Anna is 41 wks and Mel is 37 wks, new blog.

[Elle]

Sometimes the dr can tell beforehand that there isn't enough clearance for the baby to get out. They might schedule an induction then for a trial of labor to confirm that events won't proceed. If the baby were breech or some other reason like that requiring a c-section, I can't at the moment think of a rationale for trying an induction first.

If I had a quarter for every time a friend of mine was told by a doctor there wasn't enough room, only for her to have a vaginal birth without a hitch, I'd be paying rent next month with some left over. Induction meds are a lot harder on the body than natural labor. The meds force contractions when the cervix may not be "ripe" enough to dilate whereas natural labor works with the body and its natural hormones that cause dilation. One of my friends ended up having a very fast labor, and birthed at home unplanned instead of getting to a scheduled c-section. Her estimated-10-pound baby was less than 7, and her tiny frame had no problems. Needless to say, she's an advocate for telling doctors who say a baby is too big to be born naturally to shove it.

Also breech deliveries aren't much riskier than crown-down babies. The big thing is to not twist and pull and to support the body, meaning there is less control on the part of the person doing the delivery. Doctors don't like not being in control, which is evidenced by the doctor above who scheduled inductions to keep his weekends clear. A breech doesn't automatically require a c-section for safety. Too bad there's less medical liability in a c-section going bad.

[BelieveinScience]

There are some doctors who will "fudge" the medical records a bit to make it look like the induction or c-section was medically necessary, so that gets them off the hook. But you'd be amazed how many patients don't ask questions or research their options. I'm a big proponent of informed consent, and I don't think most patient are made aware that early elective inductions frequently end up as c-section deliveries, because the cervix just isn't ready.

I think a lot of how the maternity system in the US is run is rather messed up. I read part of the book Born in the USA how to fix a broken maternity system (or something like that). It was eye opening.

My friend right now is "full term" with twins who are both head down and she having to fight to have a vaginal birth with them. she found one doctor in her area who would do it but has all these restrictions on her for it. It just sucks.

[Elle]

There are some doctors who will "fudge" the medical records a bit to make it look like the induction or c-section was medically necessary, so that gets them off the hook. But you'd be amazed how many patients don't ask questions or research their options. I'm a big proponent of informed consent, and I don't think most patient are made aware that early elective inductions frequently end up as c-section deliveries, because the cervix just isn't ready.

It's really sad and disheartening how much time people will put into researching cars before deciding which one to buy, yet will just blindly trust the salesman, I mean, doctor, when it comes to their own bodies and babies. If we wouldn't trust the car salesman to pick our cars and options for us and then just pay the bill without complaint, why do so many women trust doctors to pick the delivery and "options" and then, well... I think, if we paid completely out of pocket, more women would research and question the "options" a lot more. It's easier to not feel how much the doctor's making when an insurance company picks up the tab. But you get my drift. We should be questioning doctors and their motivations a lot more than cars. More is at stake with our pregnancies and deliveries, and doctors are just as prone to greed and wanting more money and convenience as anyone else, and when the system is set up so that doctors are more protected by using unnecessary interventions, it's a perfect recipe to have what we have happening: a skyrocketing intervention rate and the 2nd highest maternal and infant mortality rate among all developed nations. Something is going wrong if the death rate is climbing despite the rise in "perfectly safe" interventions.

[Elle]

I think a lot of how the maternity system in the US is run is rather messed up. I read part of the book Born in the USA how to fix a broken maternity system (or something like that). It was eye opening.

My friend right now is "full term" with twins who are both head down and she having to fight to have a vaginal birth with them. she found one doctor in her area who would do it but has all these restrictions on her for it. It just sucks.

I hope she has the birth she's fighting for. It's appalling how there's all this screaming about women's reproductive rights and choice, but it only seems to apply to abortions, not to delivering our own babies vaginally. There should not need to be a fight to not have interventions.

[WonderingInWA]

If I had a quarter for every time a friend of mine was told by a doctor there wasn't enough room, only for her to have a vaginal birth without a hitch, I'd be paying rent next month with some left over. Induction meds are a lot harder on the body than natural labor. The meds force contractions when the cervix may not be "ripe" enough to dilate whereas natural labor works with the body and its natural hormones that cause dilation. One of my friends ended up having a very fast labor, and birthed at home unplanned instead of getting to a scheduled c-section. Her estimated-10-pound baby was less than 7, and her tiny frame had no problems. Needless to say, she's an advocate for telling doctors who say a baby is too big to be born naturally to shove it.

Also breech deliveries aren't much riskier than crown-down babies. The big thing is to not twist and pull and to support the body, meaning there is less control on the part of the person doing the delivery. Doctors don't like not being in control, which is evidenced by the doctor above who scheduled inductions to keep his weekends clear. A breech doesn't automatically require a c-section for safety. Too bad there's less medical liability in a c-section going bad.

I concur that the drugs they give you for induction (it's just petocin, isn't it -- or oxytocin?) bring that labor on like a train. My first child was born naturally with no meds after 13 hours of labor, 18 minutes of pushing, and a week early. My second, my water broke and when I had some contractions but not steady and when I finally called my OB/GYN about 9 hours later, she acted like it was URGENT that I get to the hospital RIGHT AWAY even though I wasn't having regular contractions. She couldn't hardly wait to get me on something to get that baby out! I finally showed up about 2 hours later and I begged her not to give me the pitocin, but was going to have nothing of that. She agreed to give it for only an hour, which she stuck to, and my contractions did start. But then I went through 4 hours of difficult contractions, nothing like the natural labor I'd experienced before since it was condensed into such a short amount of time. But she got that baby outta there just before 5pm when I'm sure she had to go home. Grrrrr. I didn't know to argue it more, but now I do. Unfortunately, I am done having babies!

[Fun-Dee]

I concur that the drugs they give you for induction (it's just petocin, isn't it -- or oxytocin?) bring that labor on like a train. My first child was born naturally with no meds after 13 hours of labor, 18 minutes of pushing, and a week early. My second, my water broke and when I had some contractions but not steady and when I finally called my OB/GYN about 9 hours later, she acted like it was URGENT that I get to the hospital RIGHT AWAY even though I wasn't having regular contractions. She couldn't hardly wait to get me on something to get that baby out! I finally showed up about 2 hours later and I begged her not to give me the pitocin, but was going to have nothing of that. She agreed to give it for only an hour, which she stuck to, and my contractions did start. But then I went through 4 hours of difficult contractions, nothing like the natural labor I'd experienced before since it was condensed into such a short amount of time. But she got that baby outta there just before 5pm when I'm sure she had to go home. Grrrrr. I didn't know to argue it more, but now I do. Unfortunately, I am done having babies!

Your story is much like mine. With my first baby, (more than 20 years ago) my water broke. After a day and a half of light labor I was put on pitocin. It was like being hit by a truck. Less than two years later I had my second, and last baby with no pitocin and no pain meds. The difference was amazing. I cannot imagine choosing to be induced if it were not necessary.

[Snickerdoodle]

It's really sad and disheartening how much time people will put into researching cars before deciding which one to buy, yet will just blindly trust the salesman, I mean, doctor, when it comes to their own bodies and babies. If we wouldn't trust the car salesman to pick our cars and options for us and then just pay the bill without complaint, why do so many women trust doctors to pick the delivery and "options" and then, well... I think, if we paid completely out of pocket, more women would research and question the "options" a lot more. It's easier to not feel how much the doctor's making when an insurance company picks up the tab. But you get my drift. We should be questioning doctors and their motivations a lot more than cars. More is at stake with our pregnancies and deliveries, and doctors are just as prone to greed and wanting more money and convenience as anyone else, and when the system is set up so that doctors are more protected by using unnecessary interventions, it's a perfect recipe to have what we have happening: a skyrocketing intervention rate and the 2nd highest maternal and infant mortality rate among all developed nations. Something is going wrong if the death rate is climbing despite the rise in "perfectly safe" interventions.

You're so very right.

Prior to my current job, I was a childbirth educator at a suburban hospital, along with about 5 other educators. We taught informed consent and risk/benefit, and tried to ensure that all of our clients understood their options, including medications, inductions, etc. We NEVER taught or even inferred what a patient "should" or "shouldn't" do - just tried to give them facts to make informed choices. The doctors never liked the classes, and they said - and this is an exact quote from a medical staff meeting - "The patients are getting too much information." They hired a new director of L&D with the understanding that she would take over the classes, fire all 5 of us, and run things the way the doctors wanted. And she did. The last I heard, the c-section rate at that hospital was over 50%.

[WonderingInWA]

You're so very right.

Prior to my current job, I was a childbirth educator at a suburban hospital, along with about 5 other educators. We taught informed consent and risk/benefit, and tried to ensure that all of our clients understood their options, including medications, inductions, etc. We NEVER taught or even inferred what a patient "should" or "shouldn't" do - just tried to give them facts to make informed choices. The doctors never liked the classes, and they said - and this is an exact quote from a medical staff meeting - "The patients are getting too much information." They hired a new director of L&D with the understanding that she would take over the classes, fire all 5 of us, and run things the way the doctors wanted. And she did. The last I heard, the c-section rate at that hospital was over 50%.

Wow.

The father of a friend of mine was an OB/GYN and ended up retiring early (this was maybe 15 years ago) when he decided his liability insurance rates were just way too high. All it takes in one time for them to get sued and all those years of being a professional (the house with the pool and the vacation property) can be gone. So, it's no wonder they worry about it. But I can honestly say my OB/GYN, as nice as she was, taught me almost nothing about childbirth. Her job was to make sure my baby didn't die, you know? I understand the popularity now of midwives and doulas and just a return to a more natural approach to childbirth.

[BelieveinScience]

You're so very right.

Prior to my current job, I was a childbirth educator at a suburban hospital, along with about 5 other educators. We taught informed consent and risk/benefit, and tried to ensure that all of our clients understood their options, including medications, inductions, etc. We NEVER taught or even inferred what a patient "should" or "shouldn't" do - just tried to give them facts to make informed choices. The doctors never liked the classes, and they said - and this is an exact quote from a medical staff meeting - "The patients are getting too much information." They hired a new director of L&D with the understanding that she would take over the classes, fire all 5 of us, and run things the way the doctors wanted. And she did. The last I heard, the c-section rate at that hospital was over 50%.

Wow. I've never been pregnant before so I've neve rhad an OB but I know my doctors LOVE it that I'm very informed about my medical conditions, and my options etc.. Funny, how as soon as a person's body houses another they lose their ability to be allowed to be informed.

[Eclipse]

Bad Steve, do you not remember that this is the Sabbath day and keep it holy.

My favorite comment;

Since Steve is a living God, when they praise him and his family they are praising God! So he is keeping the Sabbath Day by helping others praise his God, himself. :roll:

That made my brain hurt.

[mags]

Good grief! Here we go again with the Google University education regarding childbirth data and practices. Yes, it is correct that early term inductions (37-39 weeks) are associated with complications usually requiring respiratory support w/ oxygen or NICU stays. The flip side of the coin is that the same group has a lower perinatal mortality rate because the risk of stillbirth starts increasing around 38/39 weeks.

Since we are sharing anecdotes, here's mine: I chose elective induction twice. The first was a few days after 39 weeks, the second was a couple of days before 39 weeks. Both times I was already 3-4 cm dilated by 38 weeks and up to 5 on the day of induction. I checked into the hospital early, pitocin started, epidural when requested by me, had a baby sometime during the afternoon (first was around 5pm, second around 1:30pm). Both babies were estimated to be 7-8 pounds, but both were over 9 pounds. No one ever tells an easy induction story so I make it a point to share mine just to combat the induction-hate that gets around. My story is also a reminder that ultrasound estimates of weight can be up to 2 pounds off IN EITHER DIRECTION!

[theologygeek]

Wow.

The father of a friend of mine was an OB/GYN and ended up retiring early (this was maybe 15 years ago) when he decided his liability insurance rates were just way too high. All it takes in one time for them to get sued and all those years of being a professional (the house with the pool and the vacation property) can be gone. So, it's no wonder they worry about it. But I can honestly say my OB/GYN, as nice as she was, taught me almost nothing about childbirth. Her job was to make sure my baby didn't die, you know? I understand the popularity now of midwives and doulas and just a return to a more natural approach to childbirth.

I guess it depends on the doctor. I got lucky with my youngest. My OB let me deliver my baby. When I started pushing, I asked if I could deliver him myself, and she said sure. She was right next to me guiding me along and telling me what to do, and if anything went wrong I knew that she would jump right in, but she let me do what I wanted. It was an amazing experience. There were a lot of doctors in that group, and I saw both male and female. But I was so glad to have gotten her because I don't know if any of the other ones would have let me do that.

[Coconut Flan]

I was one of the patients where the first OB looked at me from 10 to 15 feet away and asked when I wanted to schedule my c-section. I didn't even get seated in the chair. I just turned and walked out. It wasn't the easiest delivery ever done but no c-section for any of my children.

Earlier I was merely trying to offer a possible explanation for someone talking about someone having an induction scheduled because insurance wouldn't cover a scheduled c-section at that time.

[ilovetchotchkes]

I had a GP flat out tell me I was lying. I had a 30 hour labor with my son, vaginal delivery, and my former GP told me I was lying and that "nobody labored that long without a c-section"

Sorry dude, my hospital midwives knew how phobic I am of surgery and did EVERYTHING within their power as long as me and kiddo were safe to prevent it.

My sister ? had an elective 39 week induction which ended in a c-section, dr played on her nervousness. Told her "babies left in after 38 weeks DIE" (ok YES the risk of still birth goes up, but dammit, it does not jettison really high until 42 + weeks!!! and no this isn't "dr" google telling me this, this is what I"ve been told by a former OBGYN who is now in another medical field and my Midwives). She's gobsmacked that my midwives did not induce me with my son.

I seriously think that birth is one of those things that's SO individual. Some women dont' mind a surgical birth, ok, but if I don't want one because i've heard way too many damn horror stories (friend of mine almost died, ended up in the ICU after bleeding OUT from hers, another friend's incision got horrifically infected and still almost a year later is not completely healed, another friends' also got infected really bad, another friend's scar ruptured with her subsequent pregnancy and she lost her baby ) I'm loathe to just hop up on the OR table and get one unless my hospital midwife who I trust implicitly says "yeah.... um, kiddo has to come out the emergency exit". Add to that a SEVERE phobia of all things medical.... and you've got someone who really really really doesn't want a c-section.

[WonderingInWA]

Yep, I agree -- birth IS one of those things that is SO individual. And it's the combination of so many factors. And nobody wants a disappointing birth experience, but they rarely go by the plan (at least in my experience talking to other mothers). I'm a surgery/blood phobe, too, and I told my OB/GYN I didn't want to see ANY blood. Miraculously, she kept it all out of my view, it was all cleaned away before I could see a thing both times. Obviously I had it afterward for weeks but I just summed that up to a "heavy period". LOL.

Childbirth is just really personal but the medical community tends to make it less than personal when they try to make it go by their rules. If I had to do it over again, it would have been homebirths for me.

[ilovetchotchkes]

Yep, I agree -- birth IS one of those things that is SO individual. And it's the combination of so many factors. And nobody wants a disappointing birth experience, but they rarely go by the plan (at least in my experience talking to other mothers). I'm a surgery/blood phobe, too, and I told my OB/GYN I didn't want to see ANY blood. Miraculously, she kept it all out of my view, it was all cleaned away before I could see a thing both times. Obviously I had it afterward for weeks but I just summed that up to a "heavy period". LOL.

Childbirth is just really personal but the medical community tends to make it less than personal when they try to make it go by their rules. If I had to do it over again, it would have been homebirths for me.

My MW's followed my plans, BUT my son didn't follow them. He was and still is a little stinker. :)

That's what i loved about my MW's, yes i was going through something medical, but they made absolutely SURE it was as personal as it could be. Some of my friends who have had OK surgical births were treated well. - Nothing makes me more angry when someone describes their c-section and the dr is bitching about the local baseball team. I'm sorry, dude, its the birth of someone's kid. Talk to THEM, like "so what are you naming the baby! who is waiting for you to see the baby? blah blah blah"

[mockingbird]

Wow. I've never been pregnant before so I've neve rhad an OB but I know my doctors LOVE it that I'm very informed about my medical conditions, and my options etc.. Funny, how as soon as a person's body houses another they lose their ability to be allowed to be informed.

Well to be fair with your last sentence, I am in the same boat, I have never been pregnant and I have a lot of medical conditions that I know a lot about and research - and I have had many doctors (/other medical professionals) who get defensive that I know more than them or will contradict them, or who refuse to listen to me because obviously their way is always best. None of my regular doctors (since I don't stay with doctors who won't listen to/respect me), but I don't think it's just a pregnancy thing, more of a personality thing. And possibly depends on the culture of the hospital/practice.

[WonderingInWA]

Interestingly, my OB/GYN, who has practiced for about 25 years, has decided to stop her OB side of her practice and is going only to GYN. I think she was tired of being on call and having to deliver babies on the fly while having office hours (her office was in the same building as the birthing center so when I arrived at the hospital to deliver and progressed really rapidly -- in 15 minutes -- she came RUNNING into my delivery room. I was pretty impressed, actually). I think OBs have a really stressful job trying to protect the lives they are delivering, protect the mothers, and protect themselves from liability. And knowing all the factors that can go wrong suddenly and what to do about them.

My second son was losing his heartrate with every one of my contractions (that she insisted on inducing). Come to find out (and ultrasounds don't tell you this) once his head was out, he was hanging himself on his umbilical cord. It was wrapped so tightly around his little neck that it was preventing him from being born. She cut it immediately so he could tumble out. Who knows what would have happened if he'd stayed in the womb another day without being induced (but I still don't like induction). She told me later his cord was 42cm long compared to a normal 60cm so it was already short and then of course it was wrapped around his neck (I never saw it but my husband did and said it was awful). Then she told me he might have some bruising around his neck within the first few days of his life. So, as much as I wanted a homebirth with that baby, I was glad to be there at the hospital where they probably see this all the time.

[0 kids n not countin]

My favorite comment:

My thoughts and prayers are with not just the expectant parents & grandparents, but also with all the aunts and uncles, who are so often overlooked, in happy times and sad ones. You are so important, too!!

Poor Sarah...

Well poor Sarah & the rest of the unmarried (reversal & non-reversal) siblings (I suppose)...

And yes, I do "sort of" remember that after school special (was it?) from the 70's about my mom having a baby....

[WonderingInWA]

My favorite comment:

Poor Sarah...

Well poor Sarah & the rest of the unmarried (reversal & non-reversal) siblings (I suppose)...

And yes, I do "sort of" remember that after school special (was it?) from the 70's about my mom having a baby....

1977. I found the trailer on YouTube. Unfortunately, I couldn't find the whole movie. Wouldn't that have been a prize?

[SunnyAndrsn]

Some of it is overzealousness for SURE on the part of the parent. My husband packs enough diapers for 4 days, 4 outfit changes at minimum.... Makes. Me. Crazy. Its like, we can't go to the grocery store without a Sherpa helper to carry all our crap or something. O_O

I just see all that crap and remember how sore and tired I was after an outing with this client--lifting him in and out of the van, lifting all of his equipment (including the w/c) in and out of the van, plus pushing the whole thing around a zoo, mall, or park all day. It was a good workout, but hard on the back.

[Snickerdoodle]

Good grief! Here we go again with the Google University education regarding childbirth data and practices. Yes, it is correct that early term inductions (37-39 weeks) are associated with complications usually requiring respiratory support w/ oxygen or NICU stays. The flip side of the coin is that the same group has a lower perinatal mortality rate because the risk of stillbirth starts increasing around 38/39 weeks.

Um, I don't know if you're referring to my comment that people can google "early term birth," but it's rather offensive to imply that I got my education from Google. In my field of work, I read the latest research and professional literature. If you'd like, I can dig up the actual research and the guidelines now used by the US Dept. of HHS.

Since we are sharing anecdotes, here's mine: I chose elective induction twice. The first was a few days after 39 weeks, the second was a couple of days before 39 weeks. Both times I was already 3-4 cm dilated by 38 weeks and up to 5 on the day of induction. I checked into the hospital early, pitocin started, epidural when requested by me, had a baby sometime during the afternoon (first was around 5pm, second around 1:30pm). Both babies were estimated to be 7-8 pounds, but both were over 9 pounds. No one ever tells an easy induction story so I make it a point to share mine just to combat the induction-hate that gets around. My story is also a reminder that ultrasound estimates of weight can be up to 2 pounds off IN EITHER DIRECTION!

You're absolutely right; anecdotal evidence proves nothing. I will say your story is an example of why it's good to have a favorable Bishop Score before choosing elective induction.

[BelieveinScience]

Well to be fair with your last sentence, I am in the same boat, I have never been pregnant and I have a lot of medical conditions that I know a lot about and research - and I have had many doctors (/other medical professionals) who get defensive that I know more than them or will contradict them, or who refuse to listen to me because obviously their way is always best. None of my regular doctors (since I don't stay with doctors who won't listen to/respect me), but I don't think it's just a pregnancy thing, more of a personality thing. And possibly depends on the culture of the hospital/practice.

I guess I'm just really lucky I've only had one doctor that got defensive about. She came into my room all smug saying she researched the reaction I was having and then the first sentence out of her mouth was a lie about the reaction and I called her on it. BUt thats the only one most of the others actually LOVE it and it gives them something to build on because who knows more about your body than yourself?

[BelieveinScience]

Interestingly, my OB/GYN, who has practiced for about 25 years, has decided to stop her OB side of her practice and is going only to GYN. I think she was tired of being on call and having to deliver babies on the fly while having office hours (her office was in the same building as the birthing center so when I arrived at the hospital to deliver and progressed really rapidly -- in 15 minutes -- she came RUNNING into my delivery room. I was pretty impressed, actually). I think OBs have a really stressful job trying to protect the lives they are delivering, protect the mothers, and protect themselves from liability. And knowing all the factors that can go wrong suddenly and what to do about them.

Or her malpractice insurance rates are sky high. My friend's dad is an OB and he had to quit because his malpractice insurance was way too high. From what I've been told by a few of my doctors OB have one of the highest malpractice insurance rates. We're family friends with someone who's brother i an OB and his wife actually has to work to be able to keep them floating financially because of his insurance rates.

[WonderingInWA]

Or her malpractice insurance rates are sky high. My friend's dad is an OB and he had to quit because his malpractice insurance was way too high. From what I've been told by a few of my doctors OB have one of the highest malpractice insurance rates. We're family friends with someone who's brother i an OB and his wife actually has to work to be able to keep them floating financially because of his insurance rates.

Well, how high ARE they, you know? OBs are highly paid (don't know specifics there, but they are one of the highest paid doc types). So is it that their insurance rates are as high as their income? And do midwives have to carry liability insurance?