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family doctors want to induce well before this? Sta s cally, there is a slightly increased risk of s llbirth a er 41 weeks of pregnancy. This small risk represents a major legal concern for doctors who deliver babies. An obstetrician can expect to be sued 3 mes in her career, is legally liable un l a child turns 18 years old for any problems that can be a ributed to a birth she a ended, and the stakes of a lawsuit, in addi on to the stress, can be financially and professionally devasta ng. Induc on has become the answer addressing risks to baby. Who can blame a doctor for wan ng to protect babies? Further, because the risks of induc on have been minimized for the past 20 years, it has become the "new norm" to the extent that many women request labor induc on for personal convenience. It allows siblings to share a birthday, it allows family member from afar to me their presence at a birth, it allows women to maximize maternity leave (which, by the way, is far shorter than in many other na ons that also coincidentally have lower induc on rates!) and it reduces mom's stress of wondering when the "big event" is going to happen. In our own desire for convenience and control, we have contributed to the problem! Moreover, many pregnant women feel pressured to undergo obstetric procedures, according to the latest Listening to Mothers III na onal survey of 2,400 mothers who gave birth in US hospitals from mid-2011 to mid-2012. According to Maureen Corry, MPH, the execu ve director of Childbirth Connec on, New York City, the organiza on that commissioned the survey, "We also found that the women report being pressured by their healthcare providers to have induc on and cesarean sec ons." Eugene Declercq, PhD, professor of obstetrics and gynecology at the Boston University School of Public Health and the survey's lead inves gator, told Medscape Medical News that he was surprised by the large number of mothers who felt pressure to receive interven ons such as induc ons, epidurals, and cesareans. Houston, we have a problem! hoW IS LAbor Induced? Labor is induced in one or a combina on of several ways including the use of an intra-cervical balloon filled with water to mechanically dilate the cervix, rupturing the membranes, and medica ons including hormones to so en or ripen the cervix to get it ready to dilate, misoprostol placed in the cervix to so en and dilate it, and most commonly, Pitocin, which is administered intravenously to s mulate contrac ons. Typically, more than one method is applied, with Pitocin ul mately given in as many as 70% of induc ons. IS there A probLeM WIth LAbor InductIon? One major problem is that too o en it is medically unnecessary, so any risk associated with it is an unnecessary risk for mom and or baby. Each method of labor induc on carries its own small to more significant risks. Balloon catheteriza on and rupturing the membranes increases risk of infec on to mother and baby, misoprostol increases the risk of uterine rupture, and Pitocin can cause a number of medical problems – most notably fetal distress – and generally requires an epidural to reduce the pain from Pitocin-induced contrac ons. Epidurals also carry risks. Induc on requires you to be in the hospital, which increases your risk of exposure to hospital infec ons just by being there. Once induc on begins you may be prohibited from ea ng, moving around, and you will likely need to have an IV placed – all of which increase risks of medical problems and complica ons. You will be subject to repeated vaginal exams, which also increase your risk of infec on. You will likely be placed on an external fetal monitor, which is an independent risk factor for an increased cesarean rate due to false posi ve repor ng of problems with your baby's heart rate or rhythm. Inaccuracies in es ma ng due dates increase your baby's risk of being born preterm if labor is induced, especially if done prior to 41 weeks of pregnancy increase your risk of having a C-sec on. In fact, the high na onal cesarean rate, now close to 33%, has in part been a ributed to escala ng rates of labor induc on. A study published in the journal Obstetrics & Gynecology found that among nearly 8,000 first- me mothers, labor induc on doubled the likelihood of a C-sec on compared to women who went into labor on their own. Cesarean sec ons significantly increase risks of complica ons for mothers. High cesarean rates and high rates of preterm births have become such a major problem that some hospitals have now prohibited all but medically necessary induc ons prior to 39 week's gesta on. Some hospitals are requiring doctors to provide wri en medical documenta on of reasons to induce labor. Abby's Magazine - Volume 5 Issue 4 | Page 45