The Waiting Game: Why Baby Knows Best

 

By Debby Amis, RN, BSN, CD(DONA), LCCE, FACCE

Patience is truly a virtue after 9 long months, especially when you’re a few weeks or days from your due date. The swollen feet, extra pounds and late-night bathroom trips can take their toll. Wouldn’t it be easier to just schedule your baby’s birth and get the show on the road?

Elective induction offers the satisfaction of knowing your baby’s birth date in advance, but it might not go as planned. Sometimes women scheduled for induction are bumped from the hospital agenda because the staff is busy. Plus, induction doubles your risk of cesarean birth. The major risk of elective induction is that your baby may not be ready to be born. Experts agree that a normal pregnancy lasts between 38 and 42 weeks, and research indicates that the baby actually initiates the labor process. Once his lungs are fully mature, he releases a protein that tells his mother’s body that it’s time. A baby born even a few weeks early is at an increased risk for breathing problems, admission to special-care nurseries and breastfeeding difficulties.

Inductions & Interventions
An induction usually requires more interventions than a naturally starting birth. You will need IV fluids and continuous electronic fetal monitoring, making you less mobile. Also, artificial contractions may peak sooner and be more intense than natural ones. You are therefore more likely to request an epidural, which increases your chances of needing forceps or vacuum assistance, developing a fever and/or requiring a cesarean section. Plus, the most common medication used for induction (Pitocin) interferes with the release of hormones that promote birth happening normally and breastfeeding.  

Because of these risks, some hospitals do not offer or limit elective inductions. “It seems that, if we are too cavalier about inducing labor for the convenience of either the mother or the provider, we are ignoring the baby’s essential contribution and asking him to participate even when he is not ready,” says Biddy Fein, CNM, who attends births at Brigham and Women’s Hospital in Boston. “We accept this as necessary when the risks of continuing pregnancy outweigh the benefits. But in all other circumstances, we should be respectful of nature’s plan for the initiation of labor and the exquisite interplay between mother and baby.”

Baby Makes the Date
If there are valid medical reasons for labor induction, your health-care provider will weigh the benefits of immediate delivery versus continuing the pregnancy for the health of your baby. But if you are like the majority of women who have a healthy pregnancy, the safest option for you and your baby is to wait for labor to begin on its own. Your baby may decide to come on his due date (although less than 10 percent of babies do), but you may want to plan for a later date in case your pregnancy does extend to 42 weeks.  

If your pregnancy lasts longer than expected, try not to worry. Continue normal activities and remember that you are giving your baby the best start by allowing him to decide when he is ready to make his grand entrance into the world.

This article was reprinted with permission from Lamaze International and is available on the Lamaze parent resource Web site along with many more helpful tips and advice for pregnancy, birth and parenting.

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Comments

  1. mamapoekie says:

    thank you, a clear post which leaves little room for the ‘but what about a mother’s choice’ argument. Put it in next week’s sunday surf

  2. Hillary says:

    My babies were all born well past their due date. In fact my second was born at a full 43 weeks. He was perfect, no signs of post-dates and just 7.5 lbs. Imagine if I had been induced at 38-39 weeks! Clearly it would have been much, much to early for him even thought by the book he would have been ready.

    I will also say that I know first hand how hard it is to wait the extra time. It can be a very challenging few weeks.

  3. Arp says:

    Thank you – I really wish more people would trust in natural birth and avoid the temptation of scheduling.

  4. CJvsmommy says:

    Thanks for this article. I just got back from my 35 week OB visit and she told me that at she would like to induce me at 39 weeks since it’s common practice (I guess for her practice) once a mom has had her first child. Your article gave me much more confidence to rebutle her statement!

  5. Avatar of Cara Terreri Cara Terreri says:

    Thanks Mamapoekie!

    Hillary– wow, 43 weeks… now that is a wait! Thanks for the encouraging words. It can be hard, but moms need to know that it IS worth the wait!

    Arp– agree with you. It can be difficult though, when you have a care provider who is more than willing to schedule (or pushing for) an induction. But if moms know that waiting can improve the health of their baby, hopefully they’ll be more tempted to stick it out!

    CJvsmommy– Common practice to induce at 39 weeks for your second baby? I would certainly question that! Arm yourself with facts and follow-up questions. Here are some more induction resources: http://magazine.lamaze.org/Birth/DueDateDilemma/tabid/73/Default.aspx and http://magazine.lamaze.org/Birth/InterventionIntelligence/tabid/197/Default.aspx and http://www.scienceandsensibility.org/?p=1507. Keep us posted!

  6. NewGradRN says:

    I’m a new grad RN in Labor and Delivery and I have been so put off by how doctors “manage or rather man handle” the labor process, thank you for your honesty and research!

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  2. [...] like problems with breathing, feeding, maintaining body temperature and jaundice. In most cases, babies know best when it comes to being [...]

  3. [...] membranes to jumpstart labor, performing a barrage of tests to check on baby and scheduling an induction date; and then there is the general discomfort and exhaustion that comes along with the end of a [...]

  4. [...] membranes to jumpstart labor, performing a barrage of tests to check on baby and scheduling an induction date; and then there is the general discomfort and exhaustion that comes along with the end of a [...]

  5. [...] like problems with breathing, feeding, maintaining body temperature and jaundice. In most cases, babies know best when it comes to being [...]

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