Thursday, January 29, 2009

Local News Show about Inductions...

There was a neonatal physician on the local 5 o'clock news this week who made this statement, "Having a baby as few as four days early increases the newborn complications risk by 20%!" and the statement was made that, "Northside Hospital the nations busiest labor and delivery center with over 18,000 births per year supposedly issued a new rule that women can not schedule an elective c-section or be induced before their 39th week of pregnancy." But my experience working with moms who give birth in the Atlanta metro area- and yes even at Northside is that is not being done. Doctors seem to be able to find a medical reason for an induction even when the birth later shows the risks were not there.

Who is doing all of these inductions? What is causing this to happen? I believe it is not only the doctors who schedule inductions and cesareans for factors that include convenience as well as malpractice concerns, but it is women who are demanding it. The doctor in this interview eludes to moms getting tired during their pregnancy and wanting to have the baby born. So, do no harm should mean that the doctor advises a mom that this is risky. That not only will an induction lead to more of a chance of a surgical birth, but more risks that she will not be bringing her baby home when she is discharged.

I can tell you that I have conversations almost weekly from moms who were induced or told to have a surgical birth due to their baby being too big. Then the baby is born and is well within the normal range of size. She then goes on to have a vaginal birth with a subsequent child who is much larger than the first. What happened? Did her pelvis get larger the next pregnancy?

This is a link to the original newscast:
http://www.myfoxatlanta.com/myfox/pages/News/Detail?contentId=8311537&version=2&locale=EN-US&layoutCode=TSTY&pageId=3.5.1

The news story went on to state, "The number of Cesarean sections has skyrocketed in recent years. One out of every three babies is now delivered surgically. New research shows women may want to think twice about scheduling an early delivery."

The news reporter, Beth Glavin states that "a pregnancy is considered full term at 37 weeks." But since often a woman does not know exactly when she conceived or when she actually ovulated it is difficult to know for sure if she is 37 weeks or 36 weeks and three days for example.

One OB online states "A normal pregnancy should last 38 weeks if you count from the day of conception. However, the day of conception is not always easy to determine, especially in the ancient past. Therefore, people then have used 40 weeks from the first day of the last menstrual period, on the assumption that women have 28 day cycles and they conceive 14 days after the start of their menses.This traditional way of counting has been in use till now.

Therefore, when we say you are 10 weeks pregnant, you have actually conceived 8 weeks ago. Based on this type of calculation, a pregnancy will have the expected date of delivery at 40 completed weeks but a pregnancy that has completed 37 weeks is considered full term already.

Beth states that "the recommendation is that a woman wait until she is 39 weeks to consider having a planned cesarean." But since inductions can lead to a cesarean = then shouldn't a woman wait until 39 weeks to consider even being induced? The doctor on the news report says every week of early birth due to inductions can cause the risks to the newborn escalate. It is due to lung and brain development. "Before 39 weeks the baby is just not ready."

This is another story - more reseach showing the risks of early inductions and cesarean births:
http://www.foxnews.com/story/0,2933,477687,00.html?sPage=fnc/health/pregnancy

The study showed, "More than a third of the C-sections were performed before 39 weeks, the researchers found. Those delivered at 37 weeks were twice as likely to have health problems, including breathing troubles, infections, low blood sugar or the need for intensive care. Fifteen percent of those born at 37 weeks and 11 percent born at 38 weeks had complications, compared to 8 percent of the babies delivered at 39 weeks."

A dream of mine would be for women to trust their bodies. For babies to select their day to be born. If a mom is more high risks, sure do non stress tests and biophysicals to insure that the baby is doing great. But the stress of going "late" and having a baby "on time" needs to end. We need to embrace that nature did not make a mistake. That MD does not stand for minor deity. That we can decide if we are going to get on that induction train or not. That the induction police don't come and pick us up to drag us to have our babies. We must begin to take responsibility for our health and the health of our babies.

It begins with trusting our bodies. And it also goes to trusting our care providers. So if a care provider says an induction or cesarean is needed- ask more questions. Know the risks. Weigh their guestimations with knowledge and with what the studies show- wait if you can.

2 comments:

Unknown said...

Thanks for pulling these 2 stories together. The fact that 4 days variance between the estimated due date and the actual can make such a difference in infant health hopefully will make mothers take pause. The last month of pregnancy can be tiring and uncomfortable and the unpredictability of labor onset is sometimes frustrating. At what cost do we choose comfort and convenience?

JunkMale said...

Teresa,

Just thought you might like to know that I have referenced you and your group in a recent post of mine called "I Don't Not Trust Doctors."

(you can click to see my profile, which should make it glaringly obvious who I am / who we are)