Hospitals Cracking Down on Inductions

I am sure I am not the only one who said “FINALLY” when I read this, and I am sure it is going to piss of a ton of people along the way too. I have noticed many excuses which were not of a medical nature for inductions, from “My husband is going to be away on business” or “My husband is going to be home on R&R” or “My family will only be in town on X,Y,Z day”. God, what did we all do before elective inductions?

Now, before I go on, I myself was induced with my first child for medical reasons. In the last weeks of my pregnancy I became sick, and started losing weight drastically to the point that I lost almost all of the weight I gained during my pregnancy in the period of 3 weeks.
With that being said, I experienced the most horrid experience of my life, so I guess you can say I am slightly biased. First of all, induced contractions are hell compared to natural contractions when you go into labor on your own. I will take spontaneous labor over anything, any day of the week. And second, my son was not ready to come. I realize this now, and I wish that I had known more before his birth because I am positive I would have never landed in the situation I did. But I digress, everything happens for a reason, and if it wasn’t for my experience with his pregnancy and birth, I would not be involved with ICAN on all the levels that I am.

Yesterday MSNBC ran an article detailing how regulators are going to be introducing guidelines for non medical inductions to help curb premature babies. The March of Dimes has addressed this, as well as elective cesarean sections before 39 weeks gestation also. As an authority in premature births, I believe people should really consider listening to what they have to say. Even with ACOG backing up what MOD’s has to say, you still have crappy OB’s delivering babies via elective cesarean WAY to early and increasing the risk factors of these children having problems later on in life, as well as NICU stays.
It is no secret that cesarean born babies are more likely to have a stay in the NICU, heck my second child, who was healthy, perfect, I went into labor on my own, he was ready, still had to spend a period of time in the NICU because he was delivered via cesarean, and that caused complications in him. It is a fact, it is not a speculation.

But back to these induction guidelines.

“Induced labor is on the rise for lots of reasons, some medical and some not. But recent research shows a troubling link between elective inductions and these so-called “late preemies.” These aren’t the dire too-small babies that the word premature conjures, but near-term babies who nonetheless are at higher risk of breathing disorders and other problems than babies who finish their very last weeks in the womb.”

Which is something that the birth community has been speaking out against, as well as highlighting for quite some time. What has finally lit a fire under the ass of these doctors? Is it the possibility of health care reform? Is it the possibility of suit? The NICU costs that are not being paid in full by insurance companies negotiating how much they will pay?

“New guidelines will require that a mother’s cervix be nearly ready for natural labor, and limit the hospital beds available for elective inductions.

More hospitals are expected to start enforcing that criteria this spring, when the Joint Commission that regulates health quality will require hospitals to report all elective deliveries and the gestational age to its public database, providing peer pressure for improvement. Hospitals also will have to report cesareans for first-time mothers, too often a result of a failed induction.”

I believe that the above is how it always should have been, but unfortunately for many mothers who choose OB/GYN’s just because that is what everyone else does, they may end up with a Doctor who has something what I like to call ‘The God Complex” meaning, they think they are God, and can control when babies are born, and how they come. With no medical reason, inductions should not be happening until at least after the “EDD” or “guess date” of a pregnancy.

Now do not get me wrong, I am all about choice, and moms having choices, but I do not believe in choices that halt the growth of vital organs, put your child at risk for respiratory distress, or other complications just because you are sick of being pregnant. With my last pregnancy, I was SICK of being pregnant for TWO months before he actually came, but I didn’t run off and schedule a cesarean to get it over with.
Pregnancy is not comfortable, it is not a walk in the park, and the end of pregnancy downright SUCKS. But that is to prepare us for the less than desirable side of motherhood. There is nothing fun, or glamorous of catching your child’s vomit in your hands, or getting peed on. But it happens more than we would like it to!

“1 in 4 inductions were before 39 weeks
National guidelines from the American College of Obstetricians and Gynecologists have long discouraged elective deliveries before the 39th week of pregnancy. But some hospitals that took a close look were surprised. At Utah’s Intermountain Healthcare, for example, 28 percent of elective deliveries were breaking ACOG’s rule in 2001, Oshiro told a March of Dimes meeting on preventable prematurity this month.”

When have Doctors followed ACOG’s rules all the time?
I have noticed a trend when it comes to ACOG’s Guidelines (NOT RULES) and delivery. OB/GYN’s only use their guidelines when it suits their own agenda, when it does not fit into their plan or what they want, they throw ACOG’s guidelines right out the window. Perfect examples of this is the above situation, and the Joy Szabo VBAC denial story at Page Hospital in Arizona. These hospitals, and Doctors are picking and choosing what to follow.

“Most were being induced in week 37, such a small difference that local obstetricians argued it wasn’t a problem. So Oshiro pulled the medical charts and found those near-term babies had more than double the risk of ending up in neonatal ICU, suffering respiratory distress, even needing a ventilator.”

With the inaccuracy of estimated due dates, any Doctor that is inducing a labor in the 37th week of pregnancy when a “full term” pregnancy is 40-42 weeks gestation should have their ethics and practices questioned. What is the reason for inducing a labor at 37 weeks gestation, because as cited in this article, these are not medically necessary inductions being looked at.

“1 in 5 new moms induced
Labor is induced in more than one in five births, double the rate in 1990, according to the Centers for Disease Control and Prevention. Many cases are for clear health reasons, such as a problem with the fetus or a sick mom or a pregnancy that has dragged well beyond the woman’s due date.”

My question with this statement coming from the CDC is in 1990 this rate was half of what it was today, what has happened to Women over the past 20 years to make them so sick that they need to be induced at DOUBLE the rate? It simply does not make sense. Either women are becoming deathly ill at hig
her rates, or these are not medically necessary inductions, and they are being masked as necessary.

“Patient and doctor preference helped drive the rise in inductions, such as women timing grandma’s arrival to take care of the siblings, or minimizing 3 a.m. deliveries. Then there’s defensive medicine, where doctors worried about litigation induce for minor reasons like a slight uptick of the mother’s blood pressure.”

I am really glad that this was also added into this article because it showcases the convenience factor of Doctors. Limiting 3am deliveries… Of course, because Dr. Jeckyl doesn’t want to be ripped from bed at 3am to come deliver Betty J’s baby. Well if your sleep and social life are that important to you, clearly Obstetrics was not the right career choice.
Then there is defensive medicine, which some people do not even think exists at all. (Total crock) What would happen if the doctors practicing defensive medicine were sued for the unnecessary inductions, cesareans, or invasive medical procedures during pregnancy, and birth? Would they stop? Would cesarean sections go back to only when necessary and lifesaving? Would inductions go back to only for medical reasons? The way babies are being born, and the maternity care system today as a whole is nothing more than a God Complex Doctor run JOKE!

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