; )

Thanks again.
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#12 of 52 Old 12-04-2007, 01:00 PM
 
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What was the reason for changing her original due date from January 6th to December 28th?

*If* it was an early transvaginal u/s (around 8-10 weeks is ideal) performed by a competent professional with a good u/s machine, I'd trust the new date.

Assuming the new date is accurate, I would consider induction under non-emergency conditions at 37 weeks with a favorable Bishop score. That would mean she'd need to wait until at least December 7th to be 37 weeks, more like December 16th if you go by the January 6th due date.

Before 37 weeks is just asking for trouble, and even then is not ideal at all. She needs to understand what she is asking for here.

Also, if her cervix isn't ready for induction, she might as well save herself the trouble of trying to induce and head straight to the OR for an elective section. An unfavorable cervix at that early of a gestation...sounds like a recipe for ending up with a section anyway.

I admit that I have very little empathy for women who complain of being SO uncomfortable while carrying their 6 pound singleton. I carried just under 14 pounds with my twin pg and didn't TRULY get miserable til the last 10 days.

Even with the last 10 days of misery, I'd take that again a million times over. We brought them both home with us 24 hours later.
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#13 of 52 Old 12-04-2007, 01:09 PM - Thread Starter
 
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Thanks everyone. I know I'm sick of being pg (~38 weeks), but I wouldn't think of inducing-especially that early!

She emailed me back after I sent on the info.

There is NO medical reason. She did this, apparently, with her second dd, too. She went into preterm labor, decided she just wanted it over with, so they gave her pitocin and she was born ~36 weeks. They HAD stopped her labor. But she was sick of being pg. :

So she is still going through with it. The dating is from the normal 20 week u/s. The first which would have been a transvag u/s put her date (and LMP) at Jan 6th.

I just don't know what to say. She knows the risks now if she bothered to read the email...

I have talked to several people about this looking for info, and apparently this is a new trend so that you won't have a "big baby" or get "stretched out".

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#14 of 52 Old 12-04-2007, 01:28 PM
 
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Wow.
My first was 36 weeks and I was terrified because she was too early.
She did come home with me on time but ended up being only 5 pounds 4 ounces, and after losing weight went down to 4 pounds 11 ounces at her smallest. It is scary to have a baby that small at home and to try and strap into a carseat correctly. She also was so sleepy that she had to be awakened every 2 hours, around the clock, for about 6 weeks to eat. Nursing was tough with her little mouth and sleepiness, and it took a while to establish our nursing relationship, and we had to use a nipple shield at first.

I can't for the life of me imagine wanting to be induced at that gestation. If I ever happen to be pregnant again, I'm hoping with all my might to go to at least 39 or 40 weeks.

I guess there isn't anything you can say to change her mind at this point. I think would upset me a lot too.
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#15 of 52 Old 12-04-2007, 02:39 PM
 
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No way would I trust a regular 20 wk u/s to give a "new date" - can't they be 1-2 weeks off in either direction? I know my date of conception for this pregnancy to within a day or two, and the 20 wk u/s placed my due date about a week earlier than it should be.

I think early u/s can also be wrong, for example if the mother has unusually slow-rising hCG, but overall early u/s is a much better indicator of dates.

I guess there's no point in giving her information since it went fine the other time she did it and she's made up her mind. Would you let us know how it turns out, though? Hopefully the baby will be ready to come home.
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#16 of 52 Old 12-04-2007, 03:13 PM
 
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*weeps*

The more I read about the current state of maternal care and the insane push for induction, the more I BELIEVE that OB's get a cut/end of year bonus for how many babes they send to the NICU - I suppose if hospitals are making 50% of their money from the maternity ward (and I can only assume that the NICU provides a healthy chunk of that money) would anyone be suprised if OB's were gently 'nudged' financially to produce more early babies?

*cries* Poor babe.

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#17 of 52 Old 12-04-2007, 03:31 PM
 
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*weeps*

The more I read about the current state of maternal care and the insane push for induction, the more I BELIEVE that OB's get a cut/end of year bonus for how many babes they send to the NICU - I suppose if hospitals are making 50% of their money from the maternity ward (and I can only assume that the NICU provides a healthy chunk of that money) would anyone be suprised if OB's were gently 'nudged' financially to produce more early babies?

*cries* Poor babe.
I have a hard time believing this is true in most cases. Even if for no other reason than how lawsuit happy our country is in. Imagine if a doctor routinely induced patients really early and sent lots of babies to the NICU. Sooner or later there would be a baby with RDS and the parents would sue.

Plus NICU care is so outrageously expensive, I think the insurance companies would be having fits.

And on a personal level, while there are plenty of doctors out there who do lots of questionable things, I really think that most still abide by, "first do no harm." I can't imagine a doc deliberately sending babies to the NICU. Well, I can, but most of the time, not.
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#18 of 52 Old 12-04-2007, 03:38 PM - Thread Starter
 
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I have a hard time believing this is true in most cases. Even if for no other reason than how lawsuit happy our country is in. Imagine if a doctor routinely induced patients really early and sent lots of babies to the NICU. Sooner or later there would be a baby with RDS and the parents would sue.

Plus NICU care is so outrageously expensive, I think the insurance companies would be having fits.

And on a personal level, while there are plenty of doctors out there who do lots of questionable things, I really think that most still abide by, "first do no harm." I can't imagine a doc deliberately sending babies to the NICU. Well, I can, but most of the time, not.
I disagree. I don't think half of them even remember the "first do no harm" part. Many are greedy, impatient, and negligent at best. Look at our c-section rates, induction rates, infant mortality. They do what they want for their convenience. I would be honestly surprised if half of OBs remembered that they are supposed to work for us and do what's in our best interest.

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#19 of 52 Old 12-04-2007, 03:51 PM
 
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As far as sending babies to the NICU, I don't think that in and of it self is something that can be sued for, and really, your doctor sending your baby to the NICU is less likely to be sued, because they are doing the "best" they can in the eyes of the medical field.

While I don't think doctors deliberately do stupid things that do cause harm, I do believe that a majority of doctors believe themselves above everyone else, in the same way a noble man would feel above the peasants, and therefore believes their opinions and desires are superior to everyone else's, including the patient. So the "causing" of harm is really not what they think they are doing, but just a side effect of their practice.

Though I know not every doctor is that way.

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I have a hard time believing this is true in most cases. Even if for no other reason than how lawsuit happy our country is in. Imagine if a doctor routinely induced patients really early and sent lots of babies to the NICU. Sooner or later there would be a baby with RDS and the parents would sue.

Plus NICU care is so outrageously expensive, I think the insurance companies would be having fits.

And on a personal level, while there are plenty of doctors out there who do lots of questionable things, I really think that most still abide by, "first do no harm." I can't imagine a doc deliberately sending babies to the NICU. Well, I can, but most of the time, not.
But see, that's the thing - the parents are, in most cases, CONVINCED that the doc's know best, and the docs SAVED their poor baby by getting that kid out early. If the parents didn't BELIEVE that their babes would be perfectly healthy/perfectly safe four bloody weeks early, there simply wouldn't BE as many inductions.

Doc's are more likely to be sued for NOT inducing that they are to be sued FOR inducing. It would be a long leap for a parent who was willing to be induced early to turn around a sue the doc for inducing early. *sigh*

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#21 of 52 Old 12-04-2007, 03:53 PM
 
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I guess my experience just differs from this. I had an OB that was doing his best to keep me from delivering early and to keep my baby out of the NICU.

My father is a doctor and my mother a CNM. I know that there are jerky doctors out there, but I also think many are afraid of being sued and are acting accordingly. They say, "The only C-section you get sued for is the one you didn't do." Malpractice insurance has gotten so high for OB that many of them leave the field.

I do think, overall, there is a disturbing trend in obstetric care going on, that is pretty obvious. But I think it has different motivations most of the time.

And there is a difference between something like doing a repeat c-section on a patient rather than a VBAC and inducing someone on purpose with the intention of sending a baby to the NICU.
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#22 of 52 Old 12-04-2007, 03:57 PM - Thread Starter
 
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I see what you are saying. And there *are* good doctors out there. But I worked in the hospital too long to think they are all out to do the best for the patient. And my obstetric history is just a record of it, personally.

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#23 of 52 Old 12-04-2007, 04:19 PM
 
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And I want to be clear that I don't think they are malicious - just like I don't think it's malicious when they push certain drugs to patients to fulfill their pharma quota/because the rep brings good lunch food/etc, etc.

Misguided? Yes. Not for the patients best interest? Yes. Financially Based/Biased? Yes. Evil? No.

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#24 of 52 Old 12-04-2007, 04:31 PM
 
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I also think you get better care when they know you have medical people in your family. With my daughter I got nothing until my RN Mom walked in the door, suddenly they were catering to my every whim. And if I had a doctor rather than a nurse in my family, I am sure it would have even been more in my favor.

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#25 of 52 Old 12-04-2007, 04:43 PM
 
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The early induction makes me sad. It really amazes me how different women can feel about these things.

With my DD, I went to 42 weeks without going into labor. My Bishop score was very unfavorable and I really wished I had more time. Sadly, it ended with a c-section. Yes, I was eager to meet my little girl but wasn't about to compromise her health to do so. I figure, you've got the rest of your life with your child. . whats a few more weeks of waiting? Incidentally, she was born at 42 weeks weighing a measly 6lbs9oz. I cannot fathom the consequences of taking her any earlier.

With this babe, I'm expecting to hit 42 weeks again. My 20wk ultrasound gave a "revised" due date of 4 days earlier. No way no how did I want an earlier due date! My MW agreed and kept the original. I want all the time I can get with this time and just don't understand woman who'd rather go so early just for selfish reasons.

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#26 of 52 Old 12-04-2007, 05:00 PM
 
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I have a hard time believing this is true in most cases. Even if for no other reason than how lawsuit happy our country is in. Imagine if a doctor routinely induced patients really early and sent lots of babies to the NICU. Sooner or later there would be a baby with RDS and the parents would sue.

Plus NICU care is so outrageously expensive, I think the insurance companies would be having fits.

And on a personal level, while there are plenty of doctors out there who do lots of questionable things, I really think that most still abide by, "first do no harm." I can't imagine a doc deliberately sending babies to the NICU. Well, I can, but most of the time, not.
ITA. I worked on the plaintiff's end of med mal cases and had plenty of birth related cases. A doctor's say so isn't enough to stop a lawsuit. The evidence is made up of all of the records, depositions from witnesses, etc. I think that there are flaws in our systems - but I think the characterization of doctors as total idiots seeking to perform major surgery and throw their malpractice rates and insurance into the wind in order to make it home for dinner is over-blown. I know a lot of local OBs personally and they are actually well-educated, caring people who try to do the best for their patients (mom and baby.) Sure, there are some craptastic ones out there (as there are in every profession), but the amount of hype about scalpel-happy doctors is :

I honestly have a hard time believing an OB would induce pre-term for absolutely no medical reason. If you want to say they're driven by keeping costs down, there's no reason a doctor would pretty much guarantee NICU time. And generally, people don't spend almost a decade in med school to damage moms and babies for the fun of it.

Are our C-section rates unnecessarily high? Yes, but I'd argue that's more driven by "consumer" demand than doctors.

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#27 of 52 Old 12-04-2007, 05:27 PM
 
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I guess my concern is more the "macro" consequences of all the individual decisions to bring babies into the world before the natural onset of labor. If this happens, say, 25% of the time, and just 10% of those cases result in iatrogenic prematurity, then that is that many more children (on top of the normal cases of prematurity) that will suffer from respiratory difficulties, cognitive, other developmental problems. Just makes no sense, economically for this country, or for the well-being of society. It produces both less productive citizens while simultaneously producing some one who will be more demanding of probably expensive medical services. And this is EXTRA, on top of the babies who naturally suffered complications without the interference of a doctor. Even if a parent does not care if his/her child is at higher risk, that should not trump the general principle that it is obstetrics that is charged with bringing the healthiest possible (not JUST living/surviving) babies into this society.
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#28 of 52 Old 12-04-2007, 08:10 PM
 
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I agree that those consequences are definitely to be considered. While I in no way agree with inductions at 36 weeks without medical reason, it is important to remember that the vast majority of babies born at this gestation age do not suffer from respiratory distress or cognitive/devlopmental delays. Of course some babies will have difficulty breathing at this point, and certainly if the dates are off and the baby is even younger it can be a huge problem.

I found that the greater gestational age, the rates of respiratory distress, NEC, and intraventricular hemorrhage dropped dramatically. So while I think there are consequences to delivering this early, it would be unusual for the consequences to be severe. There are babies born with difficulties at every gestational age of course, so I don't mean to discount or belittle anyone's personal experiences.
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#29 of 52 Old 12-05-2007, 03:43 AM - Thread Starter
 
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I honestly have a hard time believing an OB would induce pre-term for absolutely no medical reason. If you want to say they're driven by keeping costs down, there's no reason a doctor would pretty much guarantee NICU time. And generally, people don't spend almost a decade in med school to damage moms and babies for the fun of it.

Are our C-section rates unnecessarily high? Yes, but I'd argue that's more driven by "consumer" demand than doctors.
Why? They are doing it. I can't even count how many women I know have been talked to by 36 weeks about setting an induction appointment before their due date. Heck, I was induced early with my last two children b/c my first was 8lbs and they thought I might have more "big babies". That doesn't sound like a valid reason to me!

I don't think they do it for the fun of it. I think they do it b/c it's convenient for them and they see birth as something medical that needs intervention 100% of the time. The consumers are definitely not helping the situation, but they wouldn't have to begin with if the doctors weren't so scalpel happy. And yes, I do mean that.

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#30 of 52 Old 12-05-2007, 04:15 AM
 
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True, I don't think OBs induce for absolutely "no" medical reason. I think they can find many "medical" reasons for every single person they treat. And I don't think they do it solely for convenience although I do think they prefer it that way (I mean, really, OBs are SURGEONS, not FP doctors) but I do believe that they believe they know what is best no matter what the patient wants (in many cases, and with every doctor I have had the misfortune of dealing with) and the results are the same.

They need to care for the baby and they can not do that while it is inside the mother, so the sooner they can get it out the sooner they can be assured it is healthy, thus inductions as soon as it is determined that it can be beneficial or "safe". OK, a very generalization of OB, but for the most part, that is exactly the thinking of every OB I have ever been to, and there have been many.

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