In the final weeks and days of pregnancy most women feel tired, impatient and very ready to meet their baby. The waiting time may be emotional and challenging as you edge closer and closer to the moment when labour begins but when that moment will actually be remains an unknown – a mystery – and you simply have to wait. You may also feel the pressure to have an induction if your baby has not arrived by 41 weeks.
An induction may seem like an appealing and easy choice, however induction can be “like playing with fire, and many women do end up getting burnt. The problem with an induction is that women often end up on the ‘cascade of intervention’ – a road that many women regret taking, as the final outcome is often not the birth they wanted or desired.” writes Gabrielle Targett, birth educator, doula and author.
An induction brings risks as well as benefits and it is wise to be aware of the full picture before making any decisions. An induction changes labour from a natural process to a medically managed one, requiring increased monitoring. Further medical assistance is more likely once you begin an induction because of these risks, including an increased chance of a caesarean birth. A caesarean is the usual recommendation if the induction fails, so when you choose an induction you need to be aware that you are agreeing to a possible caesarean if your baby is not born within a safe timeframe, (this timeframe will be determined by your doctor or hospital, although you may be able to have input into this).
As a guideline, it makes sense to choose an induction when the risks of waiting have become greater than the risks of an induction and all that might follow. Ask questions and share openly and honestly your concerns and thoughts with your midwife and doctor. Ideally, you will have been able to choose the most suitable carers and place of birth in the beginning and by the time you are 37+ weeks into your pregnancy you will have a relationship of trust, respect and open communication.
If you need to, seek a second opinion. It is not too late to hire a doula for extra support or even to change place or birth and care providers if you do not feel supported and heard.
If you do need an induction, it helps to know that you are making the best choice for your unique circumstances. You may find some people will question your need for an induction, offer their advice and anecdotes, or make little of an induced birth when it may have been an enormous decision for you. You may feel sad or disappointed that your wishes for birth are no longer possible.
Read up on induction and understand the process, the possible complications and what you can do to counter these or manage them. Explore the options that may be possible (but not always offered) like turning down the artificial oxcytocin once labour is established, intermittent monitoring or using a water proof doppler so you can move more easily or labour in the shower where the warm water may help with the intensity of the contractions. If you are not able to use the shower, make use of heat packs or warmed wash clothes on your back or belly. Ask your supporter to help you breathe deeply, but not to not hyperventilate, so you can consciously keep your baby oxygenated – a lack of oxygen is one of the increased risks an induced baby faces.
A positive birth depends on the way you feel and the way you are cared for more than anything else. So gather your supporters and surround yourself with strong, encouraging and loving people. Approach your new plan for birth with as much optimism as your old plan. If it has turned out you and your baby need a different path to birth, there is no shame or failure in being wise enough and flexible enough to recognise this. You can choose to handle this change in plans beautifully and you will soon be holding your baby in your arms!
For more information on induction visit Midwife Thinking – induction