Feed on
Being born is hard enough. We need to give our babies the best chances possible.

Being born is hard enough. We need to give our babies the best chance possible.

I’ve written about it before: Both my kids were a week late. And both times my midwives and the doctors they worked with were pressuring me to induce. (Well, the second midwife not-so-much, but she did say she had to induce if I went past that weekend.) One high risk doctor told me he would have induced Keira, my youngest, at 37 weeks. If he had, she would have been classified a late preterm birth, one of a growing category of preterm babies here in the U.S.

You might not think a baby born at 37 weeks would be considered preterm, but it is. And unfortunately, even late preterm babies are at risk for a host of problems, according to the March of Dimes. Late preterm babies are:

  • 6 times more likely than full-term infants to die in the first week of life (2.8 per 1,000 vs. 0.5 per 1,000)
  • 3 times more likely to die in the first year of life (7.9 per 1,000 vs. 2.4 per 1,000)
  • Often weigh between 4½ and 6 pounds, and they may appear thinner than full-term babies.
  • Remain at higher risk than full-term babies for newborn health problems, including breathing and feeding problems, difficulties regulating body temperature, and jaundice
  • More than three times as likely to develop cerebral palsy and are slightly more likely to have developmental delays than babies born full term.

That’s why, while it’s easy to be tempted into letting a doctor or midwife induce, it may not be in the best interest of moms or babies.

November is Premature Awareness Month. Want to learn more about why you should hold off whenever possible with artificial inductions? Here’s a quick Q&A with Janie Wilson, MS, RN, Women & Newborns Director of Nursing Operations at Intermountain Healthcare in Salt Lake City, Utah, a not-for-profit hospital system that is responsible for delivering 53 percent of all babies in that state. Recently, the organization implemented a program to reduce unnecessarily early labor inductions with amazing success.

KB: Why are so many women delivering via induction today?

JW: It’s a combination of doctors and women. Women don’t want to be pregnant anymore after 36 or 37 weeks. Meanwhile, if a doctor selectively induces you on Thursday morning, he or she won’t be at the hospital at 2 a.m. on a Saturday night.

KB: What’s the risk of inducing before 39 weeks?

JW: We, as a country, are electively inducing women at 39 weeks when their cervix isn’t ripened. But if you do this, those same women may have a long, protracted labor, along with an increased risk of C-section and morbidity.

KB: What has your hospital done about this?

JW: We’ve got a guideline that says we do not electively induce a first-time mom until they pass the 39-week mark and have a Bishop’s score of 10 out of 13. This score takes into account five components of a vaginal exam: cervical dilation, effacement, consistency, and position along with fetal station — how far down the baby’s head is. We require both because due dates are just an estimate.

KB: What would you tell an expectant mom who is consider induction — whether it’s coming from her or her doctor?

JW: Some women will go wherever the provider will lead them. But this is not like scheduling your nail appointment. You have to make your own decisions. There are associated risks and costs that go along with inducing early. If you wait until your body is actually ready to deliver you will generally have a much better outcome.

Just look at what we’ve accomplished. Since 1999, our percentage of all inductions before 39 weeks has dropped significantly, from approximately 28 percent to only 3.4 percent. We’ve also seen a 90-minute drop in the average length of labor in electively induced patients, with fewer emergency cesarean sections and other medical complications associated with deliveries. Our average length of stay has dropped three hours. Today, our primary C-section rate (the rate of first time moms) is almost zero. We have really changed our culture for the better. Women should demand the same outcomes for their own births.

The March of Dimes this week released its Premature Birth Report cards. Alarmingly, the majority of states received an F; not a single state got an A. One state — Vermont — got a B. To learn more about prematurity, or to get involved with changing this dangerous paradigm, join the March of Dime’s National Advocacy Network by clicking here.

One Response to “Don’t Come Out Before You’re Ready”

  1. MarthaandMe says:

    My first was induced (then C-sec) at 41 weeks. She was 11 1/2 lbs. My second was an elective C-sec at 39 weeks (they were worried he would be as big). In retrospect I would not do the early c-sec. He had fluid in his lungs and I am convinced if we’d given him another week or two it would not have been a problem

Leave a Reply