The holidays are here!
Family comes and goes!
Your client is in her “due zone”.
Your client begins asking about being induced so she can enjoy
the holidays.
What will you say to her?
In our profession, we read nearly every day about the
cautions that need to be taken with
Here are some suggestions to helping your client:
- Your body is built to grow this baby and knows when the baby is read to leave the protection of the womb. Trust your body.
- A large amount of brain growth and development happens during the last weeks of pregnancy.
- As a mother-to-be, your job is growing a happy and healthy baby. Just this once, select someone else to do the job of hostess.
- Delegate the jobs you need to do this holiday season. Enjoy being pampered, especially now!
About the Research
This section is more for the professional. Knowing the background and rationale of
advising against an elective induction of labor can help add to the tips listed
above.
According to the Clinical Guide from the AHRQ (Agency for
Healthcare and Quality www.ahrq.gov), among
women undergoing induction, women with their first pregnancies have a higher
rate of cesarean delivery than women with prior vaginal births. This means that instead of having an
induction and going home in a few days to enjoy the holidays, mothers often
stay longer and have a much longer and somewhat more painful recovery. The AHRQ goes on the say that a potential
harm of elective induction of labor is unexpected prematurity.
The Association of Women’s Health Obstetrics and NeonatalNurses (AWHONN) has also issued a statement cautioning elective induction of
labor stating that induced labor is associated with an increased risk of hemorrhage
when compared to spontaneous labor. This
risk factor alone is responsible for an increased risk of blood transfusion,
hysterectomy, longer hospital stay, more hospital re-admissions and cesarean
survery. For infants, AWHONN states that
induction can result in more fetal stress, respiratory illness, separation from
the mother, interrupted bonding and less breastfeeding.
In 2013, the American College of Obstetricians and
Gynecologists and the Society for Maternal-Fetal Medicine reemphasized their
position against deliveries before 39 weeks, unless there is a valid medical
indication. In their statement titled “Early
Deliveries without medical Indications: Just Say No”, ACOG and SMFM urged
members to reduce the number of nonmedically indicated early-term births and
improve newborn outcomes. Their patientFAQ restates many research findings in laymen’s terms. Other organizations such as the American
Academy of Family Physicians, the American Academy of Pediatrics and The JointCommission, a US based organization that accredits more than 20,000 health care
organizations and sets standards for care, concur.
And most recently, in the December 2015 issue of Obstetrics and Gynecology, research shows that the cesarean delivery rate in the early induction group
(with a Bishop score of 5 or less), was 30.5% vs the expectant management group
of 17.7%. This demonstrates that while
elective inductions are done, the outcomes may not be what the expectant mother
(or her family) anticipated.
It can truly be difficult for some expectant women to see
past their own need for control of the pregnancy and the holidays. With a compassionate and non-judgemental
attitude, we should present the information in many forms and then allow the “informed
decision making” process to take effect.
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