Induction: Is it always necessary?

Tamra MerciecaSexual Health6 Comments

I’d never really though much about induction, until…

… let me share my story…

In the months leading up to my due date, I felt that my baby would arrive early.

I was always early – to appointments, finishing projects – that was me!

Why would my birth be any different?

So in true Tamra-style I ensured everything was ready super early.

My husband and I had carved out plenty of time to allow baby to gently come into our lives, so you can imagine my surprise when 38 weeks passed, 39 weeks, 40 weeks… still no baby.

Ok, baby wasn’t coming early.

That was cool, we had a few extra weeks to bond than we’d expected.

Yet right on my due date – which really should be called a due month, as according to the World Health Organisation it’s considered healthy and normal for a baby to arrive between week 37 and week 42 – my home birth team called to book me in for a ’10-day over’ scan to check baby.

If I made it to 10 days past my due date they told me it was wise to check the heart beat and the amniotic fluid.

While I was confident baby would arrive within 10 days, I did feel a flicker of fear set in.

Fear… and confusion over why the word ‘induction’ was now being talked about, when I’d only just reached my due date.

My midwives assured me they just needed to stay on top of protocol.

In previous meetings with my home-birth team we’d already decided that unless there was any signs of the baby’s condition deteriorating, we would hold off as long as possible, especially given the average arrival for a first time mum was actually 10 days past the due date anyway!

It seemed almost silly then that if that was the average, that the scan had to be booked in for that day!

So I did a little more research and found more stats.

The longest one woman had gone past her due date was 45 weeks and 4 days, giving birth naturally to a healthy little bubba.

Ok, so it wasn’t unheard of to have well cooked bubbas!

Now perhaps you’re asking:

Why did I have such an aversion to induction?

Because I didn’t want to force my body to do something it wasn’t ready to do, which is essentially what induction is.

When you induce, the actual labour is much quicker and therefore, much more intense for not only the mother, but the baby.

During an induction the baby receives less oxygen which puts the baby into a state of distress.

Just look at the stats and you can see that women whose births are induced, are far more likely to end up with what’s known as the ‘cascade of interventions’; more often than not, an epidural followed by a c-section.

The reason for this, is that in the lead up to labour, the body creates receptors on the uterus to prepare it for labour.

If you induce before these receptors have been naturally produced in the body, the uterus doesn’t have the natural facilities to contract in a healthy way on its own, to birth your baby.

Take away the bodies innate capabilities and it needs to rely on synthetic drugs and hormones.

When the body is not producing it’s own lovely cocktail of hormones, the woman misses out on the hormones such as oxytocin that are designed to help counteract the pain of labour.

Yes, our body is such a beautiful machine!

It knows how to give us our own natural pain relief, but as soon as we start interfering with this organic process – through intervention – the body stops producing these all-important chemicals.

The body knows how to birth a baby, and has the full capabilities to do so, if we simply allow it the time it needs.

OK, so what about the baby growing too big?

This is a huge fear for women who go past their due date.

What if baby grows so big it won’t fit out of my pelvis?

The pelvis is a wonderful structure, that is designed to shift and open in ways that most women don’t realise.

During labour, the sacrum actually moves back to create more room for the baby to make it’s grand entrance.

Of course, if the woman’s lying on her back, like she’s often instructed in a hospital setting, then the sacrum can’t do this super important task, making the space too small for baby to naturally enter the world.

This is partly why there’s such a high rate of forceps and vacuum deliveries; the pelvic opening has been obstructed.

The other important thing to understand, is that in the couple of days before labour naturally begins, the body sends extra relaxin to the pelvis to help it open as wide as necessary to accommodate the size of the baby.

That’s how smart our body is!

Yet if we go and induce the labour before that relaxin has been released, then of course the baby won’t fit.

Our body didn’t get a chance to do what it needed to do to facilitate the large baby.

So if this is the case, why then, is induction so common?

Great question!!!

That would require a long answer, but in a nutshell: Due to the medicalisation of birth.

In the days that followed my due date, I started to witness first-hand, how induction has become so normalised.

People would ask: ‘When are you due?’

And I’d answer: ‘Last week!’

To which they’d respond: ‘Oh, so when will you induce?’ as if that was the only option.

My husband even had a work colleague say to him: ‘Not to worry mate. My wife had two inductions and they weren’t a big deal’.

(I’m curious to know whether his wife felt they weren’t such a big deal!!!)

He was just trying to put our mind at ease, but for me it did the opposite.

As my pregnancy continued to stretch out, the continual use of the ‘I’ word became something I no longer wanted to hear.

So I started avoiding people I knew, not wanting their assumptions about induction to instil more fear in me.

Texts and calls from friends and family started to jam up our phones: ‘No baby yet?’

No baby yet!

I began screening my calls, feeling too much pressure from people anxious to hear the news, not realising that their enthusiasm was actually making me feel unnecessary pressure.

I was a little too sensitive to hear all this talk of ‘induction’.

And it seemed I wasn’t the average mum, with ten days past the due date coming and going, without a peep!

Obviously my baby needed extra cooking time.

I went into the hospital for my check up.

Heart beat fine.

Amniotic fluid fine (well after a mis-representation on the ultrasound machine – but that’s a story for another time!)

My midwives informed me that often a woman’s due date is similar to her own mother’s natural birthing times.

My mother had been 12 days overdue with me, and she’d given birth naturally.

So if in fact ‘genes’ came into account, then I still had a number of days up my sleeve!

Didn’t I?

I kept telling myself: ‘The body is not a robot. Each person’s gestation time is different. I don’t need to fit a mould. My body knows best.’

Yet fear was slowly creeping in, and I began to question:

Is there something wrong with my body? 

Why isn’t my body doing what is was designed to do?

In a bid to brush off the fear I did more research…

Induction, as I discovered, only began in the 60s, and we didn’t have any statistics on average pregnancy lengths before this time, so how could people really be sure on what was ‘normal’ anyway?

Mmmmm….

11 days passed… 12 days… 13 days…

Day 14 was back to hospital for another check up.

Despite being just inside the normal timeframe, according to the WHO, the hospital midwives started to press for induction.

‘Now you’re 42 weeks, the chances of your baby dying have doubled’, they told me, which was true.

However, they didn’t tell me that the chance of death had risen from 0.5% to 1%.

I had more chances of losing my baby in the first trimester, when I’d a one in four chance of miscarriage!

This was the tactic – a hospital policy – they used to convince women to induce.

Fear them into induction.

‘If you were under our care we’d be inducing you today,’ they continued.

I was vulnerable.

I almost felt swayed.

Thankfully my husband was confident we were all fine, and reminded me of my wishes: ‘To go as long as it took for baby to come naturally, unless there was a sign of risk’.

My pregnancy had been straight forward.

I was low risk, all the tests we had done had been perfect and I was actually feeling really good in my body.

Why was everyone so adamant that the baby should have arrived by now?

The only person I knew personally who had had an induction, had done so because their obstetrician was going away on holiday, so it needed to happen earlier than required.

She ended up having a horrible birth experience.

Apparently this was a common practice; births having to fit around obstetricians vacations!!

What about what was best for the mother and baby?

Have we, in the western world, forgotten this?

We put our trust in the medical profession because we have a perception that doctors are experts.

Yet what many people don’t realise is that if you’re under the care of an obstetrician, these professionals are experts in ‘surgery’ and ‘medical intervention’ for emergency situations.

They’re not experts in ‘natural vaginal birth’.

The only experts in natural vaginal birth are the mother – yes we need to trust our natural instincts – and the midwives who specialise in natural vaginal birth.

In fact, many hospital birthing ‘experts’ have never seen a natural birth!

The shocking reality is that 2% of women will have a natural vaginal birth (without any intervention) in hospital.

Perhaps then, it’s a little naive to ask someone to guide us through a natural vaginal birth, when this is not their speciality??!!

Yet despite all this rationalising with my ego, I had to dig deep into my inner well of strength to not bow to the pressure of induction, so I could have my natural vaginal birth.

Meeting with my homebirth midwife late that day helped with this.

Her comment: ‘Well it’s got to come!’

She was more than happy to wait until my body was ready to birth my baby naturally.

As it turned out, we didn’t need to wait long.

Just hours after that meeting, the first contraction came, and 3 and half hours later – 15 days past my due date – my beautiful baby boy was born still in his sac in a completely natural home water birth.

He was perfectly baked, weighing 3.31 kilos.

I’d actually read that babies who stayed in the womb longer were stronger and more resilient.

Our little Zen was certainly a healthy, happy little baby.

You can read my positive birth story here.

I write this blog to help people explore this topic in more depth, to bring awareness to the growing epidemic of inductions, and unnecessary hospital procedures surrounding birth, and to encourage you to really trust that the only expert in the birth of your baby, is you.

Trust your inner guidance above all else.

And if you’re a woman who went past your due date, please share your experience in the comments section below.

The more we get talking about this topic, the more women can make better informed decisions.

*This blog fails to address the fact that many people’s due dates are inaccurate anyway. If a person doesn’t have a regular 28 day cycle pre-conception and the date of conception is not actually known, then the due date – given it is measured from the last period, not the date of conception, which generally occurs two weeks before the preceding period, can be a number of weeks out. This wasn’t the case for us however, as we knew the exact date of conception and I also had a regular 28 day cycle.

**Inductions are just one area of pregnancy and birth where interventions are overused and thus interfere with the natural process of labour. Many women are coaxed into all sorts of other inventions. This was a large reason why we chose a home-birth, so that we would not be in that environment.

***Please note that yes, I agree that induction is necessary in some cases. If the baby or mother are truly at risk, then absolutely, an induction is required. However, induction is not necessary in the majority of births, and is unfortunately used in a bid to control birth.

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6 Comments on “Induction: Is it always necessary?”

  1. I have three babies: two were 10 days over, one was 21 days over (!!). I had the same midwife for all three, and she was great, very calm and relaxed about how overdue I was with the middle child and really protected me from the angst that the hospital had about how long my middle pregnancy was. The last scan I had before he was born was especially amusing – I said I didn’t want to hear how big they thought he’d be, the scanning “expert” was a) really rude about the fact I had my first baby at home and was planning on doing it again; b) insisted that she could only say my placenta and liquor were ok during the scan, the MOMENT she stopped scanning it could immediately deteriorate and cause my baby to die (!!) and c) told me how long he was going to be and what a big baby he was. With my hubby I googled the length she predicted – he would’ve been one of the longest babies ever born. Hence I ignored her and my pregnancy went to 21 days (the scan was on day 19). He was only 9lb4oz, not that big compared to some, and was SO healthy ! He was rolling at 6 weeks, crawled at 3 months, standing and moving about at 6 months. We would always joke that though he was late it gave him a good head start! I feel I should add that I’m an experienced health practitioner and have worked with my body a lot so felt very comfortable going with his timing. I know and respect that this is not every woman’s experience, but it does help me in clinical situations to reassure woman who are stressing about their baby being late (and I do wonder if that was his timings’ purpose!). I had an older, very experienced home birth midwife who said that back in the day you were only considered “overdue” once you went 2 weeks past due date, and that then you usually had 7-10 days of leeway. Things have changed and now we assume the scan date is gospel when it can be extremely inaccurate. Also – interesting the new research around baby’s chance of obesity increasing with scheduled C-sections as opposed to those that happen as an emergency. Allowing our baby to choose their time does seem to improve many health outcomes.

    1. Thank you so much for sharing. I totally agree with what you’re saying, and congrats on trusting your body, especially withe the 21 days over birth! These are the exact types of experiences women need to hear about, so they can be better informed. Thank YOU 🙂

  2. Wow! I went through the same experience. In fact, I made them change my due date away from day of last menstrual cycle to closer to the date of conception because I knew I didn’t want to be induced (little guy came 12 days “late”). Also, wondering if an home monitoring on a daily basis (cheep ultrasound system with images sent in) would be a way to combat this. I remember pushing my OB: if the baby is moving, has a good heartbeat, and is there is enough fluid, then he’s fine! But, I’d have to be checked daily. Hm…. I now work for a company that could have some impact on this. I know you are out at a training, but if you want to brainstorm, please email me.

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