induction and C-section

Hello,

My due date is in 4 days (july 23rd) and today my OB wanted to set up a
induction date for next week. I told him that I would prefer to wait as much
as possible because I really don't want to increase the risk of having
C-section. He told me that after 39 weeks, the risk of C-section is the same
with or without induction whereas the risk of having a stillbirth is
multiplied by three after the first week overdue and by 12 after the the
second... He also told me that the believe that induced birth lead to more
C-sections is based on old studies where they were using induction methods
that are not as efficient than nowadays. Is this true?

My pregnancy up to now went very well, both the baby and I are completly
healthy. The baby dropped and I'm one to two cm dilated for 3 or 4 weeks
now. My next appointment is the 27th. Should I plan a induction the same
week or wait one more week?

Thanks
Anne

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"Anne" fazbeta at free dot fr wrote
My pregnancy up to now went very well, both the baby and I are completly
healthy. The baby dropped and I'm one to two cm dilated for 3 or 4 weeks
now. My next appointment is the 27th. Should I plan a induction the same
week or wait one more week?

Thanks
Anne



I was induced with a Pitocin IV when my water broke a week before my due
date and contractions/labor did not start. I am not a doctor and I don't
even play one, but my personal opinion is that if everything's ok I would
wait at least a week past my due date before considering induction, IF
nothing was wrong etc. My midwife also told me that if you are induced when
your body is not ready, THAT is when you are more likely to end up having a
c-section, but she didn't give a time frame such as 39 weeks- she just
specified it depends on how ready your cervix is etc.

Even so, my water broke naturally, but I was induced because labor did not
start, and I came very close to having a c-section because the baby got
stuck at my pubic bone and wouldn't come out without assistance (a forceps
delivery ended up being succesful). I was admanatly against having a
c-section unless it was absolutely the final option and was truly necessary.
I was terrified of the surgery.

So this is only my opinion......an opinion...there is no way to guarantee
you won't end up having a c-section, and you could have a c-section if you
DO wait, and you could be induced and everything go fine...but IMO, I would
wait a week, labor may be very likely to start in the week after your due
date naturally. An induction can cuase contactions to come harder and closer
together- it did for me. I will be honest- I wasn't against inductions
before I had one. I had asked about having one around my due date if I
didn't go in labor, for convenience, just so as not to go past due. When I
ended up with my waters breaking a week early, I was not against an
induction although I did ask about the increased c-section risk. But having
been through it, I would DEFINITELY not want to be induced at all next time.
Even though mine ended up being ok, no c-section, etc, it was long and
painful labor.

Just my opinion. I have a friend who was induced for convenience on her due
date and everything went quickly and pain-free for her, no complications.
But I seem to hear about more who end up with more pain, longer labors,
c-sections etc.
Jill

Anne wrote:

He told me that after 39 weeks, the risk of C-section is the same
with or without induction whereas the risk of having a stillbirth is
multiplied by three after the first week overdue and by 12 after the the
second...

That's rubbish. The standard of care in a low-risk pregnancy is not to do
anything at all differently until the woman appears to be at risk of going over
*42* weeks, which is what is *really* considered "prolonged pregnancy" or being
"postdates". Those who go for inductions earlier than that, absent any other
medical reason (which you haven't got, sounds like), are very often just doing
it for their own convenience.

See http://www.obgyn.net/displayarticle....s/postdates_pg .

There is some evidence that first-time moms tend to average longer anyway (41
weeks), though as I recall that difference goes away if the pregnancy is very
accurately dated (e.g., a reliable record of a definite conception date, early
ultrasounds).

The overwhelming likelihood is that you'll go into labor on your own just fine,
well before there is any increased danger at all.

--Helen

Anne wrote:
My due date is in 4 days (july 23rd) and today my OB wanted to set
up a induction date for next week. I told him that I would prefer
to wait as much as possible because I really don't want to increase
the risk of having C-section. He told me that after 39 weeks, the
risk of C-section is the same with or without induction whereas the
risk of having a stillbirth is multiplied by three after the first
week overdue and by 12 after the the second...

That's an wildly inflated statistic. From everything I've seen, the prenatal
death rate at term goes from 1 in 1,000 from 37-42 weeks to 2 in 1,000
*after* 42 weeks. As far as I know, there is no difference in the prenatal
death rate per pregnancy is exactly the same until after the 42 week mark.
Now, I suppose that the longer your pregnancy continues, the more likely you
are statistically to be in the 1 in 1,000 who loses a baby to prenatal death
(because, logically, anyone who delivered before you did at 39 weeks can't
be in the 1 in 1,000 who loses a baby at 40 weeks), but that's not a good
reason for inducing everyone's labor at 39 weeks! If it were, why wouldn't
we induce everyone at 38 weeks, or even 37? The earlier you birth a live
fetus, the lower your risk of stillbirth, but realistically, the risk of
stillbirth is so small statistically that it's hardly worth the risks of
earlier induction (including that you might miscalculate and wind up giving
birth to a premature infant).

He also told me that
the believe that induced birth lead to more C-sections is based on
old studies where they were using induction methods that are not as
efficient than nowadays. Is this true?

Every study I have ever seen (including recent ones) shows that there is a
higher risk of c-section if labor is induced before 41 weeks than if it is
induced afterwards, at least for nulliparas (the risk is lower for
multiparas). Between 41 and 42 weeks, the success rate for inductions
actually is a bit higher than the success rate for inductions after 42
weeks, oddly enough.

Personally, there is no way anyone will *ever* convince me that inductions
don't lead to unnecessary c-sections. Of course, part of the problem is that
too many caregivers induce labor in women who are clearly not ready for
labor (low Bishop's scores), but even with that population factored out, I
cannot believe that inducing labor before the body is ready can do anything
but lead to more c-sections. In addition, the c-section rate is already a
monumental 25% or so (1 in 4); given that, it's probably somewhat difficult
to ferret out the amount of risk that's added by induction when there are so
many other risk factors in perfectly normal, spontaneous labors.

My pregnancy up to now went very well, both the baby and I are
completly healthy. The baby dropped and I'm one to two cm dilated
for 3 or 4 weeks now. My next appointment is the 27th. Should I
plan a induction the same week or wait one more week?

I was in your shoes when I was pregnant with my first. I consented to
induction at 41w4d (without any advice from this worthy group; I'd surely
have declined had I been better educated) and, while I wound up with a
normal vaginal delivery, I also had an IV, epidural, episiotomy, and vacuum
extraction (all things I'd hoped to avoid). In retrospect, I should have
waited it out until at least 42 weeks; he'd have come on his own eventually.
I was fortunate in that I had a good Bishop's score and thus was a good
candidate for induction and I thank my OB for that. But I hated the process
so much that when I was pregnant with my third and had high BP (no
pre-eclampsia), I fought induction for a full five weeks because I was so
terrified of another pitocin induction. In the end, I was induced
successfully by simply breaking my waters at 40w2d, but really, I'd rather
have sharp sticks shoved under my fingernails than face pitocin again.

I guess what I'd telling you is that I would *certainly* turn down induction
before 42 weeks and might well wait beyond 42 weeks if there were no signs
of fetal distress or maternal health problems.
--
Be well, Barbara
Mom to Sin (Vernon, 2), Misery (Aurora, 5), and the Rising Son (Julian, 6)

This week's suggested Bush/Cheney campaign bumper sticker:
"Leave no billionaire behind."

All opinions expressed in this post are well-reasoned and insightful.
Needless to say, they are not those of my Internet Service Provider, its
other subscribers or lackeys. Anyone who says otherwise is itchin' for a
fight. -- with apologies to Michael Feldman

If you ask your doctor to show you the studies that back up his statistics, he
won't be able to, because they are a crock of sh**.

There is NO REASON to even think about induction now. And believe me, all risk
of a section aside, you don't want to be induced if you can avoid it. It's
much more painful and carries with it a risk of rupture, among other things.

Wait a week, then ask for a NST if he starts to push for induction.


Leslie

Emily (2/4/91)
Jake (1/27/94)
Teddy (2/15/95)
William (3/5/01 -- VBA3C, 13 lbs. 5 oz.)
and Lorelei, expected 11/2/04

"Children come trailing clouds of glory from God, which is their home."
~ William Wordsworth

"Anne" fazbeta at free dot fr wrote in message
...
Hello,

My due date is in 4 days (july 23rd) and today my OB wanted to set up a
induction date for next week. I told him that I would prefer to wait as
much
as possible because I really don't want to increase the risk of having
C-section. He told me that after 39 weeks, the risk of C-section is the
same
with or without induction whereas the risk of having a stillbirth is
multiplied by three after the first week overdue and by 12 after the the
second...

Bull****.

The study that showed that is about 30-40 years old. More recent studies
show only a very slight increase in the 43rd week (after you get to 42 weeks
pg) and another slight increase at 44 weeks. THEN it can climb steeper. The
study most OB's use to justify induction was done at a time where even their
death rate at 40 weeks would be considered completely unacceptable today.

There's an article in Midwifery Today a year or two ago that deals with
this... aha! http://www.midwiferytoday.com/Magazine/issue63.asp Issue 63's
article "Induction and Circular Logic" would be the one. Gail Hart looks at
the various research studies and examines the whole induction issue.

As for "more effective methods"... if he's talking about Cytotec, you've got
some reading to do.

Jenrose

"Anne" fazbeta at free dot fr wrote in message
...
Hello,

My due date is in 4 days (july 23rd) and today my OB wanted to set up
a
induction date for next week. I told him that I would prefer to wait
as much
as possible because I really don't want to increase the risk of having
C-section. He told me that after 39 weeks, the risk of C-section is
the same
with or without induction whereas the risk of having a stillbirth is
multiplied by three after the first week overdue and by 12 after the
the
second... He also told me that the believe that induced birth lead to
more
C-sections is based on old studies where they were using induction
methods
that are not as efficient than nowadays. Is this true?

Your doctor is wrong, or, even worse, deliberately misinforming you for
his own convenience. Your "due date" is not actually *a* day, it is a
*range* of days two weeks either side of your due date. They give you
the date in the middle as a matter of convenience, because it is the
average. So, you will NOT be overdue until TWO WEEKS after your due
date.

Using threats like 'stillbirth' to get a first time mother to schedule
an induction is a form of emotional blackmail and I think it says very
poor things about the ethics of your dr. That being said, I consented
to an induction at 41 weeks with my first child and, after 17 hours of
pitocin hell, finally consented to a c-section just to make the labor
stop. Before the pitocin, they had applied a gel to my cervix to soften
it. It did *nothing* to my cervix. The whole thing was a failure from
go to whoa. It was the worst experience of my life, apart from the
getting-a-baby part, which was very good. Anyway, I would never consent
to an induction again unless they hooked up the epidural at the same
time they hooked up the pitocin IV. Pitocin is *awful*.

I know one anecdote isn't really evidence, but it's at least more
factual than what your dr. is telling you. Only agree to the induction
if you are also comfortable with the idea that your labor will end with
a section.

eggs.

"eggs" wrote in message
...

"Anne" fazbeta at free dot fr wrote in message
...
Hello,

My due date is in 4 days (july 23rd) and today my OB wanted to set up
a
induction date for next week. I told him that I would prefer to wait
as much
as possible because I really don't want to increase the risk of having
C-section. He told me that after 39 weeks, the risk of C-section is
the same
with or without induction whereas the risk of having a stillbirth is
multiplied by three after the first week overdue and by 12 after the
the
second... He also told me that the believe that induced birth lead to
more
C-sections is based on old studies where they were using induction
methods
that are not as efficient than nowadays. Is this true?

Your doctor is wrong, or, even worse, deliberately misinforming you for
his own convenience. Your "due date" is not actually *a* day, it is a
*range* of days two weeks either side of your due date. They give you
the date in the middle as a matter of convenience, because it is the
average. So, you will NOT be overdue until TWO WEEKS after your due
date.

Using threats like 'stillbirth' to get a first time mother to schedule
an induction is a form of emotional blackmail and I think it says very
poor things about the ethics of your dr.

It's called "playing the dead baby card". It's intended to manipulate and
control you. And look how well it's working?

As for the 'more efficient methods today', the only thing they can do
differently today that I know of, is to use Misoprostol (cytotec). Go to
google.com and look it up. Please. For god's sake. Don't let anyone,
*anyone*, get this stuff near you. Your body will be perfectly efficient
when it's ready. Chemically manipulating it simply because of a date on a
calendar.....which by the way your body hasn't read....seems like very bad
medicine.

Frankly, if I were you, I might even consider changing doctors (or to a
midwife). Yes, now. It's not too late. You already know this guy will play
the dead baby card to manipulate you when you're well-rested, well-fed, and
in your right mind. What will he do when you're in the throes of labor,
having had no rest for hours, and no food either? Who will protect you from
him and his agenda? What fear tactics will he use to manipulate you into
things you don't need, don't want...?

--angela

"Circe"
The earlier you birth a live
fetus, the lower your risk of stillbirth, but realistically, the risk of
stillbirth is so small statistically that it's hardly worth the risks of
earlier induction (including that you might miscalculate and wind up
giving
birth to a premature infant).

I thought that too...

Every study I have ever seen (including recent ones) shows that there is a
higher risk of c-section if labor is induced before 41 weeks than if it is
induced afterwards, at least for nulliparas (the risk is lower for
multiparas). Between 41 and 42 weeks, the success rate for inductions
actually is a bit higher than the success rate for inductions after 42
weeks, oddly enough.

That's what I heard too. Maybe it is because after 42 weeks babies tends to
be too big to be delivered vaginally...

I guess what I'd telling you is that I would *certainly* turn down
induction
before 42 weeks and might well wait beyond 42 weeks if there were no signs
of fetal distress or maternal health problems.

Thank you for your testimony and advice, I think I'll wait as much as
reasonable...
Anne

"Leslie"
If you ask your doctor to show you the studies that back up his
statistics, he
won't be able to, because they are a crock of sh**.

There is NO REASON to even think about induction now. And believe me, all
risk
of a section aside, you don't want to be induced if you can avoid it.
It's
much more painful and carries with it a risk of rupture, among other
things.

Wait a week, then ask for a NST if he starts to push for induction.

Thanks Leslie, that's what I'll do!
Anne