Angie’s List Induction-Turned-Cesarean Commercial

Screen cap of laboring woman being rushed to surgery

Transcript of an actual Angie’s List review:

At my 41 week appointment, my OB decided to induce me, but I guess I took longer than he expected because just as I went into hard labor, he told me he was leaving for an important meeting. On his way out, he said goodbye, dressed in his tennis clothes. One hour later, I was getting a c-section… while he was out practicing his serve.

Late Preterm Birth - STOP THE MADNESS

The CDC released another report on lat preterm birth today. ?Here are some of the key findings:

• The U.S. late preterm birth rate rose 20% from 1990 to 2006. If the late preterm rate had not risen from the 1990 level, more than 50,000 fewer infants would have been delivered late preterm in 2006.
• On average, more than 900 late preterm babies are born every day in the United States, or a total of one-third of 1 million infants (333,461).
• Increases in late preterm births are seen for mothers of all ages, and for non-Hispanic white and Hispanic mothers.? The rate for black mothers declined during the 1990s, but has been on the rise since 2000.
• Late preterm birth rates rose for all U.S. states, but declined in the District of Columbia.
• The percentage of late preterm births for which labor was induced more than doubled from 1990 to 2006; the percentage of late preterm births delivered by cesarean also rose markedly.

Okay so what do you need to know about this? ?DON’T GET INDUCED.

Don’t do it for any of the following reasons:

• You are tired of being pregnant. (Your baby is still enjoying the ride.)
• You are uncomfortable. (Long, hard labors don’t make you comfortable.)
• You can’t sleep. (Sleeping in the NICU is hard too.)
• Your doctor is only on call on X date. (Then wait until baby picks their doctor.)
• Your mom has a plane ticket to visit on your due date. (Either change her flight or suck it up.)

Seriously how many sick babies have to be born before someone takes a stand and says enough? ?900 per day. That is a lot of babies who are greater risk of breathing difficulties, trips to the NICU, dying from SIDS, problems breastfeeding…

Surely you can stick it out a few more days or even a couple of weeks. Do it for your baby.

The Infamous Cascade Chart

As someone strongly involved in the birth community, this is probably one of my favorite pictures floating around the internet that I run across every once and a while.? One day when I find out the person who actually put these thoughts and cascade of interventions into a physical chart to view, I am going to kiss them!

I have always loved how it starts with induction, because lets face it, so many women today are starting their labors with some kind of artificial labor stimulant. Whether it be pitocin, or the oh so dangerous cytotec. I can personally say I have been the victim of the cascade myself with my first child. Had I seen this before my pregnancy with him, I would have never opted for the induction. Many do not realize that induction in many cases will fail, almost half of the time according to the most recent figures, and when I quote that, I am quoting Robbie Davis Floyd in a 2008 interview, I believe it was in Pregnant in America but my birth/pregnancy movies and interviews all start to blur together when you watch so many of them. These babies are not ready to be born in many cases, especially when we are seeing these inductions before the “due date” or the 40 week gestation mark. Although we know that “due dates” aren’t much to put stock into, many women and providers use them as some type of eviction date, which history has shown to be a pretty bad idea. No one is going to be pregnant forever and many women left alone will go into labor on their own. Now granted, there are cases that induction is medically necessary and for these special cases, I am completely thankful. Without induction these women would be subjected to cesarean sections instead of labor inductions which could in turn be even more hard on their body, and experience over all.
What we do not understand with the induction of labor is, we are creating unnaturally strong contractions in attempt to simulate something similar to natural labor. As someone who has experienced pitocin labor, and natural labor, I would take a million natural contractions over being on the receiving end of pitocin again. The comparison in my opinion is not even in the same ball park. Another issue with these contractions as most know, is the fact that they are more likely to cause fetal distress on the baby because they are not natural contractions or what normal contractions are supposed to be. So in turn we are putting our children under unnecessary stress. Especially if they are not ready to come and join us in “our world” yet. Again something I learned with my first.
Then we have the provider who comes in and looks at the fetal heart monitoring and says, “Oh No! Your baby is in danger!!” So off to the operating room we go for an “emergency” cesarean which in reality was caused by the pitocin to begin with. You would think by this point there would be a bit of common sense in the Obstetric community to say, ya know, I think we are causing these actions instead of blaming the increasing cesarean rate on “patient choice cesareans” which only make up 3% at most of the incredibly high cesarean rate in our country.

But a cesarean is only one path that this induction cascade can lead to. There are still women out there that will have a vaginal delivery when subjected to a labor induction, but in turn these women have greater risks for other procedures including episiotomies which have all in all been proven to really have little to no benefit to women in the long run. While episiotomy rates are starting to decrease, they are still over used in many communities. For example, here in my state of Connecticut, some hospitals have an over 25% episiotomy rate, when science tells us there really shouldn’t be over 10%. Trying to obtain these numbers are like pulling teeth too FYI!

We also have vaccum extraction. I had never really discussed this or spoken with someone who experienced this until I met my Chiropractor in the summer of 2008. He was discussing with me why Chiropractic care in infants is important, and then he described his own daughters birth, they had applied the vaccum to the top of her head, and while “assisting” her out, they pulled so hard the vaccum literally flew right off of her head. My Chiropractor described it so vividly… “I thought her HEAD popped RIGHT OFF! I was horrified to even look!”? My heart broke for him because no parent should have to go through that kind of fright during the birth of their child!

These all often lead to epidurals, which especially if you are going to have a cesarean section, you will either have this or a spinal block. All types of anesthesia that will have a direct impact on the baby. Although I have experienced women told there will be no effects on their baby at all.
I am sure most know about the “breast crawl” and I can say after watching a baby who’s mother did have an epidural, as opposed to a mom who had a natural birth, there is no comparing the instincts of the baby. While I had epidurals with both of my children, I didn’t have the opportunity to breastfeed then until they were a little over an hour old. My first was almost 2 hours. For more information on epidural effects on babies, click this link!

The last thing I want to touch on is the separation of mother and baby after a cesarean section which is very common. It is pretty uncommon for an newborn to be allowed to stay in the OR with mom, although it does happen sometimes. I can really related to the lack of bonding, breastfeeding problems, and reduced bonding because of this because I deeply experienced this with the births of both of my children. While I bonded, it was not that “instant motherly love” I am sure most feel. It hurts me to this day to know that my bonding was an almost learned bonding because I knew as a mother it was something I needed to do in order to protect my babies.? While most women who have had cesarean sections are not quick to admit this, I think by discussing this and acknowledging that this is a true problem it will only help to improve it for others in the long run. I also noticed that mothers who do experience this may be ashamed or fearful to admit this because it make portray them in a less than perfect light, or maybe others may look down on them because of this, but they should not be ashamed. It happens and there is nothing we can do about it but help other women to not go through what we did!

Be empowered by your birth, no matter how you birth!
If it is a bad experience, help to educate others so they do not go through what you did, so they can avoid the pain or heartache you have dealt with!

Labor Begins On Its Own

The first healthy birth practice is simple enough - let labor start on its own.? This means no meddling around.? You don’t need to tinker with a process that’s ultimately perfect for the vast majority of women.? Your baby’s brain grows so much in the last few weeks of pregnancy - why lose that?? Why risk induction?? Here are some ways to avoid induction:

• Don’t whine about being uncomfortable to your doctor or midwife.? That’s what you do to strangers, your family and your girlfriends.? Your practitioner might just put you out of your misery (and theirs).
• Just say no to late pregnancy vaginal exams.? Sure it might tell you how far your are dilated (or not), but you also risk breaking your water, infection and the like - not to mention who enjoys vaginal exams?
• Don’t answer your phone or except pressure from email.
• Do not be swayed by false promises of fast labors or easy starts like stripping the membranes.

What would you add to this list?

Be sure to check out the advice from Lamaze on the Healthy Birth Practice #1: Let Labor Begin on its Own.? You should also see the materials provided at Mothers Advocate, including a really great, but short video.

ACOG Revises Induction Protocol

The American College of Obstetricians and Gynecologists (ACOG) has issues a press release saying that there is a revision to it’s labor induction guidelines. The basics from the press release do not look very different from what I had heard from ACOG before, so I’ll have to wait to have the paper in my hands. Here are some basics from the press release:

• Wait until 39 weeks or do fetal lung maturity testing
• Use cervical ripening before full blown labor induction
• Do not use Cytotek on someone with one prior cesarean
• Induction reasons may be for physical reasons with mom or baby or other reasons that are reasonable, like distance from hospital in a rural area
• There are risks to induction
• There are some reasons induction is not an option (placental, fetal position, etc.)

What are your thoughts on labor induction? One thing that jumped to my mind was that they said labor induction had doubled since 1990 and that now 1 in 5 women were induced. That number sounded really low to me.