The more I am around birth the more I have opportunity to see that these interventions we have can be both blessings and curses to laboring mothers.  The more I am around birth the more I see births that truly did need medical intervention.    And on the flip side the more I am around birth, the more I see births that certainly could have done without so much fiddling.

And so I get to Christine’s post on Pitocin.  I think it’s great because it cautions parents not to  blindly enter into an elective induction or augmentation simply for the sake of time when mama and baby are both doing fine.  I have supported labors where the labor was progressing just fine and the OB ordered Pit simply because that’s how she rolls, and then watched as the baby quickly became distressed.  I have also supported labors where a little Pit at the end of a long labor kept the mom out of the OR by giving her body the nudge it needed to finish well.

So to all you pregnant women check out the link, learn a little about Pit, watch the video clip and then file that info away for your labor or your discussions about inducing your labor. . .

And to you mama’s who have labored before with Pitocin -  I’d love to know what your experiences with Pit have been.  Love it?  Hate it? Necessary? Unnecesary?

My personal Pit experience was with number two.  I was unnecessarily induced.  I was in early labor and didn’t realize it and was asked to come in for an induction.  At that point in my life I didn’t even think to question the advice so we went home (THAT should have been a clue that the induction was NOT a medical emergency!!) got our stuff and returned for the induction.  Well, I certainly didn’t need it.  Within two hours of starting the Pit, I was in the throes or transition and my dear little daughter was almost born in the elevator on the way to the delivery room.  (She was born overseas in a maternity clinic that had a LABOR floor and a DELIVERY floor.  You have no idea how sensible the whole L&D combo is until you are trying not to birth your baby in the hospital’s elevator!)  I would have much preferred my body’s slower pace because it would have been so much more manageable.   Spreading out all that work over a little more time would have been so much nicer.

So there’s my little trip on Pit.  What’s yours??

Some of these situations we cover are  not necessarily dangerous for the mom or baby, they just change the options that are given to the couple.  Being post-date or going past the due date is one of these.  Depending on your caregiver’s policy induction may highly encouraged anywhere from 39 weeks 6 days to 41 weeks 6 days.  That is a BIG difference.  And if both mom and baby are fine, then they have a lot of options including refusing an unnecessary induction at 40 weeks on the dot.

Another option-changer is breech position of the baby.  While there is a movement in Canada to encourage vaginal delivery of breech babies, the recommended route here in the US right now is surgical.  And since many OB’s do not have the proper training or experience with vaginal breech deliver, I am not comfortable advising moms to ask for vaginal breech delivery with inexperienced caregivers.  So, for parents who find out before the onset of labor, there are many things they can do to encourage the baby to turn: lots of positions for mom to try, chiropractic adjustments, acupuncture, etc can be effective at turning many babies.

So when preparing for these discussions tonight, I came across Dr. Onyeije’s presentation on avoiding a Cesarean.  It mirrors so many of the things I try to stress in class, the  most important being finding a caregiver who shares your perspective on birthing.

That one thing can pave the way to avoiding so many difficult situations for a pregnant couple.  If you are wanting a natural childbirth and go to a practice with a high rate of intervention, then you will probably be very discouraged.  If you want every bit of technology used on you and your baby from the first twinge and you are with a more laid back practice, you will be so frustrated when they send you home from the hospital when you are at 3cm and still in early labor. It makes SUCH a difference.  I they to encourage couples that statistically they will not be the exception.  Exceptions are out there, but you can’t expect to be the exception for the particular practice you are using.

So here it is: 

Check out the AP’s article here.

The burden of so many cesareans is starting to weigh on more than just the women and families involved.  Regulators are beginning to hold practitioners and hospitals accountable:

Hospitals also will have to report cesareans for first-time mothers, too often a result of a failed induction.

“That’s not a good outcome for the baby or the mom,” says joint commission president Dr. Mark Chassin. “We believe this will be a very important driver of improvement in perinatal care.”

It’s time that those who set the rules and protocols for hospital birth start to realize that unnecessary cesareans are not a good outcome -  as more babies have respiratory problems, moms have much longer and more difficult recoveries while simultaneously caring for a newborn and possibly other small children, and many moms suffer from post-op infections, not to mention many other risks and side-affects of major abdominal surgery.

For more info on inductions check out Henci Goer’s articles on elective induction and due dates. Henci Goer has made combing the medical research for best practices and translating that evidence for the rest of us her life’s work.  She is the author of The Thinking Woman’s Guide to a Better Birth.

Nursing Birth gives some great advice in her “Don’t Let This Happen to You” series when describing how one couple dealt with an induction.   Nursing Birth accurately describes the birthing climate in many of today’s hospitals and writes from an evidence-based point of view.

Related Posts:

• Do We Even get a Choice?
• One Choice We Make: Where Do We Give Birth?
• Good Things Come to Those Who Wait