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Monday, July 27, 2009

Induction of labor

During each of my three pregnancies, I was most often asked, "When is your due date?" And, I have to admit, that I too ask pregnant Mamas that question all too often. We all know that due dates are just an estimate of when your baby will make his or her entrance into our world. If you are like me, after that first visit to your doctor or midwife you circle that magical date on the calendar and the next nine months revolve around that day. You start counting down the weeks until that day arrives, and so does your doctor. What all of us forget is that the "due date" is not a guarantee that your baby will be born on that day and not one minute past midnight. It might be better to think of having a "due week", as in "My baby is due the first week in January."

Having been pregnant three times, I also know the discomfort of those final weeks of pregnancy. I think my husband was ready to kick me out of the house if I asked him one more time, "When is this baby going to come?!" It is very tempting to ask your doctor or midwife to do something to make labor start. I think I tried almost every home remedy and old wives tale cure to induce labor, but each time my baby knew when was the perfect time for labor to begin. Alas, pregnancy does not last forever, even though I swore I would be pregnant forever (for the last two weeks or so of each pregnancy).

The uncomfortableness of the last weeks of pregnancy does serve a purpose (in my opinion). I remember in the early months of my first pregnancy fearing the actual labor and birth. I had heard so many horror stories about labor lasting for days and that the pain could be unbearable. My husband and I attended childbirth classes, which made me feel a little bit better, but I was still scared.....until those last few weeks when I became very uncomfortable. All of a sudden, I didn't care how long labor lasted or how painful it might be, I just wanted the baby out! I truly believe that the final weeks of pregnancy are uncomfortable to help change that fear of the unknown to a desire for labor to begin and a desire to finally be able to hold your baby.

What I don't understand is that after having acknowledged that (1) due dates are estimates (2) pregnancy does not last forever & (3) the last weeks of pregnancy, while uncomfortable help mothers to anticipate labor rather than fear it, why are so many labors induced?

Maybe there is another question to ask, "Are there any risks to labor induction?"
Yes, there are many. Inducing labor is asking your body to do something that it is not yet ready to do. Women whose labors are induced are more likely to have a C-section. Cervical softeners can cause hyperstimulation of the uterus which can lead to fetal distress (which in turn can lead to a Cesarean); rupturing membranes prematurely can cause umbilical cord prolapse, infection, and stronger contractions; and pitocin can also cause hyperstimulation of the uterus, and leads to more jaundice post-partum. To use a cliche, "If it ain't broke, don't fix it." Inducing labor for convenience leads to complications that can lead to surgical delivery.

Some of you may be thinking, "What if I go past my due date and the placenta gets old?" There is some concern that going too far "post dates" can lead to a post-mature baby and a placenta that stops working. This is a rare occurrance, and furthermore infant and maternal mortality rates have continued to increase despite all the advances in medical technology.

The bottom line: BE PATIENT! You're baby is worth the wait.

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