Written by: Viviane Schima, Executive Contributor
Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.
The winter holiday season is upon us and babies, unfortunately, didn’t get the memo. The Winter holiday season means family gatherings, celebrations, and bundling up underneath a blanket with some hot cocoa and a book. Well, most of the time. It also means inductions skyrocket at this time of year. If you’re wondering whether this is a typo, it isn't. You read that right.
The American College of Obstetricians and Gynaecologists says that “more than 22% of all gravid (pregnant) women undergo induction of labor in the United States, and the overall rate of induction of labor in the United States has more than doubled since 1990 to 225 per 1,000 live births in 2006." Of course, natural variations in birth dates exist, but one might ponder the question: does a planned and deliberate pattern occur, given the fact that hardly any babies are born during the major winter holidays?
What is an Induction of Labor?
An induction might seem like a quick, pain-free medical intervention that shortens a mother’s labor and the time she spends in childbirth. However, the reality is rather different. An induction of labor can be long and complicated with its fair share of unpleasant side effects for you and your baby. (Discussed in detail in section: The 39-Week Milestone) There are different methods of inducing labor and some don’t require medications, like a membrane sweep, which involves the mechanical loosening of the amniotic sac through the cervix. Ingesting castor oil is another medication-free method, which causes cervical stimulation by increasing the production of prostaglandins. Nonetheless, inductions that involve medications such as Cytotec, Cervidil, and Pitocin are much more popular and it’s something a mother is more likely to encounter at the suggestion of her obstetrician. Regardless of the method of induction, two goals have to be met to achieve the desired outcome: the ripening of the cervix and the onset of contractions. This is why timing is crucial and why serious side effects may occur if induction is done too early. However, no matter what induction method is used, a mother should be closely monitored by her obstetrician or a midwife.
The Convenience of Modern Medicine
Not many care providers wish to wander the hospital halls during Thanksgiving dinner time or on Christmas morning. While this is understandable, it is also important to emphasize that babies do not have a set schedule and they, certainly, do not abide by the one we have been following for centuries. However, for this exact reason,a mother can feel pressure and increased tension from her maternity care provider to move things along. Her doctor may even suggest an early labor induction. It happens too often that when a mother whose pregnancy is without any complications but whose due date is around the major winter holidays might, all of a sudden, receive a concerning statement from her doctor about her baby’s head measuring too big. Induction is, therefore, introduced to the discussion and highly suggested. However, this is not a medically valid reason to induce labor. This is how mothers are commonly treated in today’s prenatal care: ever-changing statements by the attending doctor or simply the lack of clear guidance. This isn’t to say that all medical providers practice medicine in the same manner. It is therefore paramount to find a maternity care provider that aligns with your values; one that you trust and feel secure and safe with.
What About the Turkey?
We have to take the mother’s point of view into consideration as well. Not all mothers wish to spend their holidays in the hospital with the “skeleton” holiday staff or leave the uncooked turkey on the table for the cat to eat while birthing the baby. Nevertheless, it is of utmost importance that mothers-to-be are told the information they need in order to make an informed decision on whether to induce or not. Knowing when it is safe to induce labor and knowing the valid reasons for induction is half the battle. One rising issue to mention here is that mothers-to-be might be feeling under pressure and cornered when their maternity care provider is suggesting induction earlier than 39 weeks. Because of this, The American Congress of Obstetricians and Gynecologists (ACOG) has just recently redefined the meaning of “term pregnancy” which offers a little more leeway in categorizing “post-term babies.” The ACOG now recommends that elective induction of labor should not occur before 39 weeks of gestation. This is in response to current research evidence showing decreased fetal outcomes in induced labor and a doubled risk of cesarean section.
The Catch With Due Dates
There are always two sides to everything and due dates are no exceptions. Due dates are determined by “Naegele’s rule,” which locates the first day of a woman’s last menstrual period, adds one year, subtracts three months, and adds seven days to the final date. The result equals approximately 40 weeks from the woman’s last menstrual period. The reason to mention this is to pinpoint and demystify the one reason for induction that isn’t backed up by evidence – that is, being overdue. Only 4-5% of babies are born on their due dates. A few days past one’s due date is not considered post-term and, therefore, is not considered a medically valid reason to induce labor.
The 39-Week Milestone
We know by now that due dates are far less reliable than we’d like them to be. Sometimes it’s hard to pinpoint when exactly you got pregnant. Even with an ultrasound, a due date can be off by as much as two weeks and if you’re scheduled for an induction, there is a chance that your baby might be born too early. This can lead to complications that no one signed up for. So why does a baby need to spend 39 weeks in the womb?
Important organs, like the baby’s brain, lungs, and liver, need time to develop. The brain goes through a rapid growth spurt towards the end of the pregnancy. To imagine just how massive this growth spurt is, a baby’s brain weighs only two-thirds at 35 weeks of pregnancy of what it will weigh at 39 to 40 weeks.
Babies that are given the needed time in the womb have also a better suck-and-swallow reflex and because of this, they have a much higher chance of breastfeeding successfully and without assistance.
The secret to learning efficientlyand without major difficulties can also be backtracked to when the baby was in the womb and was given at least 39 weeks.
After all, nature designed a low-risk pregnancy to last for 40 weeks so we can birth strong and healthy babies. Take some time away from this and we might end up getting something we didn’t sign up for – that is, unnecessary complications.
The Importance of a Doula
The stigma around doulas and midwives is still very much present. Doulas alongside midwives were completely banished from the practice in the 1800s because the male supporters of medicine thought they were channeling black magic and using occultism to help birth babies. This, of course, couldn’t be further from the truth but the comeback took its time.
Even today, the word doula invokes an image of a woman living in the woods, chanting incantations over a fire, and mixing herbs of all kinds in a ritualistic form. We can’t, of course, forget the dreadlocks and spare clothes that only underline and compliment their strange behavior.
Doulas are, in fact, highly educated, go through in-depthtraining, and are here to empower you. Furthermore, they act as your emotional, mental, spiritual, and physical anchors during pregnancy, childbirth, and in the postpartum period.
A doula’s presence can make all the difference. A carefully chosen support team is paramount to a positive birthing experience.
In other words, doulas matter.
A Winter Holiday Call-to-Action
I ask all mamas-to-be that after you’re done doing your research for the day, to do some more on the next. And don't hesitate to call up a doula when you get lost in the vast land of biased, medically unsupported, and confusing studies and “facts”.
You deserve someone who will research for you, who will teach you how to be a better advocate for yourself and your baby, who will help sound the trumpets of ever-lasting motherhood, and who will give you the absolute best chance at your best birth experience.
Viviane Schima, Executive Contributor Brainz Magazine
Viviane Schima is a Newborn Care & Breastfeeding specialist, founder of The AH-mazing, Pain-Free Birth Formula™, Mama Coach and a podcast host. As a certified Lactation Consultant & Doula, Viviane uses her expert knowledge and more than ten years of experience to provide mothers with the support they need and the results they want. She believes that making informed decisions creates a path to empowerment and owning your choices. For Viviane, this empowerment journey begins with preconception, to the moment of conception, and beyond. Viviane is an enthusiastic advocate of breastfeeding, low intervention births and “skin-to-skin” contact after birth. “Creating a strong and healthy community starts at home."
