Natural Induction Of Labor

Whatever Happened to Natural Childbirth?

The pregnant woman I interviewed for this story state they're too worried to undergo natural childbirth. Their doctors told them everything that could go wrong so they are simply scheduling their epidurals—or worse yet, C-sections—and foregoing the idea of a a natural method. "I don't intend to feel one contraction," said 32-year-old Shelly. "Why should I?" Suzanne Arms, a leading childbirth educator and founder of Birthing the Future international campaign, agrees that medicalized childbirth does have its place when it comes to life-saving techniques. "Hospitals, physician care, safer surgical techniques, technology and pharmaceuticals do have roles to play in childbirth," she says. "And at least 10%-20% of women across the world would prefer to, or may benefit from, what these potentially life-saving advancements have to offer them and their baby. However, to have the public believe that all birthing women and babies must birth in a hospital in order to be safe, is a dangerous misconception and makes poor use of resources." "What makes birth safe is, first, having a mother and baby enter labor in good health and the woman in a positive frame of mind. Healthy childbearing is primarily a function of public health and is directly related to the status and empowerment of women, not to obstetrics: having clean water, safe housing, adequate nutrition, knowledge of how their body, pregnancy and birth, work. The same hormones that govern healthy sexual response govern labor and birth. Naturally-secreted oxytocin (unlike the artificial form called Pitocin that's used to start or speed up 60% of U.S. births), keeps contractions effective and promotes the woman falling deeply in love with her baby and becoming a fiercely protective, yet calm, mother." Suzanne led a conference in the Canary Islands this spring which attracted childbirth educators, mother-child bond researchers, and an international group of midwifery experts from over 17 nations. She believes that the role of midwives, to support the woman and protect the process and the mother-baby, which requires patience and presence, and the safeguarding of privacy so the mother's body can work effectively. However, the training of physicians is to look for potential problems, which tends to overtreat anything that might lead to a complication, and the treatment itself often begets more drugs, technology and surgery. It's the orientation that beckons problems in many cases.

Natural Labor Is Best – A Doctor Speaks out Against Elective ...

A woman needs an induction if for some reason her baby is telling us he needs to get out, which means there’s something like a problem with fetal growth or amniotic fluid volume. She also may need one if she has a disease, like pregnancy-induced hypertension, and for her well-being, the baby needs to get out.  The other type of labor induction, which is the most common — and the most controversial — is post-term induction. Most will define post-term as 41 weeks and three days, and say if pregnancy extends beyond that, it’s time for the baby to come out.

Misleading data The post-term induction mindset is based on a large study and another meta-analysis that have come to the conclusion that if you do an induction for prolonged pregnancy, you won’t increase the c-section rate. But any sensible practitioner knows that isn’t true, despite what the research says. I believe these trials have validity where they took place but don’t actually approximate real life, so they don’t have external validity. And because of that, you get a lot of misinformation, which doesn’t apply to real life. In our hospital, for women having their first baby and who labor on their own, the c-section rate is 8 percent. If they’re induced, it’s 44 percent. And that’s not a subtle difference.

Expectant management An alternative strategy is an approach called expectant management in which you wait for the woman to go into labor. While you wait, you keep asking the baby how he’s doing by looking at the amniotic fluid and taking non-stress tests. If the baby keeps saying he’s okay, you carry on until 42 weeks, when induction is really required. In the meantime, if the woman’s cervix isn’t favorable and the baby isn’t in a good position but you induce because of the calendar, you’re inviting in a c-section, because you’ll have a failed induction. But really, the only thing that’s failed is your clinical judgment because you shouldn’t have done the induction in the first place. Yes, it’s a good idea to use a cervical ripening agent, but recent studies show that even if you do that, the c-section rate will still be higher.

Anxiety over stillbirths With labor induction and the increased risk of c-section, you’re creating large problems and making all sorts of extra interventions necessary. A medical induction with oxytocin requires an intravenous and continuous electronic fetal monitoring; the woman is now considered high-risk, and over-stimulation of the uterus with oxytocin or even induction by cervical agents can cause more fetal problems than if she were in spontaneous labor. And she’s now stuck in bed, which leads to abnormal labor progress and makes her more likely to have a c-section. She’s also more likely to require an epidural, which gives effective pain relief but causes a need for more oxytocin, so labor will be prolonged by three to four hours. And if the epidural is given too early, it can cause abnormal fetal positions, leading to more painful back labor. The epidural also decreases her ability to push, so she’s more likely to need vacuum extraction and forceps, there’s more perineal trauma, and again, a c-section is more likely. Induction changes everything.

Mothering Magazine's Having a Baby, Naturally, The Mothering Magazine Guide to Pregnancy and Childbirth

If you are working with a midwife, she may suggest natural induction methods to you as your due date approaches. These approaches are likely to get labor ...

Induction of labor

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Encyclopedia of Family Health

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Pharmacology for Women's Health

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