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The Waiting Game
When it comes to choosing a birthday, baby knows best.
By Debby Amis, RN, BSN, CD(DONA), LCCE, FACCE
Patience is truly a virtue after 9 long months, especially when you’re a few weeks or days from your due date. The swollen feet, extra pounds and late-night bathroom trips can take their toll. Wouldn’t it be easier to just schedule your baby’s birth and get the show on the road?
Elective induction offers the satisfaction of knowing your baby’s birth date in advance, but it might not go as planned. Sometimes women scheduled for induction are bumped from the hospital agenda because the staff is busy. Plus, induction doubles your risk of cesarean birth. The major risk of elective induction is that your baby may not be ready to be born. Experts agree that a normal pregnancy lasts between 38 and 42 weeks, and research indicates that the baby actually initiates the labor process. Once his lungs are fully mature, he releases a protein that tells his mother’s body that it’s time. A baby born even a few weeks early is at an increased risk for breathing problems, admission to special-care nurseries and breastfeeding difficulties.
INDUCTIONS & INTERVENTIONS
An induction usually requires more interventions than a normal birth. You will need IV fluids and continuous electronic fetal monitoring, making you less mobile. Also, artificial contractions may peak sooner and be more intense than natural ones. You are therefore more likely to request an epidural, which increases your chances of needing forceps or vacuum assistance, developing a fever and/or requiring a cesarean section. Plus, the most common medication used for induction (Pitocin) interferes with the release of hormones that promote normal birth and breastfeeding.
Because of these risks, some hospitals do not offer or limit elective inductions. “It seems that, if we are too cavalier about inducing labor for the convenience of either the mother or the provider, we are ignoring the baby’s essential contribution and asking him to participate even when he is not ready,” says Biddy Fein, CNM, who attends births at Brigham and Women’s Hospital in Boston. “We accept this as necessary when the risks of continuing pregnancy outweigh the benefits. But in all other circumstances, we should be respectful of nature’s plan for the initiation of labor and the exquisite interplay between mother and baby.”
BABY MAKES THE DATE
If there are valid medical reasons for labor induction, your health-care provider will weigh the benefits of immediate delivery versus continuing the pregnancy for the health of your baby. But if you are like the majority of women who do not have reasons for induction, the safest option for you and your baby is to wait for labor to begin on its own. Your baby may decide to come on his due date (although less than
10 percent of babies do), but you may want to plan for a later date in case your pregnancy does extend to 42 weeks.
If your pregnancy lasts longer than expected, try not to worry. Continue normal activities and remember that you are giving your baby the best start by allowing him to decide when he is ready to make his grand entrance into the world.
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