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Labour Inductions… why are we in such a rush?

September 22, 2009

“When is this baby going to come?” I think that’s a question that many expectant moms ask themselves as they approach the end of the last trimester. It can be hard to be patient when you feel that you are done with being pregnant and all the physical stuff is in place: the car seat has been purchased, the hospital bag has been packed for weeks, and the super sweet nursery is all set.

Despite the challenges of waiting for baby to arrive, there is a some very convincing evidence coming out that babies need that time in utero. We consider healthy human gestation to be between 38 to 42 weeks, with the average being 40 weeks. In the past, inductions of labour were common at 39 weeks simply because the doctors and patients believed that there was no reason to stay pregnant any longer. (There are places where this is still the case). However now I find that most care providers, both doctors and midwifes, will hold off on inductions unless there is a strong reason for it such as high blood pressure or toxemia. Actually the desire to induce quite often comes from the pregnant woman herself. She simply is not aware of the benefits of letting baby choose when to be born. So if you are considering induction or have a friend who is considering induction, please be aware of the following advantages to waiting.

1. Spontaneous labours have better outcomes! Labours that start on their own are healthier for both moms and babies. When your body and baby are not ready for labor, induction tends to lead to a more long drawn out labour that often necessitates or precipitates other interventions.

Induced labours result in a higher number of c-sections, epidurals (which have their own risks & side effects), instrumental deliveries (forceps and vaccuum extraction), and uterine rupture from overly strong uterine contractions (the risk for women without a prior cesarean is 1-3%. This risk is greater if your prior birth was a cesarean.)

Artificial labor induction also requires the use of other interventions. IV fluids and fetal monitoring either externally or internally are generally used with artificial induction. These interventions come with their own risks. In addition, labour can be more painful because the contractions may become unnaturally strong.

For babies, it has been linked to increased fetal distress as well as poor health condition at birth (as rated by the apgar score).

2. More time in utero seems to make babies smarter! New research came out of McGill University which links early dates with lowered IQ in Babies. Now granted we aren’t talking about a huge difference in IQ scores, only 1.7 points, but the number of participants in the study was very large, 18 000 participants. I think that it’s enough to make a parent pause and reflect.

The globe and mail recently published any article outlining the findings of the study.

http://www.theglobeandmail.com/news/national/babies-iqs-suffer-with-fewer-than-br39-weeks-in-womb-study-finds/article1194308/

As we know, the brain development accelerates during those last three or four weeks, and it is not the same kind of development that occurs out of the womb once the baby is born. I always make a point of emphatically letting parents in my classes know that an early induction interferes with the normal brain development. There is often an emphasis on the development of the lungs as the last bit of development, but not so. The brain is still working in there and continues for weeks after. Giving the brain the time it needs is a good idea.

So if you are considering induction of labour, then this new information is quite definitely food for thought.

Sam, a Childbirth Educator in Toronto and author of the BabyReady blog also has a really good discussion about this topic.
http://blog.babyready.ca/2009/07/induction-of-labour-why-are-we-in-such.html

I will leave you with Sam’s wise words…

Between you and your care provider you will determine what to take from research such as this. The point of me taking some time to put my thoughts out into the “blogosphere” is simply to offer you a few reminders as to why it is okay to stay pregnant a little while longer. I know the ankles get puffy, the hips hurt and the trips to the toilet are infuriating at times. Savour this time though. It won’t be long before you have to share your baby with several other people and this private and intimate relationship you and your baby have created will change forever. You **will** miss being pregnant. Don’t rush it to happen too soon.

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