Sometimes you realize how blessed you truly are; I did this morning. I met a girl whose birth story just broke my heart. She wanted a birth center birth or home birth and was bullied out of it by everyone telling her it just wasn't safe. The anger and pain in her face as she spoke of the events that unfolded and seeing how her and her beautiful baby would never be the same and never have a 'normal' life.... and to think that I was all cranky due to a lack of sleep the last couple nights. I know that story could have been from either side of the fence and I am sure there are stories that argue FOR hospital birth. I just wish that people would respect that A MOTHER KNOWS. Let her choose the birth she wants without imposing the birth YOU think she should have. If you had a wonderful hospital birth, you can share that as I do my home birth but never make a mother feel bad about her choice. To love a mommy-to-be is to encourage her to follow her own vision and help her along that path. -Aug 9
I cried at the social security office that day and it wasn't because I had to sit there all over again just to get my card with my married name on it. My mom was hanging out in the car with buddha baby while I waited inside because she is sweet enough to do that and ease my neuroses about having him in places such as crowded government buildings at 11 weeks old. There was a girl sitting next to me with a stroller that had a baby small enough to still need the carseat locked in and of course this brought out the social part of me as a new mommy. I asked her how old her baby was and explained that I had an 11 week old outside. She told me her baby was 6 months old and immediately asked me where I gave birth. I told her that I had our baby at home and, with this, she opened up about her entire birthing story. While speaking, she was so angry and so passionate that the guard at the front actually had to ask us to keep it down a couple times. It was clear that she was unhappy with her hospital birth and at first, I was happy to agree and interject a few great upsides to having a baby at home. Even now I feel a little bad because I know that as soon as I start talking about our birth I glow a bit. I can feel my face flush a little and I will gush about as much as anyone wants to hear about the entire experience. She was glowing too, but with rage at her whole experience and I cannot even pretend to know how she feels. Sitting here, I can see her face and my heart hurts for her.
I want to note here that if you are pregnant I would prefer you not read the following section until after you have given birth. I will mark 'STOP' and then 'START' where to pick up again. I believe it is best not to read about any scary birth stories while pregnant because you get enough of them everywhere else and also because it is a minority of people who have such things happen. There is no useful purpose in scaring yourself. In hypnobirthing, I was taught to stop people who wanted to tell me all their painful horrors during birth until after I was pregnant and I was glad I did. What I will do is post important information at the end so you can become informed of certain risks involved with medical labor inductions. I will just guide you to ask the right questions and have an idea how to protect yourself from unnecessary risks. So please skip this for now and scroll down to the 'START'
[STOP]
She told me how she had wanted to actually have a birthing center birth and even knew about the birth center in Ft Lauderdale (our ladies at Palms Birth House were not finished with the licensing until about a week after buddha baby was born, making it the first licensed birth house in Palm Beach County). She explained how everyone around her was so against it because they swore it was just too dangerous to birth outside of the hospital. As I have said before and will again, the people around you can really influence how you feel about your birth and birth in general and their fear can easily become your own if you let it. Even if you try not to let it, it can still get you because it is ingrained in our culture. At this point in the conversation, I am still interjecting little tidbits about my birth too. As she delves into a story about elective induction because the doctors said it would just be more convenient and prevent her baby from getting "too big," booster pitocin to move things along faster, an epidural given at 9 cm, and of course an episiotomy to top it all off, I get quiet and just listen. While these things bother me, along with all non-medically indicated pregnancy interventions, they aren't as uncommon as one might think so I wasn't sure where she was going. As she brought her baby out she explained that the extensive use of inducing drugs during her labor caused contractions that were so long and intense, her baby was being deprived of oxygen-rich blood. It was about now that I realized that her 6 month old was smaller than my 11 week old and had very little muscle control. She continued on with this horror story only to explain that her baby, who initially scored highly on the apgar test, deteriorated quickly in the first 24 hours and now has been diagnosed with cerebral palsy. As she pulls out a bottle she tells me how she wanted to breastfeed but the nurses told her a couple hours after birth that her baby was now too hungry and since he hadn't latched they had to give him formula (instead of helping her latch of course). As she continued on about lawyers, disability and NICA, I froze, I wanted to reach out and tell her how beautiful her baby was but I didn't want her to feel placated since telling me this story. I felt awful that she was so heart-broken and I had been sitting their gushing about my awesome birth. My eyes swelled with tears and I simply told her how sorry I was. I didn't even want to really look directly at them for fear she thought I was staring, At this point my number was called and I had to go. I offered my condolences and walked off in a daze. On the way out, I stopped again and told her good luck but that was it. What else could I say? I don't know her and can't pretend to understand her experiences. So, I write and decide that all I can do is familiarize people with the reality of convenience induction and warn against the practice of chemically boosting while already in labor.
[Since I had no idea at the time what NICA was or why she was so angry about it, I looked it up and according to http://www.justiceforall.com/neurological-injury-compensation-act/ NICA is an acronym that stands for Neurological Injury Compensation Act. It is another attempt to chip away at an injured individual’s right to hold the person that hurt them responsible for his or her actions. It is a no-fault system that provides that if certain situations regarding notice and type of injury are met, an injured child may be deprived of his or her right to sue, and instead be given a nominal amount of money by the state. The lawyers for the insurance companies and medical profession know this, and they try to thrust NICA on these children that bring claims. I used this website because at the official website it tells you simply how wonderful NICA is and that did not seem to be her take on it at all.]
This beautiful girl with a 6 month old baby was pouring out her heart to me and it was like watching her walk through a nightmare. I know I can't feel guilty about my own happiness but I sit there thinking, "Why did I go on about delayed cord clamping and skin-on-skin contact?! Did I really boast how my awesome midwives encouraged me to take all that time while buddha baby crowned? Seriously, I feel like an ass!" She is the epitome of my fears about hospital births and yet the logical part of me knows that this story can be told from both sides. I could have just as easily sat next to someone who had a horror natural birth story (well maybe not JUST as likely but it unfortunately happens). I was not there for her birth nor can I confirm the exact facts of it, but in her heart, this was the hospital and doctor's fault entirely and I am one to trust the mother. She did not want to be induced at 37 weeks because she felt like her baby wasn't ready yet. She had NO medical indication for induction aside from the doctor telling her it would be most convenient for everyone. This horrifies me and makes my blood boil! The continued use of pitocin as a booster and then being ignored by nurses when telling them that something wasn't right once her baby was born, the list goes on. It is insane! Its like when I hear, "...thank god they did a c-section, the cord was wrapped around the neck." [The umbilical cord is often wrapped around a baby's neck and as long as there is not a severe knot in this cord, it poses no danger and is simply slipped off at birth. Babies get their blood and oxygen from within this cord, not from traditional throat breathing as they do after birth.] It baffles me that induction is used so often without proper warning of the very real side effects that come with it. I did a brief search on correlation between induction and cerebral palsy and in a recent study by Elkamil et al (2011) "...found that labor induction at term was associated with excess risk of bilateral spastic CP and in particular CP with four-limb involvement." http://www.ncbi.nlm.nih.gov/pubmed/21275920
[START]
What is induction of labor? It is defined as the process of artificially stimulating the uterus to start labor. In a hospital and OB setting, it is usually performed by administering oxytocin or prostaglandins to the pregnant woman or by manually rupturing the amniotic membranes. But, please note that there are many other ways of encouraging labor naturally. To medically induce labor, the risk of staying in the womb should outweigh
the risk of induction to mother and baby. These medical indications include things such as cancer, hypertension, diabetes, kidney disease, small-for-dates baby and waters releasing without labor beginning in a reasonable time frame.
Why is this important to know about induction?
It is so common now to know someone who has their labor induced. In fact, the majority of people I know did have their labor induced and in only one of them was it medically indicated. According to the World Health Organization, induction rates in any geographic area should not exceed 10 percent. This is nuts when considering that a U.S. hospital can vary from 12 to 55 percent and individual doctors can have a rate upwards of 80 percent. What compounds the scariness of this is what ISN'T being told to mothers such as how this will affect them and their unborn child. A baby born at 37 is considered full-term but that by no means means that baby is ready to be born. At 37 weeks, a baby's brain weighs only 80 percent of what it will weigh at 40 weeks. That all-important cerebral cortex is the last part of the brain to develop and it is essential for things like cognition, reasoning and motor control. The point I am making is that there is a reason a baby stays in the womb as long as he or she does and that reason has NOTHING to do with a doctor's social schedule or yours. Convenience is not an indication for labor induction and while those last few weeks can seem like an eternity for some people, they are so important to the health and well-being of your child.
Some of the risks that artificial induction of labor brings are: increased pain to the mother which in turn increases the use of epidurals (which carries a whole other set of risks); increased fetal distress; lack of oxygen-rich blood reaching the fetus during these often more intense and frequent contractions; lack of oxygen to the fetus causing neurological problems in the newborn baby; continuous fetal monitoring which inhibits mobility during labor and increases pain; a huge increase in likelihood of cesarean; and an increase in the passage of meconium during labor which if inhaled by the baby causes serious breathing difficulties. There is also the risk of having a premature baby from induced labor and the risks that come with being born premature a far too great for me to cover in this blog. Again, these are just some of the risks that come with a practice that is supposed to reduce labor and birth complications.
I want to interject here that the suggestion of induction was one of the factors that changed my birth plan from an OB to a midwife. At 16 weeks I wanted to start establishing who my doctor would be so that I did not have to keep repeating my birth plan to all of these people. Also, different doctors had different answers to my questions and this was frustrating. I was told that if I wanted to know who would be there then I should just be induced at term and hope I had the baby while that doctor remained on duty. This horrifying suggestion was said to me in such a casual way that I as I left the building I burst into tears swearing that I couldn't do this, I couldn't have a baby like this- this was INSANITY to me!
The World Health Organization is clear in stating:
-Induction of labour should be performed only when there is a clear medical indication for it and the expected benefits outweigh its potential harms.
-In applying the recommendations, consideration must be given to the actual condition, wishes and preferences of each woman, with emphasis being placed on cervical status, the specific method of induction of labour and associated conditions such as parity and rupture of membranes.
-Induction of labour should be performed with caution since the procedure carries the risk of uterine hyperstimulation and rupture and fetal distress.
-Failed induction of labour does not necessarily indicate cesarean section.
Questions to ask
(Remember that it is your RIGHT as a pregnant woman to have ALL of your questions answered! No matter how annoyed the doctor may seem, or how rushed for time they appear, this is your body and your baby. Ask questions before it is too late to switch providers, this really is all about you and not about the provider at all. If someone won't answer you or keeps brushing you off... switch.)
- Why are you scheduling an induction of labor?
- What are the risks of inducing my labor?
- I know that my due date is only an estimate. What precautions will you take to make sure my baby is not born too early?
- How do you plan to induce my labor?
- How will an induction affect my labor and the health of my baby?
- I know that compared to waiting for labor to begin on its own, an induction is more likely to lead to a cesarean section. What measures would you take to reduce my odds for a cesarean?
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