Induction or Augmentation?

When a woman’s labor is started artificially, it’s considered an induction — whether elective or medically indicated. When a woman’s labor starts on its own, but for one reason or another is put on Pitocin to strengthen the contractions, it’s considered an augmentation of labor. But what is it called when a woman’s water breaks but contractions don’t start immediately, and she goes to the hospital and is put on Pitocin? Is it an induction or augmentation?

My first pregnancy, my water broke about half an hour before contractions set in; one of my sisters had rupture of membranes followed by no labor for 18 hours, at which point she went to the hospital for… an induction, or augmentation?

Usually, when a woman’s water breaks before labor begins, contractions are not far behind; but sometimes, some time passes before it happens. I think of stories I’ve read of women who have had “high leaks” or even a full “water breaking”, but either the tear resealed itself, or the baby was so premature that even with ROM, it was better for him to stay in utero than to be born (as long as the mom didn’t have an infection or any other medical reason for the baby to be born then). Most of the time, however, either the baby needs to be born early, or the woman is at term or close enough to term that the doctors want to start or speed up labor, out of fear of infection.

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The next birth? What about *this* birth?

Far too often, women put their wishes and dreams for birth on hold, promising to make changes for the next birth. Many women “plan” on having a natural childbirth (and I put that in quotes because too many women are like my oldest sister — their “plan” is assuming that they’ll show up to the hospital and have a natural labor and birth simply because women have been having unmedicated births for millenia), but then end up agreeing to an unnecessary induction (or other intervention), and regretfully let go of the dream or plan “this time… but next time will be different!”

But what about this birth? For one thing, it’s your only chance to give birth to this baby, which makes it important, even if you have other children. But for another, one intervention leads more easily to the next, and you may end up with a C-section for your first birth, and then find it difficult or impossible to have anything but a C-section for subsequent births. Click here to read an awesome post on “this birth”.

I wonder how often pitocin is really necessary

One of the blogs I keep up with is a new L&D nurse. She worked over the Christmas and New Year’s holidays, and blogged about it. One of the stories she told was that of a first-time mom who came into the hospital in labor on the holiday, when her doctor was off and didn’t want to disrupt his holiday to come in to catch the baby, so he didn’t want to do anything to speed her labor up, so didn’t order Pitocin. The nurse sounded like this woman was one of the few women if not the only woman she had ever attended who did not have Pitocin to induce or augment labor.

But this mom — a first-time mom, you will remember! — actually managed to dilate without any Pitocin! At all! Can you believe it? (Yes, I’m being sarcastic.) Wow — her body actually was able to contract the uterus and open the cervix without any help from artificial substances. Incredible.

When the nurse got off of her shift, the mom was almost fully dilated — stll without a drop of Pitocin, because it was still before office hours and the doc hadn’t showed up yet.

Judging by the tone of the post, most if not all of the women this nurse attends in labor get Pitocin — or at least the first-time moms who tend to have slower labors. Probably these women think that it is necessary. Somehow, I doubt that it is “necessary” for any reason other than speeding up a normal labor so that it is more convenient for the doctor.

Industrial Childbirth

“My experience of childbirth was not an unusually traumatic one. In medical parlance I had an NVD: a Normal Vaginal Delivery. The midwives were pleasant. I was given an epidural. I was admitted to hospital at 2pm and delivered a healthy baby boy ( 8lb 7oz ) eleven hours later. This is the essential information, is it not? This is the only kind of information that we ever really hear about other women’s experiences with childbirth.

“But there is more to it than that. It took me a while to sort out my feelings after the birth – the elation you feel at the presence of a new life combined with your physical exhaustion leave room for little else. And I never really experienced the hopeless grief of the flippantly named “baby blues” in the weeks or months that followed. What I felt – when I was finally able to identify the reasons for my confusion – was anger.

Click here to read the rest of this…

Knowledge vs. Wisdom

This is an excellent post on an L&D nurse’s blog, about the difference between medical “knowledge” which is highly prized in our society, and the “wisdom” that comes from the laboring woman’s body itself. And what happens when that “wisdom” is ignored, because the “knowledge” says differently.

While the entire post is excellent, and I hope you will go over there and read the whole thing, my favorite section of it is near the end (the last sentence is what I’m talking about — the rest is provided for context):

If the mother has an epidural and cannot feel when to push, the care provider places a hand on the mother’s abdomen to feel when the contraction starts. The care provider then relays this information to the mother. The mother’s body is speaking, but the mother needs an interpreter to interpret the message because the technology has come between her and her body!

This true statement is so sad!