this is a very good write up from a childbirth educator: extract from:
http://groups.yahoo.com/group/asiaparents/message/189325
Re: When should I go to the hospital?
I'm commenting on this as a childbirth educator. Personal
convenience, doctor convenience, fengshui convenience etc. all do
not take into account baby's own timing - which is always perfect.
There is a reason why the system works as it does and the old adage
of "don't fix what ain't broken" always rings true.
Elective inductions, as in elective cesarians, always carry risk.
They carry risk to the mother and to the baby.
To the baby, it is the risk of prematurity (note that 37 weeks is
really an estimate. If your dates are not right, the baby may well
be younger than what it is projected to be). There is also the risk
of respiratory distress at birth because the lungs are not ready and
do not have enough surfactant to inflate the airsacs. Additional
risks include a higher risk of operative births because the baby
does not take the stress of uterine hyperstimulation well. If you
can understand the analogy of holding a person's head underwater and
only allowing him to surface for a quick gasp of air before holding
him under again - well, that is the sort of stress that induction-
contractions gives to the fetus. Some babies can take this stress.
Some can't - hence the increased risk of fetal distress and all the
other cascade of interventions that follow ie a c-section.
To the mother, inductions bring the added risk of very painful
unnatural contractions with no rest/intervals in between. It takes a
very heroic woman to withstand the onslaught of such contractions
without drugs and very often, understandably, they call for the
epidural - which again leads to other risks, namely the increased
risk of operative births.
Inductions also carry the risk of uterine hyperstimulation (as
mentioned above) and hence the risk of PPH - post-partum
haemorrhage.
Finally, if at 37 weeks, the cervix is not ready, tightly shut etc,
then no amount of oxytocin induction or prostaglandin induction will
work. All this does is to hyper-stimulate an unripe uterus, leading
to the increased likelihood of a cesarian section for "failure to
progress".
Inductions are a serious medical procedure and should never be taken
lightly. And unless medically indicated, should never be for
convenience sake.
Your previous experience may have worked well for you. That does not
mean that this experience will turn out the same way. There are just
too many risks associated with inductions, particularly elective
inductions.
Underlying all these posts seems to be the disdainful fear of home
births, or giving birth at home. If you study the literature
carefully, it has not been shown that home births are more dangerous
than hospital births. In fact, the outcomes are almost similar.
Indeed, homebirths might even be safer because the risk of infection
is minimised. I'm sure everyone has read about the risks of MRSA in
yesterday's newspapers - these are serious bacterial infections that
take place in hospitals due to poor hygiene. And Singapore's
infecton rate is 35% - not good at all. I'm not sure what the stats
are in private hospitals, but I don't think the deviations can be
much.
Home birth is safe. It is not as messy as people think it is. By all
means, if your preference is to birth in a hospital, do so. That is
your choice. But birthing at home if you had to, is no tragedy
either.
To choose an elective induction simply because you wish to avoid a
home birth does seem rather drastic. Might it not be better to
prepare yourself better, be equipped with knowledge of risks,
benefits and alternatives to all scenarios before deciding? And then
in the event that a homebirth does take place, you'd be better
equipped to deal with that too.
I'm also not sure what you mean by your statement: "Normal delivery
signs are no longer accurate signs for peoplel like you and
> me. By the time you see it, it's probably too late."
Labour signs are labour signs. I always tell women to best rely on
their gut - anywhere between 5min and 3min and if their gut agrees,
that would be the best time. If you mean that some women dilate
before any signs of labour, that is true. Some do. But that does
not happen all the time with the same woman. Every labour is
different. And as I said, giving birth at home unexpectedly is not
necessarily high tragedy.
pat
childbirth educator
birthright
