Sunday, February 14, 2010

On Inductions

It's time for another rant as I am now 40 weeks and 3 days along, and there is very little action from my uterus. Well, there's still a great deal of action in my uterus (thank goodness), but not much from said bag of muscles.

I am scheduled to be induced on the 17th if this baby doesn't come spontaneously before then, and the closer that date comes the more I'm slightly wishing I could run and hide in a desert or something. I do not want to have to be induced again (though my previous inductions were for medical, not "due date" reasons).

I hate obstetrics in America. Despite the fact that the average gestational age is just short of 42 weeks, and I've known moms expecting their 8th child who've carried them that long, my uniquely natural-oriented practice of midwives still has pressure to induce me just before I hit 41 weeks. It's just ridiculous! Why do they have to rush our babies out with Pitocin when our bodies could literally be a day or two from naturally delivering?

Yes, I know I've delivered naturally with Pitocin, but it was no walk in the park. Also, I've sometime analyzed the decision the midwives made to blast me through the labor the way they did. I mean, when we decided to induce, the plan was to start me on Pitocin, and then once my contractions really got underway (remember, I was starting at 5 centimeters) the Pitocin was to be shut off to allow my body to labor naturally. Unfortunately, once the Pit started, my son's heart-rate seemed to get a little messier. I have a sister-in-law whose baby didn't love the Pitocin in her induction, and so they shut off the Pit and used a different induction method (some kind of balloon thing against the cervix).

In my case, however, they just decided to up the Pitocin levels until it was full blast for most of the labor. It made for a short but very difficult labor. I guess the big difference between my induction and my sister-in-law's induction was that my baby started with variables in the heart-rate, and her baby was simply "overdue." Oh well! All's well that ends well, I guess.

That doesn't make me more excited about the prospect of another induction or about the practice of doctors and midwives to set expiration dates on pregnancies. In my opinion, as long as the baby is doing well, Mom should be allowed to ride out the pregnancy unless she doesn't want to.

Since I love stories, here are three stories that illustrate why I'm afraid of Pitocin and would prefer not to have another induction with it - one happy story and two... not so happy stories. I have a friend who recently had a VBAC, and what a blessing it was that she could have a VBAC! It was her third pregnancy, and in her second pregnancy she had placenta previa, which makes a cesarean medically necessary for the safety of Mom and Baby. In her third pregnancy, she was informed that if she wanted to deliver vaginally, she would have to spontaneously begin labor before the "expiration date" (probably set at 41 weeks minus a day), because she was required to birth her baby by that date, and they could not induce her with Pitocin.

Now let's examine that last statement: They could not induce her with Pitocin. Why was that? Now, considering a VBAC is a perfectly reasonable possibility for most women, and yet a Pitocin induction is not, could this be an indicator that Pitocin is not a perfect replica of the body's natural oxytocin? Is it an indication that a constant drip of contraction inducing hormone might be tough on someone's body? Is it possible that Pitocin could overdue it on the uterus and is not a completely safe option at all times? I think so. Well, these risks are completely known (and they stand for non-VBAC contenders as well), and yet Pitocin is used all of the time to induce and augment labor.

The good news is this mom did go into spontaneous labor just before the set expiration date, and she was able to deliver vaginally. What a blessing it was for her! (Though she ended up having some other health problems soon after, but that's another story and one that I don't think was actually related to the VBAC. I'll have to look it up though...)

Here's story #2: I have a friend who has three children but was never able to deliver vaginally? Well, I have a few friends like this, but this one had this experience for the most interesting reason - her babies "never dropped." In other words, her doctors set an expiration date on her pregnancy, and she never delivered spontaneously before the expiration date. So they attempted to induce her with Pitocin, and because the the cervix was not ripe and there was not sufficient dilation, they had to deliver her babies via cesarean - all three pregnancies!! Yikes!!! Can you hear me screaming at the top of my lungs at this?

What I am totally convinced about this situation is that my friend's babies wanted to gestate a little longer than the average baby. They were probably good solid 42-weekers, but their mom was never given the chance to carry them to their full gestational age. They were not facing distress requiring induction, either, nor were they particularly huge babies. They just weren't allowed the come when they wanted to come.

Here's story #3. Are you ready? A friend of mine has a sister overseas whose bag of waters leaked with her second baby. She went to the hospital after some time, and the law required that she be allowed to wait awhile longer before they induced with Pitocin. (I think having a waiting period is smart, by the way. Waiting usually works for labor to start, though I guess that sitting in a hospital bed might make it a little useless, but I digress...) The labor didn't start spontaneously, so they induced her with Pitocin. Shortly after the delivery of the baby, who was fine, they became concerned about Mom's bleeding. They checked out the condition of the uterus, and it was practically in shreds. After having just two children (when the couple had planned on more), Mom was given a hysterectomy.

I haven't done the research on this last one, but here's my only slightly educated theory. I think they inadvertently overdid it on her uterus with the Pitocin.

What are the potential dangers of Pitocin? Babycenter gives a pretty bland explanation that Pitocin sometimes overdoes it on the uterus and on the baby. Birthing naturally has a decent breakdown on some of the risks, which include uterine rupture and fetal distress as well. And finally, this article from Associated Content actually mentions potential links between the increase in cases of autism in recent decades in congruence with the increased use of Pitocin to induce or augment labor. I'm not saying they're linked, but it's an interesting thought.

I think that the fact that, once a woman is given Pitocin, she automatically has to receive continuous (not intermittent) fetal monitoring is an obvious indication that the drug is not without risks. And yet, tons of my friends are induced with most of their labors, and they look forward to it.

I'm not saying that Pitocin should go away. It helped me get my last son here safely, and it gave me a fantastically tight tummy afterward with minimal post-partum bleeding. :) It's just a shame that medical providers aren't more cautious about their use of Pitocin, and women would do well to educate themselves about the drug before embracing it whole-heartedly.

So I need to get going with the walks, pineapple, accupressure, or whatever else it takes to have this baby soon. I have just three days if I'm to avoid another encounter with Mr. Pit. Please pray for me and my little one!

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