Why do inductions end in more c-sections??? — The Bump
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Why do inductions end in more c-sections???

(someone suggested I ask this on this board...)

Is it because the cervix isn't ready..like not soft enough or not dilated enough?

I think my Dr. said I have to be 2cm dilated, but not sure.  I am looking into it at 39 weeks.  Not scared of a c-section..just wondering why there is more risk for surgery.

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Re: Why do inductions end in more c-sections???

  • 1. The cervix may not be ripe enough. (Do a web search for "Bishop score" for more information.)

    2. The baby may not be optimally positioned. We don't know exactly WHY spontaneous labor starts, but part of it may be that it waits until the baby is in the optimal position. If you induce, the baby doesn't get those last few days to get into the right position.

    3. Pitocin is generally used to induce. Depending on the dosage used, this can make contractions significantly stronger, which increases the risk of fetal distress, which then requires a c-section. (Good blog post on this: http://nursingbirth.com/2009/07/08/%E2%80%9Cpit-to-distress%E2%80%9D-a-disturbing-reality/)

    4. Due to problem #3, women who are induced are more likely to get epidurals. Then they are stuck in bed and cannot move around to get their baby in the optimal position -- which compounds problem #2.

    5. Inductions can take a LONG time. Mine took almost 24 hours. I've had friends who have been induced for 2-3 days. Some doctors aren't willing to wait that long, and will call for a c-section.

    Even if the induction ends in a vaginal delivery, there are a whole host of problems that can come about after the birth, because you're forcing a baby out before s/he is ready. Dates can be off, babies develop at different rates, and so a"full term" baby could actually be a late preterm baby.

    So, bottom line, induction should only be considered for babies who are clearly better out than in, i.e. for whom the risks of continuing in utero are higher than the risks of inducing.

    If you do need to be induced, some tips to increase your odds of success:

    - Wait as long as possible.

    - Know your Bishop score. Start with cervical ripening (Cervidil or Cytotec) before going to Pitocin, if indicated.

    - If Pitocin is required, ask your doctor to use a low-dose Pitocin protocol.

    - Avoid an epidural as long as possible. Take advantage of your epidural-free time to move around so that you can get your baby into the best position possible.

    - If you've been in labor for a long time and there's talk of a c-section, ascertain whether it's truly necessary, e.g. if there is risk to you and/or the baby if you continue to labor. If it's not, and there's just concern about you getting tired (or the doctor's upcoming golf game), ask to keep laboring.

    Good luck!

    Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)

  • I think PP covered it, but it basically boils down to your baby is not ready to come out. Is there a reason they want to induce at 39w?

    PS- we have the exact same due date. :)

  • Have you fully researched the risks of an early induction and emergency csection to you and the baby? I don't think a medically necessary csection or induction should be scary because at that point the risk of not medically intervening may be more than the risks of the medical interventions...BUT when someone makes a statement that they are not scared of a csection it makes me give a little side eye because it is a HUGE deal and I am left with a lot of emotional scars to go along with my csection scar. It also increases the chance of future csections which is the frustrating place I find myself in now. There have been very few days this pregnancy that I haven't beat myself up for not FULLY educating myself about medical interventions during labor and delivery. I wish I would have never had a scheduled csection with my daughter.
    Baby Birthday Ticker Ticker

    Keegan Patrick - Bilateral Clubfeet found at Anatomy Scan. Baby Birthday Ticker Ticker www.facebook.com/portraitave

  • I lurk occasionally because i'm very interested in a live birth. I've heard that inductions, especially ones with pitocin end in more C-sections. Pitocin is a synthetic form of oxitocin, a big part of labor. Pitocin, however, bypasses the brains ability to regulate it because it's passed right into the blood stream. This overloads the system so to speak...That's why people who have had pitocin notice an extreme boost in pain levels because the contractions aren't as controlled by the body's hormone. This can cause fetal distress. Any fetal distress is usually resolved in birthing the baby via C section. Well, that's what i heard any way.
    July 16th 2010 - BFP with Kenny, HB seen Aug 16th 2010 Preterm labor started on November 24th, Kenny delivered 310am Thanksgiving morning 2010 at 22w3d. Kenny had a type 2 CCAM. BFP 31sep11 betas: 27.3 @ 13 dpo 467 @ 19 dpo over 10000 @ 31 dpo, HB 169! stick baby, stick!! December 22 2011 - It's a Boy!!! Lilypie First Birthday tickers
  • Because basically you are trying to force your baby out before he/she or your body are ready.

    In addition to the risks for c-sections, I would also consider the possible risks to your baby.  Just because 37 weeks is technically "full term" does not mean that your baby is ready to come out at 39 weeks.  Those last few weeks in the womb are SO important for brain and lung development...not to mention that early babies can also be more tired- which can lead to nursing/feeding/weight gain issues.

    Unless it is a medical necessity I would NEVER risk my baby ending up in the NICU because I was tired of being pregnant.  


    Lilypie - (ZESJ)Lilypie - (QAi1)

  • image flyer23:

    1. The cervix may not be ripe enough. (Do a web search for "Bishop score" for more information.)

    2. The baby may not be optimally positioned. We don't know exactly WHY spontaneous labor starts, but part of it may be that it waits until the baby is in the optimal position. If you induce, the baby doesn't get those last few days to get into the right position.

    3. Pitocin is generally used to induce. Depending on the dosage used, this can make contractions significantly stronger, which increases the risk of fetal distress, which then requires a c-section. (Good blog post on this: http://nursingbirth.com/2009/07/08/%E2%80%9Cpit-to-distress%E2%80%9D-a-disturbing-reality/)

    4. Due to problem #3, women who are induced are more likely to get epidurals. Then they are stuck in bed and cannot move around to get their baby in the optimal position -- which compounds problem #2.

    5. Inductions can take a LONG time. Mine took almost 24 hours. I've had friends who have been induced for 2-3 days. Some doctors aren't willing to wait that long, and will call for a c-section.

    Even if the induction ends in a vaginal delivery, there are a whole host of problems that can come about after the birth, because you're forcing a baby out before s/he is ready. Dates can be off, babies develop at different rates, and so a"full term" baby could actually be a late preterm baby.

    So, bottom line, induction should only be considered for babies who are clearly better out than in, i.e. for whom the risks of continuing in utero are higher than the risks of inducing.

    If you do need to be induced, some tips to increase your odds of success:

    - Wait as long as possible.

    - Know your Bishop score. Start with cervical ripening (Cervidil or Cytotec) before going to Pitocin, if indicated.

    - If Pitocin is required, ask your doctor to use a low-dose Pitocin protocol.

    - Avoid an epidural as long as possible. Take advantage of your epidural-free time to move around so that you can get your baby into the best position possible.

    - If you've been in labor for a long time and there's talk of a c-section, ascertain whether it's truly necessary, e.g. if there is risk to you and/or the baby if you continue to labor. If it's not, and there's just concern about you getting tired (or the doctor's upcoming golf game), ask to keep laboring.

    Good luck!

    This.  

    We still haven't figured out all of the exact mechanisms that lead to labor and we are probably missing something important.  We're just still not as good as mother nature is at getting babies out. 

    image

    Big sister {September 2008} Sweet boy {April 2011} Fuzzy Bundle {ETA July 2014}

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  •  I don't know if it's regional but inducing at 39 weeks doesn't seem right unless there is a good medical reason. I don't know of anyone who was allowed to choose induction as it's usually the doctor's suggestion and even then they usually wait until at least 10-14 days after 40 weeks. The only people I know who have been induced were 2 weeks over. (different hospitals in different parts of the city and province) One, my sister, was going to the doctor every day-second day to check on the baby and when they noticed the baby wasn't doing as well they induced. (just past 42 weeks)

    If people are inducing before they are well past 40 weeks perhaps the baby just isn't ready to be born. (you body just isn't ready yet)

  • image pinksweetpea2:

    Because basically you are trying to force your baby out before he/she or your body are ready.

    In addition to the risks for c-sections, I would also consider the possible risks to your baby.  Just because 37 weeks is technically "full term" does not mean that your baby is ready to come out at 39 weeks.  Those last few weeks in the womb are SO important for brain and lung development...not to mention that early babies can also be more tired- which can lead to nursing/feeding/weight gain issues.

    Unless it is a medical necessity I would NEVER risk my baby ending up in the NICU because I was tired of being pregnant.  

    This - especially the last part. I've heard of people going in for an induction at 39 weeks, one that I know went in because her doctor told her she was going to have a big baby. Her 4 lb baby needed to be in the NICU for a month because her lungs weren't mature enough. Obviously her due date was off and so was the ultrasound scans. I'm sure that was a rarer occasion, but I'd never risk it just because I was sick of being pregnant. Especially for first time moms - the average is 41+ weeks. 

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  • I had a friend who had to be induced at 41 weeks for medical reasons - not convenience, discomfort, or scheduling concerns - and the Pitocin caused fetal distress and they had to do a C-section immediately or risk losing the baby. And that was when the baby was past the due date. If you attempt to induce labor when the baby isn't "fully cooked," as my mother says, you're more likely to end up ramming its head against an unripe cervix that isn't ready for labor for a couple of hours, and after some amount of time the doctors will require a c-section because that puts the baby at risk.

    The baby and your body know when it's time. Unless there's a medical reason to do so, I strongly urge you to reconsider scheduling an early c-section. As my husband's best friend, who's an OB, says: "your due date isn't like the expiration date on a carton of milk. It's not the day your baby goes bad. It's an estimate of when you should expect to deliver, and like any estimates, some will be early, and some will be late."

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