Induction: The Root of All Evil

The bible talks about the love of money being the root of all evil, but the more I learn about maternity care in the US, the more I think that in obstetrics, the root of all evil is actually labor induction.
Daily Life In Afghan Maternity Hospital - Kabul
How

Generally induction is started with the drugs pitocin or cytotec or some other kind of prostaglandin.  There are plenty of "natural" ways to induce too.  I always find it slightly riduclious for somebody devoted to the natural process to try to "naturally" induce themselves - but maybe I am a purist.

Anybody who has ever had both an induced labor and a naturally occuring one can tell you that a natural labor is generally much less painful, more comfortable, and easier to handle.

Why

There are seemingly countless reasons for a woman to be induced, big baby, small baby, toxemia, convenience (for her or her care provider) past due, and so on and so on.  It seems to me that a doctor who really wants to induce can find a "medical" reason if he wants too.

Sadly, all these add up to many inductions, probably far far more than are acutually necessary, more epidurals, more horriable birth stories, more c-sections, and more fear of birth.

And - if you manage to avoid the induction, good luck trying to avoid induction agents to "speed" up your labor.  They are so widely used that most hospitals today seem to see most every mom getting pitocin at some point in her labor.  If I never hear the phrase "I was handling my labor fine until they started the pit..." again it will be too soon.

 (When I interviewed nurses at the two closest hospitals to me in N Texas, they both had induction rates over 90% - and c-section rates 45% or higher- I think this is pretty accurate in many parts of the country but it varies everywhere I go.  ACOG claims that only about 20% of labors are induced which I find absolutely laughable.)

What Happens to You

Should you choose to be induced know this- even if you avoid pain medications your labor will no longer be natural.  In nature, labor starts when the baby is ready to be born, in an induction, it starts when your doctor says it does, probably on a Tuesday.

You will have continious fetal monitoring and all that goes along with it (restricted movement, ultrasound exposure, and people staring at your printout instead of you).

You will have an IV and all that goes along with that, namely, restriction of movement.

You will labor in the hospital if on pitocin, rather than in the comfort of your home.

You will be taking drugs into your system for which little or no research on their effect on the human fetus has been done.

Than Again.... Maybe Induction Isn't the Problem

When I started this I was thinking of how I really believe that induction is one of the great evils in obstetrics today.  So many of the horror stories that I hear about birth start with an induction or the introduction of a labor induction agent into a naturally occuring labor.

But when I think about, why are all these inductions REALLY happening?  Could it be because of money?  The money that can be saved when you know exactly how to staff a hospital because most of your labors occour between 9 and 5 Monday through Friday?  Could it have something to do with the fact that women who are induced almost NEED pain relief that costs 1000's of dollars for each one of them?  Could the encouragment that doctors get for induction have anything to do with the increase in c-sections they see after the induction (and the increased profits that go along with a c-section rather than a vaginal birth)?  Might hospitals be OK with induction rates because they know that they will have NICU's full of tiny babies that have difficulty breathing and need to stay longer, be given oxygen, tests and drugs to stay alive?

Maybe the Bible was right, the love of money is indeed the root of all evil, even in obstetrics.

Comments

I think I agree with you Sarah! Great post!
Sarah C said…
Thanks- I think I sounded kind of intense!
Froddy1 said…
I gave birth twice after being induced. Both times my waters had broken but two days later no other signs of labour had occurred. I was told infection could set in due to the ruptured membranes. I'm sceptical about this but I'm not a doctor, you take the advice you're given. I actually think you're right, it's more about the predictability, the ability to be able to staff the maternity unit. But then I have some sympathy for this too, staff need to be predicted so the emergencies can be attended to to the best of the hospitals ability. Life's not perfect, we do the best we can with what resources we have. If my babies were in dire trouble at birth I'd hope that the staff would be there to save them if it came to that. I'm happy with my lot, both my boys were born healthy and in safe hands. We were given time to allow skin to skin and the natural journey from lying on my tummy to feeding at the breast. And for this I did not pay a penny, I'm from the UK where healthcare and maternity care is free to all. It's not a perfect system, it has many critics, cost saving rather than profits drive maternity decisions but induction rates are hight here too. Go figure...
happy.mama said…
Yeah 20% my ass. If that's true, then I know every single one of them.
Unknown said…
I can attest to the vileness of induction. But mine was for pprom. And it was my second birth first was at home. But let me tell you I didn't let IV, monitoring or anything stop me from moving. My favorite escape was the bathroom I got unhooked except for the iv!