Are You Due on Christmas? Don’t Be Pressured into an Induction!

In the rush of the holiday season, most people worry about on-time delivery of important gifts and packages for friends and loved ones.  But if you’re a pregnant woman due around the holidays, there’s an added worry about when your baby will arrive.

Around the holidays, many pregnant women experience pressure from family or their healthcare providers to “schedule” their baby’s birthday around festivities and travel plans.  Be aware, however, that scheduling a baby’s delivery without a compelling medical reason can put your baby at risk.

“Few doctors want to be pacing the halls on Thanksgiving or Christmas, waiting for a mother to deliver,” said Marilyn Curl, CNM, MSN, LCCE, FACCE and president of Lamaze International.  “So it’s not uncommon to see a surge of women with normal pregnancies being told that there might be an issue and that they should consider scheduling the delivery, coincidentally, right before a holiday.”

It’s not just your healthcare professional who may try to rush your baby’s arrival.  Families often can feel stressed about the uncertainty of the baby’s arrival and feel it may compromise the celebration of holidays.  Some women also fear that their preferred healthcare provider won’t be available and will agree to a scheduled early delivery to guarantee that their provider will be available for the birth.

“I really understand that pressure.  You build a relationship with your care provider over the course of a pregnancy.  Plus, you build up expectations about your holiday celebration.  So it seems like ‘no big deal’ just to get the birth over with,” said Sue Galyen, RN, MSN, HCHI, LCCE, FACCE, a Lamaze childbirth educator from Brownsburg, IN.  “But it’s so hard to think that a scheduled delivery, whether through induction or cesarean, was worth it when either the mother or baby experiences a complication as a result.”

One complication of scheduling your baby’s birthday is that often, baby is delivered just a little too early.  A growing body of research shows that giving a baby those last few weeks or days inside the uterus can be crucial to the baby’s health.  Babies born even a “little” early face risks including breastfeeding difficulties, learning and behavioral problems, breathing problems, increased chance of time in the neonatal intensive care unit (NICU) and risk of death.

You can play a key part in driving down avoidable prematurity.  “Red flags” that might signal being pressured into an unnecessarily early delivery include:
• The care provider suggests that the baby is too big and will be easier to deliver “a little early”
• The suggestion is made that the care provider won’t be available for a holiday delivery or will be “booked up”
• The timing of the delivery is centered on travel and celebration schedules
• Holiday stress is driving feelings of wanting to get the pregnancy “over with”

Here are some things you can do if you feel you are being pressured into an early delivery:

  • Ask your provider if you need to make a decision right now.  If not, ask why not?  Few decisions need to be made on the spot unless the mother or baby are clearly doing poorly.
  • Research your options.  Use credible sources of information, like LamazeChildbirth ConnectionMothering Magazine’s online forum or your doula to see what the research says and talk to other moms about their experiences.
  • Make a pro/con list.  Label your pros and cons with “medical” vs. “personal” and weigh the “medical” pros and cons more heavily.  If you are talking about a major medical intervention like cesarean or induction and you don’t have a good list of cons, it’s a good sign that you need to do more research.
  • Trust your gut.  Your instincts are geared to protect you and your baby from risk.  Listen to what your gut is saying in the context of the research.
  • Find support.  It’s hard to disagree with your health care provider, so be sure that you go into your appointments with someone who can help you have an informed, evidence-based conversation about your best options.

Inducing labor without a compelling medical reason is one of many routine interventions that has not proven a medical benefit to mothers and babies and can impose harm.  Other common routine interventions include continuous fetal monitoring, coached pushing, being positioned on your back during labor, requiring repeat cesarean surgeries for women with a prior cesarean and separating mothers and babies after birth.

You can learn more about the Lamaze Six Healthy Birth Practices by enrolling in a Lamaze childbirth education class and visiting www.lamaze.org/healthybirthpractices.

Induction and the Holidays: Part 2

In case you missed the first post in this special holiday series, we are talking about induction and the holidays. Women may feel the pressure to schedule an induction if their due date falls on or near a major holiday. Pressure can come from all sides — care givers, family, and even from within. If you’re feeling the pressure to schedule an induction that is not medically necessary, we urge you to do your homework and ask questions.

Today, we’re talking about where to find the best, evidence-based resources on induction.

Resources for Information on Labor Induction

Childbirth Connection – Childbirth Connection is a not-for-profit resource center dedicated to helping women and health care professionals make informed maternity care decisions. Among the many topics on their site, they have an in-depth section called “Induction of Labor.” Questions addressed include medically necessary reasons for induction, tips for avoiding induction, and the safest point in pregnancy for babies to be born.

 

March of Dimes – March of Dimes is a not-for-profit group that helps moms have full-term pregnancies and researches the problems that threaten the health of babies. March of Dimes has a resource on their site that explains why at least 39 weeks is best for your baby, including detailed information on the important development that babies undergo in the final weeks and days before they are born.

 

ACOG – The American Congress of Obstetricians and Gynecologists is the organization responsible for developing guidelines by which most OB/Gyn offices are expected to follow. Their site offers a basic FAQ section on labor induction that, most notably, states, “Unless a problem occurs, labor induction is not done before 39 weeks of pregnancy.”

 

If you’re looking for more information on induction and would like to talk to an expert, Lamaze International is hosting a live web seminar on December 12 called, “Is Labor Induction Right for You?“ During this one-hour interactive session, you will:

1. Receive unbiased, research-based information to help you in your decision-making process regarding labor and elective induction.
2. Interact with a professional Lamaze educator and other expectant parents.
3. Learn about indications for induction and what to expect during labor induction.
4. Discuss “talking points” to aid communication with your care provider on induction of labor.

Whether you’re facing induction or considering it, we urge you to learn more to make the best decision for you and your baby.

 

Induction and the Holidays: Part 1

Throughout the rest of this month and December, Giving Birth with Confidence will be posting information on inductions. Why now? Well, if you are pregnant and due around one of the major holidays, you might be feeling the pressure to induce so that you’re not giving birth on Christmas day, for example. We want to give you some solid reasons to think twice about induction as well as information to use if your care provider or well-meaning family and friends start mentioning the “i” word.


Is Your Baby Due on a Holiday? Don’t Be Pressured into an Early Delivery!

In the rush of the holiday season, most people worry about on-time delivery of important gifts and packages for friends and loved ones.  But if you’re a pregnant woman due around the holidays, there’s an added worry about when your baby will arrive.

Around the holidays, many pregnant women experience pressure from family or their healthcare providers to “schedule” their baby’s birthday around festivities and travel plans.  Be aware, however, that scheduling a baby’s delivery without a compelling medical reason can put your baby at risk.

“Few doctors want to be pacing the halls on Thanksgiving or Christmas, waiting for a mother to deliver,” said Marilyn Curl, CNM, MSN, LCCE, FACCE and president of Lamaze International.  “So it’s not uncommon to see a surge of women with normal pregnancies being told that there might be an issue and that they should consider scheduling the delivery, coincidentally, right before a holiday.”

It’s not just your healthcare professional who may try to rush your baby’s arrival.  Families often can feel stressed about the uncertainty of the baby’s arrival and feel it may compromise the celebration of holidays.  Some women also fear that their preferred healthcare provider won’t be available and will agree to a scheduled early delivery to guarantee that their provider will be available for the birth.

“I really understand that pressure.  You build a relationship with your care provider over the course of a pregnancy.  Plus, you build up expectations about your holiday celebration.  So it seems like ‘no big deal’ just to get the birth over with,” said Sue Galyen, RN, MSN, HCHI, LCCE, FACCE, a Lamaze childbirth educator from Brownsburg, IN.  “But it’s so hard to think that a scheduled delivery, whether through induction or cesarean, was worth it when either the mother or baby experiences a complication as a result.”

One complication of scheduling your baby’s birthday is that often, baby is delivered just a little too early.  A growing body of research shows that giving a baby those last few weeks or days inside the uterus can be crucial to the baby’s health.  Babies born even a “little” early face risks including breastfeeding difficulties, learning and behavioral problems, breathing problems, increased chance of time in the neonatal intensive care unit (NICU) and risk of death.

You can play a key part in driving down avoidable prematurity.  “Red flags” that might signal being pressured into an unnecessarily early delivery include:
• The care provider suggests that the baby is too big and will be easier to deliver “a little early”
• The suggestion is made that the care provider won’t be available for a holiday delivery or will be “booked up”
• The timing of the delivery is centered on travel and celebration schedules
• Holiday stress is driving feelings of wanting to get the pregnancy “over with”

Here are some things you can do if you feel you are being pressured into an early delivery:

  • Ask your provider if you need to make a decision right now.  If not, ask why not?  Few decisions need to be made on the spot unless the mother or baby are clearly doing poorly.
  • Research your options.  Use credible sources of information, like LamazeChildbirth ConnectionMothering Magazine’s online forum or your doula to see what the research says and talk to other moms about their experiences.
  • Make a pro/con list.  Label your pros and cons with “medical” vs. “personal” and weigh the “medical” pros and cons more heavily.  If you are talking about a major medical intervention like cesarean or induction and you don’t have a good list of cons, it’s a good sign that you need to do more research.
  • Trust your gut.  Your instincts are geared to protect you and your baby from risk.  Listen to what your gut is saying in the context of the research.
  • Find support.  It’s hard to disagree with your health care provider, so be sure that you go into your appointments with someone who can help you have an informed, evidence-based conversation about your best options.

Inducing labor without a compelling medical reason is one of many routine interventions that has not proven a medical benefit to mothers and babies and can impose harm.  Other common routine interventions include continuous fetal monitoring, coached pushing, being positioned on your back during labor, requiring repeat cesarean surgeries for women with a prior cesarean and separating mothers and babies after birth.

You can learn more about the Lamaze Six Healthy Birth Practices by enrolling in a Lamaze childbirth education class and visiting www.lamaze.org/healthybirthpractices.

Considering Induction? Learn Your Bishop’s Score

If your care provider suggests an induction, the first step is to determine if it truly is necessary for the health of you and/or your baby. While the practice of induction is common in the U.S. medical establishment (it occurs in more than 22% of births), research shows that it is not always necessary (as in the case for a suspected large baby).

When discussing induction with your care provider, one of the first questions to ask is, “What is my Bishop’s Score?” The Bishop’s Score is a set of scores, ranging from 0-13, given before a woman is in labor to assess her likelihood of success with labor induction. The Bishop’s Score looks at the following parameters: the baby’s position and station, and the consistency, effacement and dilation of a woman’s cervix. Additional points are given or subtracted for preeclampsia, prior vaginal deliveries, a pregnancy that is postdates, fist-time pregnancy and early or prolonged rupture of membranes. The higher the score, the more favorable a woman’s body is for induction and less likely that birth will end in cesarean surgery. A score of 5 or less generally indicates that induction is unlikely to be successful.

Find our your Bishop’s Score using the standard scoring chart (also available as an iPhone app!).  Discuss the score with your care provider and ask about your options. If your score is low, ask about the risks of waiting for your body to become more favorable for induction or for labor to start on its own. If your care provider insists on inducing, consider seeking a second professional opinion.

Healthy Babies Are Worth the Wait

Source: PRNewswire-USNewswire

Every week of pregnancy is crucial to a newborn’s health, and today, the March of Dimes unveiled a new public education campaign to raise awareness about the important development that occurs during those last few weeks.

The campaign, called “Healthy Babies Are Worth the Wait,” encourages women to allow labor to begin on its own if their pregnancy is healthy. It aims to dispel the myth that it’s safe to schedule a delivery before 39 weeks of pregnancy without a medical need.  

Babies born after 37 weeks of pregnancy are full-term. However, new research has shown that a baby’s brain nearly doubles in weight in the last few weeks of pregnancy. Also, important lung and other organ development occur at this time. And, although the overall risk of death is small, it is double for infants born at 37 weeks of pregnancy, when compared to babies born at 40 weeks, for all races and ethnicities.

“Some women mistakenly think that the only thing a baby does during the last weeks of pregnancy is gain weight, making labor and delivery more difficult,” said Judith Nolte, a member of the March of Dimes national Board of Trustees and former editor-in-chief of American Baby Magazine Group, who worked with the March of Dimes to develop the new awareness campaign. “When the moms in our focus groups learned about the important brain and organ development that occurs, they were more than willing to put up with their own discomfort so their baby could get a healthy start in life.”

Only 25 percent of women know a full-term pregnancy should last at least 39 weeks, according to research published in the December 2009 issue of Obstetrics and Gynecology.

“Women may feel worried, anxious, or simply uncomfortable near the end of their pregnancy.  But unless there are medical complications, the healthiest and safest place for that developing infant is in the womb,” said Eve M. Lackritz, M.D., chief of the Maternal and Infant Health Branch, Division of Reproductive Health, Centers for Disease Control and Prevention, who outlined the health consequences of an early birth. “Term labor and delivery are not just normal and natural – they’re the healthiest alternative for both the mother and the infant.”

Information about the new Healthy Babies Are Worth the Wait educational campaign can be found at marchofdimes.com/39weeks.

The March of Dimes is the leading nonprofit organization for pregnancy and baby health.  With chapters nationwide, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality.  For the latest resources and information, visit marchofdimes.com or nacersano.org. For free access to national, state, county and city-level maternal and infant health data, visit PeriStats, at marchofdimes.com/PeriStats.

Early Induction: Why all the Hype?

The term “early induction” has been tossed around the Internet a lot lately– it has even shown up on mainstream media outlets like Wall Street Journal and BusinessWeek. What are they saying and what does it mean for pregnant women? Below are some basic points with links to more in-depth information from credible resources.

How early is an early induction?

An “early induction” is any induction that is performed before 39 weeks of pregnancy. Experts from several recognized organizations, including the American College of Obstetricians and Gynecologists (ACOG), Childbirth Connection and March of Dimes, state that a baby needs at least 39 completed weeks in order to fully develop their brain and other vital organs.

What are the risks of early induction?

Induction in and of itself carries risks to mom and baby. Because induction is an artificial process for starting labor, your body may not be ready to follow its cues. As a result, inductions can cause a cascade of additional medical processes (interventions) to keep labor going, which can ultimately lead to an increased risk for cesarean surgery. Unless there is clear medical indication (see below), letting labor begin on its own is the safest decision.

Induction before 39 weeks brings an additional risk of prematurity. Babies born even a little too early can experience complications like problems with breathing, feeding, maintaining body temperature and jaundice. In most cases, babies know best when it comes to being born.

What if I need to be induced?

There are solid medical reasons for induction before 39 weeks. Being done with being pregnant, isn’t one of them. ;) There are also several reasons given for induction that are not true medical reasons. It’s important to know the difference. Click through and read up on the two links provided above on the new induction resource page on Childbirth Connection, a not-for-profit organization founded that works to improve the quality of maternity care.

If you’re pregnant and faced with the decision to induce — and even if you’re not — read up! Inform yourself. Learn all that you can, from sources in addition to your care provider and other than well-meaning family and friends. Start here: