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Discussion Starter · #1 ·
If a pregnant woman chooses to be induced (not medically necessary), is that more likely to point toward a c-section or other interventions?<br><br>
I don't usually post or even lurk in this forum. My dd is 11 yrs old, and MDC didn't exist when she was born. So my apologies if this thread is not placed correctly or if this issue is covered elsewhere.<br><br>
My boss, S, was only 4 days past her due date, but chose to be induced just to get it over with (big event coming up at work, and she wanted to be close to two weeks postpartum). The doctor did not say that she had to be induced, she just wanted it.<br><br>
Is being induced linked, statistically speaking, to an increased chance for other, more invasive procedures? Or even to a less-good outcome for mother or baby?<br><br>
I was explaining to my dd that S chose to go to the hospital and be induced, and that she was not in labor when she went. DD thought it was kinda neat, but I don't. But I'm not sure why, I just have this feeling left over from my own pregnancy and birth that it's a bad thing. So, I'm looking for facts (that I must have forgotten) that back up my feeling.<br><br>
Thanks!
 

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There are risks for just about any intervention. Check this out. <a href="http://www.motherfriendly.org/Downloads/induct-fact-sheet.pdf" target="_blank">http://www.motherfriendly.org/Downlo...fact-sheet.pdf</a>
 

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That's what I was going to post. I think for a first time mom, induction doubles the risk of cesarean.
 

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Yep, it sure does. And when you are induced you are typically hooked up to every machine they can find that goes !ping!<br><br>
I had an elective induction with ds (before I was informed about birth!). Let's see, I had an IV drip, pitocin drip, blood pressure cuff, contraction monitor, and continuous fetal monitor all hooked up before contractions even started. It took an army of nurses to disconnect me so I could go to the bathroom even. Everytime I tried to move while in bed they would lose ds's heart rate or one of the other monitor's would move and they would come rushing in and put it back and then tell me to stop moving. Then later I had an epidural (that didn't work at all) so that was another tube coming out of me. I basically laid in bed in one position for about 15 hours, only 4 of which I was actually in labor. There's no way any of that was good for me or good for ds and I just count my blessings every day that he somehow managed to deal with all that pitocin and stuff ok and I was still able to deliver vaginally.
 

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<a href="http://www.mothering.com/discussions/images/smilies/greensad.gif" target="_blank">http://www.mothering.com/discussions...s/greensad.gif</a><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"><br><br>
Some women are selfish, don't want to be pregnant. Some doctors are selfish, don't want to deliver babies in the middle of the night. Selfishness=high rates of inductions when women's bodies aren't ready=C-sections
 

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Documentation of a medical reason doesn't really amount to much. It's easy to come up with something. Quick ultrasound, have the tech write "low fluid" and off you go. Or any number of other "problems." Oops, your BP was high-must be pre-eclampsia. Let's induce.
 

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<div>Originally Posted by <strong>SublimeBirthGirl</strong> <a href="/community/forum/post/8183422"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Documentation of a medical reason doesn't really amount to much. It's easy to come up with something. Quick ultrasound, have the tech write "low fluid" and off you go. Or any number of other "problems." Oops, your BP was high-must be pre-eclampsia. Let's induce.</div>
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Not quite that simple. According to best practice, you need to have several indicators to diagnose pre-eclampsia. BP that's a little elevated is not enough--you have to document continuous high blood pressure plus elevated proteins. And low fluid? You have to have other indicators the baby's in severe distress to go along with that.<br><br>
Just to clarify--I am NOT promoting inductions. I think elective inductions are asking for trouble, and even with the complications I had, I would not have considered induction before 41 weeks. I was just saying that there are some methods with higher C-section rates than others.
 

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In my local area it's belived that about 70% of our 36% c-section rate is results of failed inductions (including mine). What percentage of those are "medically necessary", we don't know. But, mine was deemed medically necessary by my OB for post-dates and unsettled lie (at 40w1d), which is about as far from medically necessary as you can get without it being totally elective IMO. We know that at least 3 local OBs have an un-announced office "policy" of induction at 40w. So... yes, I do think that elective inductions are a huge factor in the cesarean rate.
 

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Wow, that is so sad. Hugs mama--you must've been upset at your OB. Hearing stuff like this is what makes me happy to live in the "sticks," where we don't have OBs who deliver at our hospital and some of the family docs even do home deliveries for the Amish or close friends. I guess you could just call me sheltered! At one point, I think the section rate here was something like 9 percent. Anyhow, from what I have seen I think the care providers' philosphy makes a huge dif in the section rate, but maybe that's not the case? Just thinkin out loud here.
 

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Discussion Starter · #10 ·
Thanks, everyone. I just wanted to back up my feeling with hard data, when talking with my dd about choosing to induce.<br><br>
By the way, S had her baby. She was almost a c-section. I don't know any more than that.<br><br>
Thanks again!
 

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Recent research showed that women who were induced were twice as likely to have an Amniotic Fluid Embolism. This is a rare condition, but it is almost always deadly to the mom (or leaves her with severe brain damage), there are a few that survive. Inducing a VBAC mom is very dangerous as this increases the chance of Uterine Rupture. One of the prostoglandins used in inductions (Cytotec) is not FDA approved for that purpose, and I believe they have even put a warning out that it is not to be used on pregnant women.<br>
I believe there is a greater risk of c-section with induction, but I don't have any stats, I have also heard postulations that the research doesn't show one because our c-section rate for even normal, uninduced labors is really high anyway.<br>
Knowing what I know now, I would never be induced without a true medical reason (i.e. severe pre-eclampsia that cannot be controlled), but I will also be a VBAC mom next time, so it is probably out of the question for me anyway.<br>
It is frustrating that these moms are asking to be induced for no medical reason, but I don't blame them, I blame the medical professionals that don't inform them of all the risks.
 

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Amen, if I were VBACing and a doctor wanted to induce, I would run the other way as fast as I could. Cuz if a doc hasn't done their research on that, who knows what other important stuff they could be in the dark about.
 

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Medical necessity is very easy to come by. At the end of the day, the doctors just want to make sure the insurance companies will pay for the induction. Every OB that induces knows exactly what to document to make sure that induction is paid for-it's very easy to come up with a reason (hence the proper code on an insurance form) to induce.<br><br>
Prostaglandin inductions scare the crap out of me-while I wasn't induced with my first child, I remember clearly in my mainstream childbirth class (before I saw the light and educated MYSELF about birth) the nurse educator talking about inductions and how wonderful they were. You knew exactly when your baby was coming, you could check in the night before, get your Cytotec, go to sleep, wake up the next morning, get an epidural and have a baby. Simple as that. When I was in labor and checking into the hospital, I saw all the charts lined up and nearly all of them were labeled "cytotec" on the outside indicating they were inductions. It was overwhelming.<br><br>
Needless to say I'm NOT having my baby at that hospital this time <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> In fact, I want to have this baby at home but DH isn't quite ready to take that step yet...hopefully for #3! Instead I'm delivering at a small community hospital with a midwife. It's not ideal....though I haven't ruled out the possibility of an "accidental" home birth <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br>
As for research-there is a TON of research that shows inductions put you at higher risk for c-sections. Regardless of the method of induction (prostaglandin versus pitocin), they always break your water which automatically puts you "on the clock" often resulting in failure to progress and surgery.<br><br>
It's so sad <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> But I agree with the PP-women today wouldn't be so keen on inductions if the practitioners, childbirth educators, and everyone else with a stake in the mainstream birth business didn't push them so strongly without a full discussion of the associated risks.
 

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<div>Originally Posted by <strong>turtlewomyn</strong> <a href="/community/forum/post/8188088"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Recent research showed that women who were induced were twice as likely to have an Amniotic Fluid Embolism. This is a rare condition, but it is almost always deadly to the mom (or leaves her with severe brain damage), there are a few that survive. Inducing a VBAC mom is very dangerous as this increases the chance of Uterine Rupture. One of the prostoglandins used in inductions (Cytotec) is not FDA approved for that purpose, and I believe they have even put a warning out that it is not to be used on pregnant women.<br>
I believe there is a greater risk of c-section with induction, but I don't have any stats, I have also heard postulations that the research doesn't show one because our c-section rate for even normal, uninduced labors is really high anyway.<br>
Knowing what I know now, I would never be induced without a true medical reason (i.e. severe pre-eclampsia that cannot be controlled), but I will also be a VBAC mom next time, so it is probably out of the question for me anyway.<br>
It is frustrating that these moms are asking to be induced for no medical reason, but I don't blame them, I blame the medical professionals that don't inform them of all the risks.</div>
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AIUI, inducing with prostaglandins is a major no-no for VBAC, but the jury's still out on pitocin. (I'll be trying for VBAC next time). Whether or not most OBs would actually do it is another matter.<br><br>
Teasing out stats on C-sections and inductions is difficult because of the problem that at least some induced births would have gone on to be CS anyway. You're definitely at greater risk for CS just from the induction, don't get me wrong, but how much greater is difficult to say. I think you'd have to look at women who weren't induced for medical reasons.<br><br>
You're definitely much, much more likely to end up with an epidural with an induction, because the contractions that pitocin produces are so much stronger.
 

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My first was an "elective induction"--when my OB offered to schedule me at 39w3d after 3 weeks of hearing "you're 4cm and 80%, you should go into labor at any time now," I agreed after asking him a bunch of questions. He assured me that a Pitocin-induced labor would be no more painful than a natural one, and that there were no specific risks to the baby from induction.<br><br>
I was incredibly lucky to have my mom there as my support person (she had 3 babies at home and knew that I was dedicated to having as natural a birth as possible), otherwise, I would never have made it through an 8-hour Pitocin-induced labor without an epidural. Because of the Pitocin, I had to have continuous fetal monitoring, and when the external monitors wouldn't reliably pick up baby's heartbeat because of my position, they had to place an internal monitor--which means they also had to break the bag of waters.<br><br>
Later, after doing some research, I found out that because Pitocin is an artificial hormone, it doesn't cause your body to release endorphins (nature's pain relievers!) the way that oxytocin does. So my OB lied to me when he told me that a Pitocin-induced labor wouldn't be more painful. I also know now that he didn't really have any reason to believe that just because I was 4cm and 80% that I would go into labor soon, and that constant expectation was so tiring that it was a big part of the reason I went with the induction.<br><br>
I guess my point is that since most OBs don't view labor as a normal, natural thing, to *them* an induction is the same as a natural labor. But from mom and baby's point of view, it's not even close!
 

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<div>Originally Posted by <strong>October16Mom</strong> <a href="/community/forum/post/8183935"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Not quite that simple. According to best practice, you need to have several indicators to diagnose pre-eclampsia. BP that's a little elevated is not enough--you have to document continuous high blood pressure plus elevated proteins. And low fluid? You have to have other indicators the baby's in severe distress to go along with that.<br><br>
Just to clarify--I am NOT promoting inductions. I think elective inductions are asking for trouble, and even with the complications I had, I would not have considered induction before 41 weeks. I was just saying that there are some methods with higher C-section rates than others.</div>
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Just because "best practice" says that there needs to be continuous high BP and proof of elevated proteins doesnt mean thats the system all doctors are using. I had no protein increase from either of my last pregnancies, and in the first I was sectioned (scheduled) for pre-e and in the second they were on their way to a repeat cesarean for the same reason when I stopped going.
 
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