What does this mean? It generally means that the doctor feels that your pregnancy has gone long enough. To induce a mother into labor it is wise to have a very, very good reason. So what is the reason? Here are some common ones.
Reason #1- To avoid a stillbirth.
The rationale is that by the time a woman has reached 41 weeks gestation, the chances of a stillbirth are increased. Really? Jennifer Block, a former editor at Ms. Magazine wanted to get to the bottom of some of these procedures and if they had any evidence-based science behind them. She found some very interesting things. In the end, after interviewing OB/GYNs, midwives and childbirth advocates she wrote the book, “Pushed: The Painful Truth About Childbirth and Modern Maternity Care,” in 2007. She learned that studies show that odds of having a stillbirth in general are 1 in 1,000. After 41 weeks, the odds increased to 5 in 1000. Does this merit being induced?
Reason #2- The Fetus is Getting Too Big
How do they judge this? Often it is by ultrasound. In late stages of pregnancy, ultrasounds can miscalculate the fetal weight either too much or too little by about 15%. This is according to Evidence Based Birth. Physicians may claim that the shoulders might get ‘stuck’, termed ‘shoulder dystocia.’ Rebecca Dekker, PhD, RN, APRN, author in Evidence Based Birth states, “Do I need to have an induction if they suspect a big baby? Not necessarily. A very early induction (at 37-38 weeks) may lower the chance of shoulder dystocia from 7% to 4% but researchers have not shown early induction to have any impact on nerve injuries or NICU admissions that could be associated with shoulder dystocia. Induction may increase the risk that you have a severe tear, and it may also increase the risk that your baby will need treatment for jaundice” (Dekker, 2016).
“What is the risk of difficulty with the birth of their shoulders? The vast majority of these cases are handled successfully by the care provider with no harmful consequences to the baby. Permanent nerve injuries due to stuck shoulders happen in 1 out of every 555 babies who weigh between 8 lbs, 13 oz. and 9 lb. 15 oz.” (Dekker, 2016). Does this risk justify inducing labor?
Are There Drawbacks to My Care Provider Suspecting a Big Baby?
Yes. Rebecca Dekker points out that many studies have shown that the “suspicion” of a big baby typically increases the risk of Cesarean without improving the health of the mother or the baby. Since half of the time this prediction is wrong, it might be a good idea to ask your care provider what their routine procedure is for suspected big babies. You could also ask if your care provider trains regularly on how to manage shoulder dystocia outside of a cesarean delivery.
Hurricane Charley in 2004
Let me share a story from “Pushed…”, by Jennifer Block. She interviewed some labor and delivery nurses in Florida who helped staff their hospital during the hurricane, Charley. It was decided that the hospital would only take patients who were truly in labor and not schedule any inductions. The doctors opted to let nature take its course and not take an ‘active management’ (interventions) with the labors. The nurses found that the women still delivered but the deliveries were very smooth. After that week, the hospital went back to their old style of ‘active management’ with their patients, despite the protests of the nurses. By the end of the year, 5 of 6 nurses quit. They now knew a better way.
In closing, have an inquisitive mind in the care of your pregnancy and birth options. This is your baby, your body. Decisions that are made could impact you for years. Realize that you have the final say. Getting outside opinions could be worthwhile. Add to that, Read, Read, Read.