All in Good Time

To induce or not to induce - is impatience the question?

"...if you know that you are pregnant and if you know when you conceived your baby and you think that everything's okay, doctors can probably do nothing for you. Women need to realize that the role of medicine in pregnancy is very limited..."  Michel Odent MD (in Optimal Birth)

Your due date approaches, you are tired and possibly even 'over it'...your care providers offer a 'stretch and sweep' or 'membrane sweep'..a simple procedure, they will place a finger in your cervix and sweep around it, the idea being that the membranes will come away and release 'go into labour' hormones.  Evidence suggests that it works 50% of the time within 48 hours...seems to me that labour post this procedure probably would have happened anyway, so really, all this procedure does is introduce a seed of self doubt and possibly increased risk of infection.  At the same time as this is done, a 'cervical exam' will provide you with information such as 'softening' or '2cm dilated'...

You are now past your due date, and induction is being discussed: gels, syntocinin/pitocin, breaking waters/membranes...to speed thing along....seems like a good idea..I mean really...you're over it, everyone is asking "haven't you had that baby yet"?



It is important to understand the induction methods being offered, and why. 
What risks are involved?  
Have you heard about the 'intervention cascade'? 
​If you are induced you are more likely to end up with an epidural, and assisted delivery (forceps, vacuum, episiotomy) or c-section, and post-natal depression (PND). Whether or not the increased risk of PND is due to a sense of failure or dissatisfaction with the birth or hormones being interrupted and inhibiting bonding, or genetic predisposition, is the topic for another post.

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So when do you induce and when do you politely refuse?  When is it truly medically indicated?

Lets consider the 'over-cooked' scenario.  You are being offered induction because you are past your due date.  Often this is not pressed until you are 10 day past the due date. So how late is late?
http://www.findadoulatoday.com/articles/timely.asp

What follows is links to help build your understanding of normal, and find your comfort zone.  

Smart babies stay in the womb longer; Study shows improved brain development in full-term infants 
www.nydailynews.com/life-style/smart-babies-stay-womb-longer-study-shows-improved-brain-development-full-term-infants-article-1.1106249#ixzz2B9r9DTWp

Dating Scans: A comfort or crime?
http://calmyorkshirebirth.co.uk/blog/dating-scans-a-comfort-or-crime/

Alarm over jump in induced births (newspaper article)
http://smh.com.au/national/health/alarm-over-jump-in-induced-births-20111125-1nz9r.html

The surprising lack of evidence for Post Date Birth Induction
http://www.greenmedinfo.com/blog/surprising-lack-evidence-postdate-birth-induction

Induction - a step by step guide (Midwife Thinking)
http://midwifethinking.com/2011/07/17/induction-a-step-by-step-guide/

Babies' birthdays can be risky if rushed, hospitals are told
http://seattletimes.com/html/localnews/2020031594_babies01m.html

Induction of Labour
http://www.maternitycoalition.org.au/infosheets/INFOSHEET_Induction.pdf

Induced labour may double the odds of C-section
http://www.reuters.com/article/2010/06/21/us-induced-labor-c-section-idUSTRE65K6DW20100621

Inductions risk birth complications, study finds
http://www.news.com.au/breaking-news/national/inductions-risk-birth-complications-study-finds/story-e6frfku9-1226313742090#ixzz1qULvnXPJ

Induction Of Labour - To Induce Or Not Induce?
www.bellybelly.com.au/birth/induction-of-labour-to-induce-or-not-induce

Considering Induction? Learn Your Bishop’s Score
http://givingbirthwithconfidence.org/2011/06/considering-induction-learn-your-bishops-score/

Length of pregnancy can vary by up to 5 weeks, scientists discover
http://www.independent.co.uk/news/science/length-of-pregnancy-can-vary-by-up-to-five-weeks-scientists-discover-8749081.html

Induction, labour and autism:
http://sarawickham.com/2014/01/06/induction-augmentation-and-autism/

Labour Induction, Choosing What’s Best for You and Your Baby, and The Low Down on Natural Approaches: Part 1
http://avivaromm.com/labor-induction-choosing-whats-best-for-you-and-your-baby-and-the-low-down-on-natural-approaches-part-1

Labour induction, augmentation may be tied to autism risk
http://www.clinicalpsychiatrynews.com/news/childadolescent-psychiatry/single-article/labor-induction-augmentation-may-be-tied-to-autism-risk/3d80b7831cd25fd0cde3627e8cb3df41.html?tx_ttnews[sViewPointer]=1

Postdates: Separating Fact from Fiction
http://www.theunnecesarean.com/blog/2009/10/3/postdates-separating-fact-from-fiction.html#sthash.QVPLv8wm.dpbs