Every doctors appointment we have assures us that our baby is developing normally and that no complications, due to my Gestational Diabetes, are presenting themselves...yet both doctors and all three midwives keep insisting I "need" to be induced at 39-weeks (which is a little over a week away). A couple weeks ago we were finally able to speak with the midwife who would initiate the induction process, if we went into the hospital on April 26th like they want, and she gave us general info about their induction processes. Each midwife has their own variation they are comfortable with, but most methods used by members of this office are similar enough to be interchangeable depending on how the woman's body is responding. According to the midwife who'll be on duty at the hospital on the 26th, her method is the "least medicated" and "most effective".Induction Method:
1) A Foley Bulb/Catheter (which is non-medicated) will be introduced into the cervix in order to force dilation...the Foley Bulb falls out once the cervix is dilated to 3cm.
2) Pitocin (a synthetic form of Oxitocin) is administered, at the same time as the Foley Bulb, in small doses until contractions begin and dilation continues.
3) Sleeping pill is offered to the mother so some rest can be achieved before the hard labor, which is expected to begin the next morning.
4) More Pitocin is administered if contractions and dilation have not progressed within a certain time frame.
(They assure us we will never be rushed or expected to resort to a c-section to speed things up)
5) If a stall occurs in the progress of labor, they will rupture the membranes and cause the water to break...usually resulting in stronger and faster contractions.
6) As long as labor progresses, the mother is allowed to labor as long as needed until baby is born.
Risks Involved With Induction:
Basically, they want to physically force my cervix to dilate (which has been known to cause damage, to the cervix, to the point of risking premature labor or miscarriage with subsequent pregnancies). Although Pitocin is a synthetic form of a hormone the body makes naturally (when in labor), it is still man-made and medicated...if not monitored properly it can cause excessive contractions which are famous for causing fetal stress, low fetal heart rate and loss of fetal heart rate (which then results in emergency c-sections). The sleeping pill appears to be the most harmless of all the steps involved, although sleeping pills are not recommended for pregnant women because of the risks they may pose to the baby. Rupturing the membrane doesn't guarantee labor progression, but once the membranes are broken the mother and baby risks infection due to the exposure to the amniotic fluid and uterus in the time frame between broken water and delivery (especially each time a doctor or nurse checks the cervix for dilation and places their hand or another foreign body on or near that area). Each and every step of an induction goes against the natural flow of things within the bodies of both mother and child. The body's natural reaction to induction is to fight against it, which then manifests as complications, which then causes the medical professionals to use increasingly severe methods for intervention. There is also a natural flow to the baby's preparation for labor. If the baby is not in proper position when labor begins, complications could arise...if they induce before our baby has engaged the birth canal, she could be moved around by the unexpected contractions and placed in a position not condusive to a safe delivery. If her limbs are also in the wrong position at the start of an unexpected (induced) labor, damage could be done (bruising, breaking, etc). So not only would this be bad for me, it would certainly be bad for our baby.
Knowing their specifics, my husband and I were able to research each method. What we found made us very uncomfortable. Since my pregnancy is progressing flawlessly (despite my GD), and no complications have presented themselves, there are far more risks associated with the induction (itself) than there are with letting us go into labor on our own time. In fact, each step of their induction process (and it's variations) create situations where numerous complications could occur...but with our baby being of "normal" size and development and my body functioning exactly as it should (with maintained glucose levels), there is absolutely no reason why I wouldn't continue on and have a perfectly healthy and complication-free labor and delivery on my own. We also went to the official Gynocology and Obstetrics website to research this "policy" we keep hearing about (with regard to inducing "every GD woman" at 39-weeks), and we found out that the website does not state (anywhere) that GD alone (without any complications) is grounds for induction. The website even warns against medical intervention when no complications are present in the pregnancy.
We have two more doctors appointments between now and the 26th (one next Tuesday and one the morning of the 26th). The last time we suggested an alternative to induction, back when they told me I needed to be medicated, the doctor immediately threatened to drop us from her care. She also claimed that not inducing at 39-weeks would put our baby at a greater risk for S.I.D.S. (sudden infant death syndrome). My husband and I immediately researched this, and got other opinions, and there is absolutely NO correlation between GD and S.I.D.S. She was trying to scare us into compliance. Each appointment we've had with the doctors and midwives, since, we've made it a point to state that since everything was developing "normally" we wanted to look into postponing or canceling any induction plans. Every person we spoke with said that was "impossible" because it was "policy"...they even told us there was no point in trying at-home induction methods (to avoid the medical induction) because we would most certainly be unsuccessful. We would not have considered inducing ourselves had they not suggested we try. In fact, we're not attempting any at-home induction methods because we want her to be born when she's ready to. When we ask what, about my specific pregnancy, makes them feel induction is necessary, all we get are words like "common practice", "policy", and "possible complications due to GD". Each appointment proves more and more that my pregnancy weight, urine tests, blood pressure, belly measurement, sonogram (at 34-weeks), non-stress test (at 34-weeks) and fetal heart rate are all PERFECT, and yet they all insist induction is the ONLY way our baby can be delivered.
Last week the midwife we met with said it was possible to "push" the induction back to 40-weeks, but even she said it was a hard push and one that would most likely concern our doctors to the point of sending us to counceling so we are made aware of the added risks an additional week's worth of gestation could cause. They keep trying to convince me she is in danger inside me, but they cannot find or provide any proof of this...although even they will admit a properly managed GD patient can have a complication-free pregnancy and delivery (as long as they are induced, of course). We're not trying to be difficult, we just want answers. If they can prove to us that induction is the safest way for our baby to be born, we will follow their direction. It feels as though we are not being treated like individuals. Granted, if I were experiencing complications due to my GD, induction would be safer...but again, it all comes down to the lack of complications (in our case) and we want them to recognize that and encourage us to do what's best instead of scaring us into following some mold we don't fit into.
I'll keep you informed when I know more...
- Angel & Gummi Bear
