Induction Doubles Risk of Cesarean

Ok, so if you’re going into a hospital that has a 30% cesarean rate, and you go in for an induction, does that make your chances of a cesarean go up to 60%? Probably not, but it did make me ponder. SO many of the induction I hear about from friends, relatives, etc. end in a cesarean. To say that half of them do is not a stretch.

CONCLUSION: Labor induction is significantly associated with a cesarean delivery among nulliparous women at term for those with and without medical or obstetric complications. Reducing the use of elective labor induction may lead to decreased rates of cesarean delivery for a population.

LEVEL OF EVIDENCE: II

(C) 2010 The American College of Obstetricians and Gynecologists

Here is the article just published with these stats:

Labor Induction and the Risk of a Cesarean Delivery Among Nulliparous Women at Term

Ehrenthal, Deborah B.; Jiang, Xiaozhang; Strobino, Donna M.

Obstetrics & Gynecology. 116(1):35-42, July 2010.

doi: 10.1097/AOG.0b013e3181e10c5c

Off-label drug use

I understand that the off-label use of pharmaceuticals is a normal occurrence in the medical world. I get that. What’s not cool is that this is done in maternity care as well with dire consequences.

I’m not talking about the random, “uh-oh”, I’m referring instead to the drug company themselves issuing statements saying “We do not endorse the use of this product for any use other than that described on the label.” Yeah, they’re probably just covering their b*tts but still. They said it. Yet it happens everyday in the labor and delivery department of nearly every hospital in the country. It has become so commonplace to induce labor that not only have we stopped wondering how/if this affects the baby or the mother we have now started grabbing whatever drugs we can find that give us “a better induction outcome”.

Hrrumph.

Bishop’s score be damned. God created women’s body to birth. With consideration made for the odd-one-out with pituitary damage or other disorders that truly make her body hold onto her baby long past safely, using drugs to begin labor before the body begins to open up on it’s own is risky risky risky.

Births are kindof like bowel movements. They happen on their own. Can’t plan ’em, can’t stop ’em, can’t hurry them along. Bowel movements happen (errr… I can’t help but think of a certain bumper sticker I’ve seen alot of right now).

Birth HAPPENS as well. Babies are born when it is TIME. If we have accepted that every other body system has knowledge to know when to open and release, then why can’t we accept the body’s wisdom in birthing when it is time?

You might have had a Cytotec induction. And so did your sister, your friend, aunt, daughter’s 2nd grade teacher… and all went well. On the surface perhaps. But what did it do to that baby’s emotional/psychological health to be so rudely pushed into the world before he/she was ready to come? And what about the women reading this who is a victim of a cytotec induction who is grieving the loss of her womb? Suddenly hurrying a baby out seems less important when faced with an emergency cesarean to save your baby’s life and a hysterectomy to save yours.

All from a couple of tidy white pills manufactured to treat ulcers. Who’da thunk?