Hospital research study

mvargas12 · May 2015

so at my doctor's appointment today, the OB I saw said the hospital is doing a research study to determine ways to lower ceserian rates (theirs is 25%). Basically women will be divided into two groups, one group will be induced at 39 weeks and the other will go to 41. Obviously if the baby comes naturally earlier than the scheduled C-section then that's that.

He said there are 2 risks:
1) the baby can't handle induction and I will have to have a C-section
**OB said if a baby can't handle induction, it probably can't handle a natural birth and would end up having a c-section anyway (not sure how true, just what I was told)**

2) my cervix won't be "ripe" (that's the word he used) enough and won't open so I'll have to have a c-section.

I think my biggest reason for not doing it is that I don't want to spend ALL of labor hooked up to machines. I would like to ride it out at home and much as I can and then go to the hospital. It's just so uncomfortable there and idk how long I'll be in labor for.

My biggest reason for participating is that I would love to have my little girl here sooner than later, I'm a planner and having a somewhat time of her possible arrival would be aweeeeesome!, and I'm just done being pregnant... Okay, that's 3 reasons.

We are first time parents and don't know what's best when it comes to L&D. What would you do if this study was being done in your hospital?

DISCLAIMERS: I'm asking for opinions. We're not deciding based on things others tell us but maybe someone has something to say we haven't considered.

Also, I'm not exactly sure what they are trying to prove. He explained it but there was just a lot of information getting thrown at me.

btm013 · May 2015

As a FTM myself, I personally wouldn't participate in any study. But that's just me! I totally get wanting to be done but I've heard inductions can be intense. I guess it depends if you are opting for pain medicine and if you are ok with thr possibility of a csection.

KaLikeAWind · May 2015

FTM also so I have no input, but I find this interesting. Looking forward to hearing the replies

kbbtah · May 2015

FTM too. Personally, I'm not interested in participating in research studies. To each her own!

balderasmama · May 2015

I would advise against an induction. As a lactation consultant and birth educator, it is harder on your body and baby to be induced without any signs of labor (imagine pushing a boulder up a hill to the other side (straight induction) vs pushing a boulder from the top of the hill down to the other side (natural labor furthered by pitocin) (hopefully that makes sense). Being induced with pitocin makes the contractions very strong with no build up or peak, it just stays at peak strength for the entire contraction, with a very short break between, as opposed to a natural contraction that builds, peaks and then receeds and has a break in between. And current research says induced births are more likely to end in C section as opposed to going into labor on your own.
As a mom, I totally understand your desire to plan this (I like planning things too

). If you give yourself to 41 weeks you have a much better chance to go into labor on your own (and you can google or contact me for tips on that).
Would you get a say in which group you are placed in? If so, and you can be put in the 41 week group I would say go for it, if you make it to 41 weeks you will be induced anyway.

henrytviii · May 2015

I know it’s hard not to know when are LO’s will be arriving,
and to deal with such a wide date range. I feel like it’s a waiting game for 4-5 weeks for some of us, and I
remember how tough that was with my first. But I’d want to do whatever is best for the health of the baby, not what’s
convenient and it sounds like you want that as well. I personally wouldn't
participate in the study, nor would I consider a 39 week induction short of
serious medical reasons for doing so. Dating isn't perfect so a baby induced at 39 weeks could have an actual
gestational age of a little as 37 weeks, and could be too young for induction
even if it does go smoothly. I’m guessing
this is your first. Typically FTM go over a week late so you might be inducing
2 weeks before your body is ready.I also wouldn't want to be hooked up to
monitors throughout L&D, and from what I've heard from others induction can
cause very painful contractions. I would also be worried about a failed induction
and C-section. I’m actually against any
induction at all for that reason but I would agree to an induction past 42
weeks as risks seem to increase then, and if there was a medical indication
such a decrease cord/placental health, low fluid etc.

What is the study looking at? Are they trying to see if they C-section rate
is higher in women that are induced at 39 weeks than those that go to 41
weeks? If that’s the case I’d want to
avoid being the 39 week group and I’d imagine you can’t choose. I’m in MN and it’s my understanding that
elective inductions are prohibited before 39 weeks, and are discouraged until
after 41 weeks due to a legislations that was aimed at lowering C-section rates
and other risks.

mvargas12 · May 2015

@balderasmama I would be randomly put into a group, I wouldn't have a say to which. Great points to consider though, thank you! I will reach out to you for some tips if we decide not to do it

@henrytviii I'm not exactly sure what they are looking for. I don't remember exactly I just remember the terms. You're right about induction before 39 weeks. The OB said they can't legally do it before 39 weeks unless there's a medical need. Not sure if in all states, I'm in PA.

laurendutch · May 2015

I'm not a FTM, but my sons and I have a rare autoimmune disease. There have been studies that have been conducted that I have signed up for...but its really not going out of my way to participate. Meaning, no new drugs, just our lab results get sent to the research hospital. My feeling is that because our disease is rare, and not much is known that there is a lot to benefit from it. Not only for us but for others. However, I find this study to be kind of redundant...I mean, I'm pretty sure that there have been studies in the past on this exact same issue. I know our local hospital system conducted something similar over 10 years ago but it was comparing inductions at 37/38 weeks compared to 39 weeks.

ElRuby · May 2015

I am surprised they got approved for an actual experiment on pregnant women... I like research but what if you get into the 41 week group?! I wouldn't do it personally but please keep us updated of your decision and experience!

OnWayto3 · May 2015

I'm a huge proponent of research, especially if the eventual outcome will further medical care. Like you, the idea of being 'done' with pregnancy sounds pretty spectacular these days as well. I've also been induced for medical reasons in my first pregnancy. That said, here's how I outline the pros/cons for myself if given this opportunity.

PROS:

Likely a shortened pregnancy, but within healthy standards

Lack of surprise, thus lack of such anxiety (will my water break? will I get to hospital in time? Will my doctor oversee my care? and so on)

Contributing to science/medicine

Financial reward???

CONS:

A lack of the excitement that goes along with a naturally-progressing labor (truly, an amazing thing to be part of! It was sooooo rewarding to go into labor 'naturally' with my second pregnancy).

Medically questionable given Baby isn't ready

More intense pain with the shortened intervals between contractions

Stuck in a hospital bed, hooked to monitors, thus unable to actively participate in helping labor along and also increasing boredom/anxiety

Higher risk of c-section with induction (though that did not occur with me)

Years left wondering if X health problem would be present had I not induced labor (aka GUILT)

Ultimately, after having gone through both types of labor (induced and not), I wouldn't participate in the study. But I don't think deciding otherwise is a horrible choice; just not one I would opt for with all that I've experienced.

Good luck in whatever decision you make!

karaelaine1991 · May 2015

I'm actually participating in a medical study right now with the dental program at the school that I go to. Baby will also be participating once she's born. Apparently the area where I live has a much higher rate of cavities in young children, so the study is to try to find out why that might be. LO and I will be participating until she's two years old, and we'll be compensated around $500 during that time. To me, that, plus the free dental exams, is totally worth the very minimal risk of participating.

I would be much, much more hesitant to participate in the study you've described. I'm sure that it's as safe as it could be, or it wouldn't have been approved by the IRB -- but there is still a significant amount of risk involved, since it's involving a pretty major medical procedure as opposed to spitting in a cup, haha. Also, I really want to avoid an induction unless it's medically necessary, since as PP have noted, it apparently involves more pain and would force baby to come out before she's totally ready. That's just me, though. I definitely think that before you agree to participate, it would be in your best interest to ask lots and lots of questions (the ones that PP have suggested are a great start), and, if possible, obtain the opinions of medical professionals who are not affiliated with the study or anyone involved with the study (easier said than done, perhaps, but I think it would be worthwhile). Again, while this isn't something I personally would choose to participate in, I do think that you can go in feeling confident that it's *mostly* safe, but this is a research study, so there's definitely room for the unexpected to occur. Bottom line (in my opinion): inform yourself as much as possible! Good luck with whatever you decide!

klkonwi · May 2015

Inductions are not always evil. They are not always horrible and "forcing" your child out. A lot of women simply don't go into labor on their own. Going until 41 weeks can increase risk of stillbirth...... There's science on everything ladies....... Pros and cons to everything.

mlindzz · May 2015

I just finished one of my prenatal classes and we talked about inductions. It was shared that here is Canada, 96% of the woman who get induced later also require an epidural.

I get anxious about the idea of having a medical intervention when it might not be necessary, although I realize this isn't everyone's standpoint, for that reason though I wouldn't agree to a planned induction. My only recommendations would be that you keep doing your research, ask your doctor lots of questions before making any commitments and base your final decision on what's best for you and your LO.

I enjoyed reading the dialogue above and there are lots of interesting perspectives!

karaelaine1991 · May 2015

klkonwi said:
Inductions are not always evil. They are not always horrible and "forcing" your child out. A lot of women simply don't go into labor on their own. Going until 41 weeks can increase risk of stillbirth...... There's science on everything ladies....... Pros and cons to everything.

I didn't mean to imply that inductions are evil - sorry if my post came across that way! Just not a choice that I will be making unless my doctor tells me it's necessary. Best of luck to those of you who are choosing this method of birth!

Serenamarr · May 2015

Labor is different for everyone and the care and treatment you get should be specifically tailored to yours and baby's needs. Being lumped into a category with no room for adjusting to personal circumstances, being treated as a statistic, and being cared for a certain way because of what group you were assigned-not because of what's best for your labor- sounds awful and scary to me personally.

klkonwi · May 2015

@karaelaine1991 my post was just directed to this thread in general. It's kind of hating on inductions AND unnecessarily scaring people. And if someone has to be induced I do not want them to fear they are failing or it will end up a disaster.

klkonwi · May 2015

Also to OP @mvargas12 there is such a thing as the bishops score. It can tell you a percentage of failure of induction. You could get checked in the office ( cervix ) and then decide if you want to be in the study.... If that's an option. I don't know if you have to tell them right away

amhowell14 · May 2015

klkonwi said:
Inductions are not always evil. They are not always horrible and "forcing" your child out. A lot of women simply don't go into labor on their own. Going until 41 weeks can increase risk of stillbirth...... There's science on everything ladies....... Pros and cons to everything.

Totally agree! I was induced with both DD 1 & 2. My OB said I probably would've never gone into labor on my own. I had a great experience with both inductions. Baby #3 will be induced at 39 weeks as well.

KiwiMumof3 · May 2015

I was induced with my first and had a fully drug free birth. For me it was a nice experience. I'm not a fan of medical intervention unless it is needed. Sorry not really related to your question but agree with @klkonwi induction doesn't need to be feared.

jesscmv · May 2015

I feel like there should be more of a reward for you. I understand you are going to have a baby regardless but they are essentially telling you which way you are having it. Maybe it's just me.

Sammy K · May 2015

I'd be interested in finding more about this study. C-section rates in the US are really high but inducing labor doesn't seem like it will solve the problem. But I am no doctor. I agree with PP about risk/reward. If you're not dilated and show no signs of moving towards birth, an induction for the sake of research doesn't make sense. If you're 2 cm dilated, baby dropped & is head down, you've lost your mucus plug, etc, then an induction might be fine. There are too many variables for me to be comfortable with being randomly assigned an induction date. This coming from someone who is planning on an early induction, but for reasons other than research.

APago · May 2015

I am a big supporter of research studies. I've actually signed up for 2 during this pregnancy. I am a FTM so I can't speak to the induction side of things but both studies I've signed up for don't necessarily "require" anything of me or anything to be done differently. I am high risk and my studies pertain to my cardiac condition, and they basically just asked for access to my regular blood work, ultrasounds, fetal ultrasounds etc. I am not sure how I would feel about a study that actually could change the course of my delivery. But that's just me. I do think it's great that you're considering it, in regards to the research side of things. Being hooked up to all sorts of things would also be a cause for concern. I can see your point on that! But this may be the case whether you sign up for the study or not!

laurendutch · May 2015

Sammy K said:
I'd be interested in finding more about this study. C-section rates in the US are really high but inducing labor doesn't seem like it will solve the problem. But I am no doctor. I agree with PP about risk/reward. If you're not dilated and show no signs of moving towards birth, an induction for the sake of research doesn't make sense. If you're 2 cm dilated, baby dropped & is head down, you've lost your mucus plug, etc, then an induction might be fine. There are too many variables for me to be comfortable with being randomly assigned an induction date. This coming from someone who is planning on an early induction, but for reasons other than research.

Previous studies have correlated early inductions with increased c-section rates. Our hospital system has in place no elective inductions (unless medically necessary) before 39 weeks. We have one of the lowest c-section rates in the country and it has saved hundreds of millions of dollars. If every hospital had this in place, it would save 3.5 billion every year.

Sammy K · May 2015

@laurendutch I agree! I'm planning on being induced at 39 wks due to my previous delivery. If they really want to reduce C-section rates, why not assign half the group a doula (for free) and let labor occur naturally? Small studies already show Doulas decrease the chance of c-section and other interventions. Let's get some better research and get them covered by insurance!

My autocorrect does not like the word doula!

mvargas12 · May 2015

Thank you everyone for your input. I was interested in both sides of the argument. After reading your responses, speaking with each other, and speaking with family, my husband and I decided we're not going to participate. At the end of the day I just don't know enough about it and I'd just rather incubate my little girl until she's ready. Thanks again!

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