Sunday, May 31, 2009

The Induction of Labor

I copied this from Luna Maya's blog, the birth center in Chiapas where my midwife is currently working.


Cristina's Handy Guide To Surviving the Induction of Labor

I'm due for March 13th.... it's now March 15.... Do you think the baby is ok?... You are now 41 weeks... I will send you for a non-stress test.... Your placenta seems to be aging... your fluid levels are decreasing.... The head is still high.... Any contractions?.... You are now at 41.3 weeks.... If you pass 40 weeks we will have schedule an induction... We must induce.... We will induce... You will be induced on Friday.... We will induce on Monday.... You should have the baby within 12 hours.... Induction....


Seems like we have gone from "pregnancy can last anywhere between 38 and 42 weeks to"... "you are an oven and if your bun is in there for more than 40 weeks it will be horribly burnt and thus useless"...

Outside of out of hospital midwifery, the induction epidemic is rampant. I will not go into the dangers of induction in this entry. You can learn all about those in books, movies and webpages and by asking midwives. Instead I have created a list of questions to ask your doctor or midwife when they schedule or suggest an induction. I'd love to hear your comments:

10 Questions to Ask your Inducing Provider:

1. How many more years might I be pregnant?

2. If I am pregnant for another year will my child learn to walk and garble in the womb?

3. If my pregnancy lasts 3 years will my child learn to identify colors in the womb?

4. After you put the artificial oxitocin in my vein how do you expect to compensate for the other hormones that won't be naturally produced by my body that are necesary for labor, such as endophines, prolactin, catacolmines, prostaglandins.... and won't be produced by my body because of the artificial oxitocin.

5. How do you feel about the fact that I will be expereincing contractions that are about 3 times stronger than natural contractions? Does that matter to you at all? Will you be there to hold my hand and help me breathe?

6. How do you feel about my chances of me ending up in an emergency cesarean? Does that make you nervous at all? Are you pretty good at doing emergency cesareans?

7. After my baby is in intensive care for meconium aspiration, will you have any trouble sleeping at all? Do you think you might have nightmares?

8. After my baby comes home from the NICU and feels like a complete stranger to me, can you recommend where I can find my "maternal instincts" and "innate ability to breastfeed"?

9. What are your thoughts on the fact that, if my baby hasn't initiated labor maybe its not ready to be born, may be too small, not ready to breathe, not ready to handle extrauterine life, and may need another week to mature?

10. So, can you, once again, really clearly explain to me why it is dangerous for my baby to stay within MY womb, where it has lived its ENTIRE life for another week?


  1. Thanks for posting this. Unfortunately, I was induced in January. She is my first baby and I fell hook, line and sinker for all the dangers of letting her stay in there until she was ready to come out. I think it made the entire process much harder and I had lots of trouble breastfeeding too, which I realize now was probably due to the induction. :(

  2. Of course inducing before 42 weeks is not the best idea. But there are times when it is neccesary to protect the child, and hence, the mother. Not ALL inductions are bad, nor are ALL C-sections bad.


  3. Yep good post. I just had a friend who birthed at home at 43 weeks...yep, three weeks overdue, and had a healthy 8lb baby.

    When I had my second son last year (home birth) I was nervous because we thought I was going to go overdue. My husband had paid someone to fly out to help me for a month and so we had to "guess" at the best dates, and it looked like she was going to leave before baby was even born. In the end, he was born one day before his "due date" and was 8lbs and 2oz, but although he was a good size, the midwife said with all the diagnostics etc he was showing up as only 37 weeks old! So, had I gone three weeks over, he would have been "normal" although he was very healthy and there was nothing wrong with him lol.

    Baby knows when it is time to be born.

  4. Love it! I so agree with you. I am going to keep this list handy in case I need it next time ;-)

  5. Good post. I know you are not in favor of epidurals and I was wondering if you or your midwife knew of any studies that say that for some women epidurals make it harder to deliver the baby as was the case with me. While it is effective pain relief I thought it hinderd my ability to push . I thought it was in my head till I mentioned it to a family member of mine who is also a nurse and she agreed that epidurals are not that great and even said that she had a harder time giving birth to her first child with whom she had an epidural than she did her second in which she did not have one. My second child is due in January and I don't want a repeat performance of my son's birth in which the doctor had to vaccum him out because I was so exhausted by that point.

  6. Jen,

    that is so sad, but at least you know more about inductions for the future. Our first baby was induced, which ultimately led to us having all home births since him, something for which I am very glad.


    of course, I agree that C-sections and inductions are sometimes necessary, but in most cases that they are used they really are not.

    Mrs. W,

    it is almost unheard of these days for a woman to get to 43 weeks. My MIL had her first child 3 weeks late, and that was after she took castor oil. Today, no OB would allow that to happen.

    So glad you had a wonderful home birth. Some babies just like to "cook" a little longer than others, or the dates could be off.


    next time, see a midwife, and chances are you won't need this list! :)


    epidurals do make labor, especially pushing, much longer and harder, and you can find lots of information on that online. If I have some time (haha) I'll send you some links.

    I am very much in favor of home births, but if you really want to go to the hospital, your best option would be to find an OB that is very naturalistically minded, and to hire a doula. I do not so much like hospital midwives (CNMs), because to me, they can be just as intervention-happy as an OB, and usually have little clout at the hospital if you/they want to refuse something but the doctor on call thinks its necessary. So I think you would be better off with a good doc, which is very hard to find.

    But my advice would definitely be to have a doula there, too. I'll have to blog on that sometime soon.

  7. We caught a lock of flack for the fact that our daughter, my first, was induced.

    Had she not been induced, it is likely she would have died in utero.

    Noone can tell me what caused it, but she was bleeding into me via the placenta. She was acutely anemic. Her blood looked like water color. She had to go into NICU for a week. Her apgar scores were like 2. She was very illl, and noone had any idea. She was induced merely because it was past my due date. She weighed 9 lbs 5 ozs.

    Perhaps some doctors are too quick to induce. But, my daughter is now a healthy 10 year old and I am glad she was induced.

  8. I do think some OBs are rather induction-happy, but they are occasionally needed. I had my baby in a hospital birthing center with a CNM (no offense to those who like direct-entry midwives and/or's just not for me!) and it was great.

    Nurse Bee

  9. Hi Zsuzsanna.
    Yes, in CA I have seen an epidemic of inductions among my friends too. Some cases were blatantly unnecessary. Perhaps the doctor had a weekend out of town all planned out, and he did not want someone else to get his patient. If my doctor started mentioning induction even before the due date I would run from her as fast as I can. It takes a lot of will to resist pressure from doctors, women tend to get themselves induced or cut in C-sections just out of love for their baby because they are scared into thinking that the baby may be in danger.Nice post.

  10. I was induced with all three of my children. I had no problems with the induction. I have been told that the contractions are stronger than just going into labor on your own. I don't have any other experience to compare it to. My labors were pretty intense. I did not have an epidural. If I added all of the time up to be in hard labor with all three it would come to about 7.5 hours total. I went very quickly. I guess it does not take long with pitocin. All of my children were healthy and I had no problem with breastfeeding. I know my experience is rare. As soon as I had the pitocin the contractions started, strong ones were it is hard to breathe. If I could do it again I would not have been induced.

  11. I was scheduled for an induction, once, when my son was only 2 days overdo. The Lord answered my prayer and put me into labor a few hours before the scheduled induction. Now I know the many dangers of induction and I am so thankful to have a wise midwife.

  12. This is one of the topics that can rub me the wrong way.

    I have 2 people close to me that proudly get induced 1 week before their due dates for convienence.

    I try not to let it bother me, but it does. Their babies are too small, and one of there babies ear wasn't all the way developed yet.

    I have been induced twice myself. 1 X because I was a week late. It was my 3rd child and my previous 2 were here within 2 days of my due date. So obviously something was wrong! right?... nope wrong! Poor guy he was small for one of mine. At a week late he was not ready. The other induction was actually not such a bad situation given the circumstances. I was just over 39 weeks and found out I had a breech baby. Thankfully the Dr I was seeing was ok trying a version. The version was successful and then I was induced to keep him from turning back. This was good because with this particular preg I was seeing a Dr at a hospital, and I doubt he would have done the version twice, thus I would have been risking an auto c-sec... Guess I was risking that anyway with an induction!

    When I had my 5th, my midwife came over and checked me (at my request, this was a planned homebirth) because at this point I was nearly week overdue and was getting axious. She said I was already 5 + centimeters. I went to a family farewell party, and all I heard about is if I was seeing a 'real' Dr. I wouldn't be where I was at because the baby would all ready be here (by induction) funny how everyone finds it exceptable. Anyhow, our 1st princess entered the world after a fast 1 hour 45 min labor.

    I do think medical procedures save lives, but I also think Dr are to jumpy about it and tell their clients they need to do so and so or the baby will be at risk, when in fact they are just not educated enough about a natural birth to wait it out.

    Well time for me to get off the computer for now.


  13. Hi Zsuzsanna,

    I would like to add this. One of the other posts here reminded me that I once asked an ultrasound technician what she thought was the accuracy of the due date measured by ultrasound. She said that it's two weeks. She also said that the very first ultrasound at 8 weeks is the most accurate, the further along you go, the less accurate the determination of the date, so due dates are all based on that one ultrasound at 8-10 weeks.
    So if there are no problems with a baby's health, wouldn't it make more sense to wait a couple of weeks after the due date?

  14. Thanks for the information! I know that some women go past their due date because of stressful situations (my midwife told me this could happen... because I told her about a friend of mine that it happened to). I definitely believe it's best to let the baby come out on his own time unless there's something wrong and he needs to come out immediately.

    Of course, I'm only 12 weeks pregnant with my first child, so I'm not experienced with any of this yet. I'm just basing my opinion on what I've learned from others who have more experience than I do. :) (and common sense, of course!)

  15. I just wanted to add, it's important to know your providers policy on this stuff. When I was pregnant, I had a friend whose water broke and within 2 hours she was in the hospital being induced (no other reason for the induction). I asked my midwife what their practice was and it was different (waiting 24 hours before induction if GBS positive and 48 if GBS negative). It's good to know that stuff ahead of time.

    And Mrs. L, most women go past their due dates, esp with the first baby. It's completely normal!

    Nurse Bee

  16. many nurse midwives do just "go with the flow" at the hospitals and think medical over natural but that's not always the case, the best way to find out if your practitioner is supportive of your wishes for non-intervention and invasive birth is to ask a lot of questions. The best practitioners will be fully supportive of your wishes.
    BTW I am fully supportive of home-birth non-nurse midwives and would very much love to be one some day but just wanted to say that there are great nurse-midwives out there who are natural practitioners.

  17. Zsuzanna-
    Hello! I just found out I am pregnant and have read all of your posts labeled pregnancy. Any suggestions for good websites about pregnancy care? Thanks for posting your blog. I love to read it.

  18. To be utterly crass, here´s the answer to #2 and #3: no, because your baby will be dead.

    I wish I doctor would have recommended an induction to my mother. I´d have a baby sister today... and a mother. Induction is *not* synonymous with injection of hormones, is *not* always wrong, and "baby does not know best" when something is wrong with him or her. Look up rates of intrauterine death by week.

    Perhaps it´s just that it´s less common here for mothers to get inductions of convenience where I live, or inductions of any kind. But please stop to consider all factors before dismissing a whole practice.


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