To induce or not to induce, that is the question

Induction is a word that all of you pregnant or postpartum people have heard before. In today's birth culture, getting induced is incredibly common, with roughly 21% of births in Canada being either medically or surgically induced (according to the Canadian Perinatal Health Report from 2005). As a birth doula and childbirth educator, I am oh-so-familiar with induction. It also helps that the birth of my first child was induced! So as someone who knows how inductions feel and has seen them happen, I wish for every parent to understand what really constitutes a necessary induction. In today's post, I'm going to talk about what an induction really is, when they should happen and when they shouldn't, and how you can navigate the health care system so you don't experience one of these bad boys unless it's truly needed!

Inductions don't just happen with your care provider

Theres a saying that's very common in the world that us doulas reside in, and that's "baby will come when baby is ready". The only way to guarantee your baby comes before they are ready is by heading into the hospital for medically-necessary synthetic oxytocin... and even this has not brought on labour before! However, attempting any form of induction, both "natural" and not, before your baby and body are ready does have consequences. Things like PROM (premature rupture of the membranes), infections, prodomal labour, etc. can all be a result of trying to jump the gun. Many birthing people believe that things that are considered more natural, like castor oil and nipple stimulation, are safe regardless of when they are performed because they don't involve western medicine. It's very important to remember that EVERYTHING that could potentially bring you into labour earlier than it was meant to start is an induction and has risk. Always speak to your care provider and obtain the lastest evidence-based information on any of these natural methods before attempting them.

Humans do not all gestate for 40 weeks

Shocker! Babies don't have a time stamp, and I don't even really like the term "due date". Many of us doulas like to refer to it as "guess date" because honestly, it's a total crap shoot! What we need to remember is that research has shown that BABY initiates labour. Once their last bit of necessary development has completed, its Baby that sends signals to your brain to start producing oxytocin and get things going. I can't tell you how common it is for birthers to be told "if you haven't had your baby by our next appointment, we'll schedule an induction for (insert date here)" at their 39 week appointment. But whyyyyy? Sometimes there's a good reason, like blood pressure issues, or there may be risks in going too far along like with gestational diabetes, but in a lot of cases this is more out of convenience. Waiting until labour starts on its own can seem excruciating when you're overdue and anxious - and unfortunately society doesn't make it any easier (I've heard the "you STILL haven't had your baby yet?" more times than I'd like to remember). But trust me when I say, the beautiful cocktail of hormones that your body will produce when you go into labour on your own time is soooo worth it.

A "Big Baby" is not a reason to be induced

Macrosomic babies are babies that are born at over 4000g. So how can you determine if your baby is going to be big? Well actually, you can't! Palpating the uterus and measuring the fundal height can give you a rough idea and ultrasounds are about 45% effective in guessing baby's weight, but there is absolutely no completely accurate way to measure the size of your baby until they are born. And really, so what if you've got a chunky monkey growing in there? People deliver big babies every. single. day. If you truly understand the physiology of how babies are born, you'll know that a baby's size doesn't matter. Things like fetal position, pelvic shape and genetics will impact whether or not you're able to birth your baby vaginally, but these are all things you have very little control over. Embrace those extra pounds on your sweet bundle and let them cook for as long as they want!

Don't want to be induced? Then say no!

While we are all very lucky to be birthing in a time in history where it is very safe to give birth, when birth moved into hospitals and under the guidance of doctors the unfortunate side effects are things like medical coercion, white coat syndrome and not obtaining full, informed consent. While I understand that some care providers may make it hard to steer away from their preferences for your birth, you have every right to say no to anything and everything you don't want - including induction. Now, this doesn't mean that you get to take a shot in the dark or flip a coin, these decisions you make must come from an educated stand point. If you do your homework, you'll realize that inductions do carry a lot of risk, and only in certain situations do the benefits outweigh the risks. However, you'll need to have factual information to bring to your care provider if you want to refuse the induction date they've suggested for you - you owe it to yourself and your baby to have the opportunity for true, informed consent.

Have you ever been induced? Have you been offered an induction when it was or wasn't necessary? Feel free to share your induction stories with me!