Birth Comes Naturally - Part I

Birth Comes Naturally - Part I

  Autor Oana Melinte Moraru, certified Lamaze Educator Data: 19.09.2006


Birth Comes Naturally - Part I

A pregnant woman attending Lamaze courses said to other students: "My doctor says my baby is big enough. My neighbor had induced labor because it was thought that her baby will "be too big". Do you think I should also ask my induction of labor?" Such statements are often heard during prenatal education classes.

Induction
Artificial initiation of labor is one of the most controversial topics in today's maternity. In many hospitals, labor is induced for medical reasons only, and strict guidelines are followed.

However, in many hospitals, women have elective induction, done for convenience, rather than medical reasons. There are problems with the induction of labor? What are the benefits of allowing labor to start by itself?

Nature's Plan for Birth
During the last weeks of pregnancy, both mother and baby's body prepare for birth. For mothers having their first baby, the baby often falls into the pelvis with approximately 14 days before delivery. The cervix is heading towards the exit and gradually begins to soften.

Over a period of several weeks, a mother may (or may not) feel irregular contractions that help your cervix to thin and maybe even dilate a few centimeters. During the last period of pregnancy your baby's lungs mature and a protective layer of fat deposits on it, taking the appearance of roundness of the new-born.

Many researchers believe that when the baby is ready for life outside its mother's uterus, his body releases small amounts of hormones that signal to maternal hormones the initiation of labor. In most cases, only when both mother and baby's bodies are ready, maternal hormones begin the complex process of birth.

How is labor induced?

Most often, labor is induced in the hospital by taking a drug called Pitocina through an intra-venous infusion (IV). Sometimes there are used before agents for wetting the cervix and for preparing it for labor.

Medical reasons for inducing labor

There are a number of medical indications (reasons) for induction of labor. According to the American College of Obstetricians and Gynecologists (CAOG), labor should be induced only when it is more risky that the baby stays in the womb than to be born. This is true:

  • When water bag around the baby breaks and labor does not start;
  • When mother's pregnancy arrived at 42 weeks;
  • When the mother's blood pressure is too high;
  • When the mother has other health problems such as diabetes or pulmonary disease that can affect the baby;
  • When the mother has a uterine infection.

Suspicion of a large or very large baby is not a medical reason for induction. In a press article published in November 2002 CAOG reports that labor induction for macrosomia (large baby) almost doubled the cesarean birth rate without improving perinatal outcomes (healthy baby).

Several previous studies have also shown that induction for macrosomia rather increases than decreases the rate of cesarean birth, without providing improvements of baby's health. In the professional journal Evaluation of Cesarean Birth, published by CAOG, the authors make recommendations against the induction of labor in healthy women giving birth to big babies, concluding that "induction of labor for suspected macrosomia [large baby], do not make any result improvements, using considerable resources and may result to the increase of the rate of cesarean birth".

Induction for convenience
Induction is sometimes considered to be convenient for those involved. Hospitals can supplement the nursing staff when they are scheduled for induction; doctors can schedule births for days and times that are convenient, and future parents can work and can make travel plans with relatives according to the date scheduled for induction.

However, elective induction is not convenient when routine hospital delays the start of induction. It is not convenient when it does not work and the pregnant woman is sent home, being scheduled for another time. And certainly, it is not convenient when it involves a cesarean birth and the new mother needs to recover from a major surgery, rather than after a normal birth.

End of Part I




Read the English version of this article: Birth Comes Naturally - Part I