Issue link: http://cp.revolio.com/i/855118
SAyIng "no" to InductIon There is rarely a need for an emergency induc on, so there is generally me to have a conversa on with your doctor, do your homework, and make an informed choice. Are there alterna ves? What are the real risks of wai ng? Is induc on likely to be successful (see below)? It's your body and your baby so you have a right to ask ques ons and make an informed decision. A lot of obstetric providers are really scared of nature. I'm serious. Because in their eyes, nature can be dangerous for mom and baby. And "bad births" lead to a lot of grief for everyone. So, to them it seems safer and smarter to induce – because that's controllable and legally defensible (please remember, I am sharing this as a physician it's not jaded propaganda). But what if you're not comfortable or in agreement with your doctor's assessment or sugges ons? Some mes this can get tricky and rarely it can even get legal, but most of the me, a reasonable conversa on can be had and buy you me. Try to approach the conversa on in the spirit of partnership. A good OB, family doctor, or midwife is going to want to make sure everything is safe, but ideally will also want you to feel comfortable and sa sfied with your birth. Start by acknowledging your apprecia on for her concern for you. Then ask if she really thinks the induc on is absolutely, medically indicated and if it has to be done right away. If she says yes, ask for a clear explana on of the reason(s). Ask her if she would consider wai ng a few days, and what would make her feel comfortable doing so, for example, if you came in for an extra ultrasound in a couple of days and everything looked good would this reassure her? If your OB or other provider really s cks to her guns on the need for induc on, it could also be that it really is indicated. It could also be that she previously had a bad experience in a similar situa on to yours and is afraid to repeat it. Again, try to talk it out. If you cannot reach a resolu on that you feel good about you'll have to decide whether to acquiesce or take your birth elsewhere. You could at least obtain a second opinion if you have good reason to believe that the induc on in not indicated. WAIt And WAtch pASt 42 WeekS? Many midwives and natural birth proponents encourage le ng nature take its course, even if pregnancy extends well into or beyond 42 week's gesta on. In most cases things turn out just fine. But things don't always come up roses. Births past a full 42 weeks are some mes longer, with more challenging labors, and have more complica ons including increased risk of bleeding for mom and greater need for emergency resuscita on of the baby. Not all homebirth midwives are experienced or skilled in handling these complica ons effec vely. If you are planning a home birth and are post due, please make sure you truly understand the risks and make sure your midwife actually knows how and is prepared to handle complica ons that could arise. MAkIng An InforMed decISIon And MAxIMIzIng your SAfety If labor induc on is truly indicated, there are ways to maximize its success while minimizing risk to you and your baby. One of the most important indicators of success is how ready your cervix is for labor. It has to be both very so (effaced) and ready to open (dilate) for induc on to happen readily. Your midwife or doctor can use a simple scoring system called the Bishop's Score to see if you are ready. The be er your Bishop's score, the more likely you are to be induced successfully. If your Bishop's Score is low, ask your doctor for the best op ons to help your body get ready for labor – but don't just let them start Pitocin against an "unripe" cervix – this is a common recipe for failed induc on and need for cesarean. Some methods of induc on are more effec ve than others. Cervical ripening with medica on before a emp ng to induce contrac ons may be more effec ve than star ng out with Pitocin. Rupture of membranes is commonly recommended to facilitate labor and regular vaginal exams are commonly done to see if you are progressing. Neither are recommended as they increase your risk of infec on. Request that you be allowed to keep up your nutri on, keep your loved ones and doula nearby, move around during labor, and have your vision of how you'd like to birth be respected as much as possible (i.e., quiet at the me of birth, delayed cord clamping, baby to momma's breast rather than warmer). The more you maintain your power over decision-making and the less you succumb to the role of "pa ent," the more likely you are to feel empowered by your experience in the end. And empowerment is ideally a natural outcome of birth and a posi ve feeling with which to enter motherhood. Abby's Magazine - Volume 5 Issue 4| Page 47