Sunday, February 26, 2012

Inductions & Due Dates: Things to think about for the women of San Luis Obispo!

Listen to Ina May Gaskin, master midwife, author and recipient of the Right Livelyhood Award, shares her wisdom about  induction and due dates.

Convenience Masquerading as Risk: Have you ever thought about induction from the doctors' and hospitals' management perspective? 

~ Marsden Wagner, MD "Induction of labor is an important convenience not only for obstetricians but also for hospitals, as it allows hospitals to organize an induction assembly line, with slots into which doctors can fit their patients."

Let's face it, spontaneous labor is inconvenient in lots of ways; from doctors’ sleep, time off and office hours interrupted, to hospital staffing, room availability, and work flow. This was made blindingly clear to me years ago. I had a doula client who was between 41 and 42 weeks pregnant. At her prenatal visit her Certified Nurse Midwife told her how dangerous it was for her to continue simply waiting for spontaneous labor to start. After a long discussion and lots of pressure the pregnant mother gave in and agreed to be induced. The midwife went to call the in San Luis Obispo hospital to schedule the induction for later that day. When she came back into the room she said there were no rooms at the hospital, so my client couldn't be induced that day. She said she was scheduling her for 3 days later. Why? Because we were there on a Friday and it wasn't convenient to induce her on the week-end!

My thoughts: What happened to the danger? If there were no rooms for an induction what were they going to do with women who spontaneously came into the hospital that day in labor? To schedule an induction means having enough nurses to cover the more time and labor intensive work of an un-natural, drug driven labor so perhaps it wasn't room but staffing that was the problem? I was angry, as was my client, and so grateful to be given a reprieve to go home to Grover Beach. We worked hard on creating the elements she needed to go into labor spontaneously and were rewarded with a spontaneous, un-medicated vaginal birth before Monday.

Due Dates~Inductions~Cesarean Sections: making the connections

Dr. Marsden Wagner's "Born in the USA"
"Now we are in big trouble, because forty-one weeks is entirely within normal pregnancy limits, and when we start inducing at forty-one weeks, we put large numbers of normal pregnancies at risk with an unnecessary procedure. At this point we have a situation in which the treatment is worse than the disease." 

Connecting the dots: This book was published in 2006. When I was pregnant with my son in 1990 my nurse midwife told me to EXPECT to go to 42 weeks, that this was NORMAL for first time mothers. Over the last 2 decades this assumption of 42 weeks as being normal has been replaced with an ever increasing fear based medical perspective for each day that the mother goes past 40 weeks. Perhaps it is just a coincidence that since 1990 the national cesarean rate has been climbing every year until reaching a rate of a whopping 32%! I don't think Dr. Wagner thinks it is just a coincidence. Do you? Compare my cesarean rates to our local hospitals in San Luis Obispo, Templeton and Santa Maria.

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