Induction, or no induction, that is the question

I have just been reading some threads in local facebook groups, and also in a national forum where women were being asked for opinions about the information given before and during the induction process.

It made for very sad reading. There was post after post about the bad experiences women had suffered. There were different issues that came up in the various birth stories and comments, but there was one common theme…..that the vast majority of women had not been provided with sufficient information to make such an important decision. That they hadn’t been given the full picture, that they felt let down and frustrated in a system that doesn’t treat women as individuals. Most of them didn’t have the knowledge to cope with the intensity of induced labour and felt like they had failed.

Induction isn’t the bad guy
Now I want to make it clear from the outset that I am not against induction at all. When needed it can save lives. And more importantly, induction can be a positive experience (more about that in a minute) BUT the rates of induction are rising rapidly (1 in 3 births are now induced), as are the number of women suffering from birth trauma, so it is vital that women are aware of the issues and that they have sufficient education and knowledge to make INFORMED DECISIONS (something I bang on about all the time!). Induction isn’t the only option.

So what are the issues surrounding induction?
The issues surrounding the increasing intervention rates are complex and there is no black or white answer to any of this, but what we do know is that the rise in intervention is not leading to better outcomes for mums and babies, and the World Health Organisation is trying to reduce intervention rates back down to what has been agreed as the optimum level.
We know that induction can increase the risks of other interventions which is one of the main pieces of information women are not told about.

And most importantly, there are often other options which many women aren’t even told about.

Why induce?
There are a few reasons why induction may be suggested, here are some of them.

Going past your estimated due date
If your waters break before labour starts
If your baby is suspected to be large
If you have gestational diabetes
If you are pregnant with twins
If you are classed as an older first time mother

There may be other situations as well and each different reason requires in depth discussion and investigation. I don’t have time to be able to do that in this blog, and your decision must be based on your personal circumstances so I recommend booking an appointment with your consultant, or a consultant midwife, to find out all the information you need to make an informed decision. I will focus on the most common reason for induction which is going past your estimated due date.

What do you mean by informed decision
It means you need to find out the benefits of having the induction (for both you and baby) alongside the benefits of any alternatives. The same for risks of induction vs risks of any alternative. What all the alternatives are. And don’t be rushed into making a decision. Most cases of induction are not emergencies so there should be no reason why you can’t take another day to think about, discuss it with people around you, do your own research and don’t be afraid to ask for a second opinion if you feel you aren’t getting all the answers you need, or if you feel you aren’t being supported in your decision.

Overdue?
One of the most common reasons induction is recommended is because a woman has gone ‘overdue’ (to understand why I use quotation marks please read 'the ridiculous origins of your due date'), you should be told about your other options at that stage….mainly that you can choose not to be induced. You can take a wait and see approach and have additional monitoring. You can take it day by day. Women are often treated like a ticking time bomb once their pregnancy reaches 41/42 weeks which is so ridiculous. Our body doesn’t suddenly stop working properly once we get to 42 weeks. And who can measure exactly when 42 weeks is anyway. Maybe your cycle was longer than average. Maybe you ovulated later than usual. A scan can not 100% accurately predict the day your baby was conceived, and even if it could, all babies and mothers are different and we won’t all grow our babies to the exact same gestation.

Where can I get information to help me with my decision?
You can read reliable, unbiased information at Evidence Based Birth
And the best place to get support and advice is AIMS (association for improvements in maternity services)
I also have a variety of books published by AIMS that contain valuable information and advice and these are available to borrow.

I think induction is right for me, how can I make it a positive experience?
See my top tips for a positive induction.
I work with all my clients to help them navigate their options, to gather all the information they need, and to help them understand how to have a positive induction.