This blog is inspired by a conversation I had with a mom a couple of days ago. She said that she had been induced 8 times in a 24 hour period! When her labor did not pick up as expected, she was given the option of getting induced again the next day after a few hours rest. Being mentally and physically exhausted, she chose to go in for an elective C-Section ( I think I would have probably have done the same, were I to be faced with similar circumstances).
Induction of labor is very common, yet women seem to be very misinformed (or not informed at all) about what it involves, or what is done to them during induction, the cascade effects of trying any form of induction, and the likely consequences and risks involved. When the risks involved in continuing the pregnancy are more than the risks involved in induction, this could be an option. But, once the process of induction starts, there is very little you can do to back out of it; usually you are committed to getting the baby out one way or another – in many cases by an otherwise unnecessary C- Section, since C- Section is usually recommended after a “failed induction”. Today, induction rates – and so, by corollary, C-Section rates – are increasing world-wide. A 2006 study in the New England Journal of Medicine of 5500 low-risk first-time mothers, reported that 40% of the women were induced into labor and 70% received Pitocin at some point during labor. Dr. Marsden Wagner writes in his book “Born in the USA – How a Broken Maternity System must be fixed to put Women & Children First” … “it is ridiculous to think that nearly 60% of American women have such lousy uteruses that they must be whipped into shape with drugs in order to have babies”!! We do not have good data about induction rates in India, but to the casual observer of any obstetric practice in urban India, they look remarkably high.
Now, why are we taking about “Induction” in the same breath as other increased interventions and C-Sections? In a study published in the July 2010 issue of the journal Obstetrics and Gynecology found that among 7800 women giving birth for the first time, those whose labor was induced were twice as likely to have a C-Section, than those who started their labors spontaneously. Doesn’t it make sense to let labor begin on its own?
So, what has medicalizing birth done? Here is an article written in the British Medical Journal that talks about the impact on maternal and fetal well-being due to the over-medicalization of birth. This article was written almost 10 years ago, and since then the C-Section rates have been increasing dramatically in the US. Here is an article highlighting this problem in the US. Again, good data is hard to come by in India; and anecdotally and through personal communications we know that the C-Section rates in many private urban and sub-urban hospitals ranges from 75-85%.
So, what is truly behind the rising C-Section rates?? Here is a wonderful short video in which Professor of Boston School of Public Health, Eugene Declerq debunks the myths surrounding the increased Cesarean rates.
So, before you commit to anything, please be sure to ask questions – Informed parents do have more fulfilling births. Do your research. Choose your care-provider carefully. Remember: Obstetricians are experts in surgical birth. Midwives are experts in normal natural birth. Both are specialists in their particular area. Think about this – if you do not want surgery, should your primary care provider at birth be a surgeon??