There are a few reasons doctors are very commonly using (of which are very rare and unlikely complications) in order to get women to concede to induction. Among the most common are:
- Going past 41 weeks gestation
- Fetal Macrosomia (Baby suspected to be too big for vaginal delivery)
- Breech babies are too dangerous to deliver vaginally
- Presence of Meconium
Going Past 41 Weeks
The first thing doctors fail to remember is that the due date is "estimated." It is not an expiration date. A baby is considered "term" or mature if it is born between 38 and 42 weeks gestation. 40 weeks in and of itself is not a magic number. It's just a midpoint. A due date should rather be expressed more accurately as a "due month."
The Wall Street Journal covers the growing shift to keep babies growing until at least 39 weeks if possible. They tell the story of one mom whose attempts to have her baby before her husband was deployed (at 37 weeks) resulted in years of respiratory problems for their son.
"According to the National Institute of Child Health and Human Development, infants born at 37 to 38 weeks face problems with brain development and function, including psychological, behavioral and emotional problems."
http://online.wsj.com/article/SB10001424052748704615504576172291331227676.html
This is another great article that discusses why 41 weeks is not reason enough to warrant induction.
“…it is uncertain that routine induction at 41 weeks will reduce the number of fetuses who die, and it is arguable that such practice could increase perinatal mortality and morbidity.”
“Approximately one-quarter of pregnant women have not laboured by 41 weeks. Their stillbirth rate in the subsequent week without fetal surveillance is approximately 1 in 1000. Routine induction at 41 weeks is ritual induction at term, unsupported by rational evidence of benefit. It is unacceptable, illogical and unsupportable interference with a normal physiologic situation.”
Read the full article with much more great information here: http://www.glorialemay.com/blog/?p=83
Fetal Macrosomia
Ultrasound Diagnosis of Fetal Macrosomia Found Inaccurate:
Just because a doctor says the ultrasound baby is too big doesn’t mean a c-section is necessary. In fact, it means nothing. In most cases (this does not include cases of gestational diabetes), a healthy mom can deliver a large baby if her body grew it!
And unfortunately, many doctors tend to overestimate the predicted size of the baby, once again, for their convenience.
http://www.familypracticenews.com/news/more-top-news/single-view/ultrasound-diagnosis-of-fetal-macrosomia-found-inaccurate/36fa34152d.html
Breech Babies
This one hits close to home with me. Towards the end of my fourth pregnancy, my obstetrician (or one of them) told me out of the blue at an appointment that the baby was breech. He said he was feeling baby's butt down there at the bottom. At the next week's appointment, he said the same thing. A week later, I went in because I was feeling sick. Apparently, I was in labor and they admitted me to the hospital. They were scheduling a cesarean for me. After having 3 vaginal deliveries without medication, this broke my heart.
Fortunately, a different obstetrician was on duty that day. She decided to do an ultrasound just to double check. Turns out--the baby was not breech. Either God performed a miracle while I walked from the clinic's parking lot to the hospital that day (which I believe in miracles, don't get me wrong) or the first doctor was wrong. Very wrong. So my advice is to first make sure the baby's breech through the use of an ultrasound!
If the baby still appears to be breech and it is immediately before labor (because remember--babies can turn!), check out this article.
C-Section NOT Best for Breech Birth
Breech Babies Are Another Variation of Normal
This very concise article describes various breech positions, as well as suggested safe practices to attempt baby to turn, and recommended resources for moms with breech babies.
Meconium
Some things every pregnant woman MUST know in case there's meconium in her water before or during delivery. The methods taken in hospitals as a result of the appearance of meconium unfortunately often causes baby to breathe in more meconium-stained fluid. Too bad docs don't know this. . . :(
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