Why are so many women being recommended for induction of labour?
For most expecting mothers, the countdown to their due date is filled with mixed emotions – anticipation, excitement, and perhaps a touch of nerves. As you prepare for the arrival of your little one, you may find yourself facing a decision that could significantly impact your childbirth journey and trigger a cascade of interventions: unnecessary induction of labour.
It’s important to acknowledge that every woman’s progression through her pregnancy, her labour, the birth of her baby and breastfeeding is unique, and there are no one-size-fits-all answers when it comes to the question of whether or not to induce labour. There will be times when medical intervention is necessary, and in these unique situations it can be a blessing, even life saving.
However, our goal at The Thompson Method is to make that decision a little easier for you by providing you with the knowledge and confidence you need to make informed decisions – decisions that keep you in control and that respect this very personal experience in your life.
Here, we delve into the complexities and implications of labour induction, as well as the chain of medical interventions that typically follow – known as the cascade of intervention. Everything we share is rooted in the 50+ years of experience and evidence-based PhD research conducted by The Thompson Method founder, Dr Robyn Thompson, OAM.
So, let’s dive in and equip you with the information you need to navigate this potentially pivotal moment of your journey.
Why is labour induced? Induction of labour in a nutshell
As the name implies, induction of labour is when the uterus is prompted to contract before the onset of natural labour. Labour may be induced for any number of reasons, ranging from various medical conditions, a uterine infection, or gestational diabetes, to post-term pregnancies where a woman’s labour has not started naturally past the expected and estimated due date.
The reality is that labour is induced across a whole spectrum of situations, from the most dire to the completely unnecessary. It is important to acknowledge that, as mentioned above (and you’ll probably see this a few times in this blog) in the presence of emergency situations, induction of labour and other medical interventions can be life-saving.
On the flip side, however, we cannot ignore the fact that, often, perfectly healthy pregnant women are also recommended for induction of labour – in cases where medical intervention is actually not necessary. You may be wondering: is this really an issue, and does it matter if labour is induced outside of an emergency?
We’re glad you asked!
Considering the Options: Questioning the Necessity of Induction in Healthy Pregnancies.
The cascade of intervention: what are the risks to labour?
Time and again, over her five-decade career, Dr Robyn consistently observed that a seemingly harmless first intervention – such as an induction of labour – typically increases the risk of further interventions down the line, triggering the documented principle of the cascade of intervention.
This sees women taken through a series of medical interventions, each presenting significant implications that are best avoided, and that most likely can be avoided if labour is not induced (again, provided that there is no emergency and it is not in the mother’s and baby’s best interests to do so).
For example, the initial intervention of inducing labour often gives rise to the need for opioid pain relief (another medical intervention). This generally involves administering Fentanyl – a highly potent pain management drug that can have adverse effects on both mother and baby.
One risk is Sleepy Baby Syndrome, which can lead to difficulties with the all-important first and early breastfeeds – the outcome of which could impact a mother’s entire breastfeeding journey, as we shall see in a later section.
What’s more, as one intervention leads to another following induction of labour, the likelihood of these interventions cascading into a caesarean section – itself a significant intervention – shoots up drastically as a result. While a c-section is a perfectly viable procedure where there is a genuine reason or emergency situation, its implications as a major abdominal surgery cannot be taken lightly, coming as it does with its own set of risks for mother and baby.
What if my doctor recommends induction of labour outside an emergency?
If induction of labour should be avoided outside of emergency situations to avoid triggering an unwanted chain of problematic medical interventions that could complicate matters unnecessarily – then why are so many healthy women (who are enjoying perfectly healthy pregnancies) being advised to have labour induced?
Well, the truth is that hospital births are at the mercy of time constraints imposed by the hospital system. The emphasis is all too often placed on time efficiency and how swiftly a woman’s labour progresses, rather than ensuring conditions are set up for a labour that unfolds gently, calmly and with ease.
This leads to the acceleration of labour according to the hospital system’s own mathematical timeframes, and is often the underlying reason that many women are recommended for induction of labour when not faced with an emergency situation.
If you find yourself in this position and your healthcare team suggests inducing labour, you are encouraged to ask as many questions as possible so you can fully understand the situation and why this is being recommended, and then make an informed decision for you and your baby.
Not sure what to ask? Start with the following:
- What are the benefits to me and my baby?
- What are the risks if I choose not to be induced?
- What are the alternatives?
And remember, if this is not an emergency situation, you are well within your rights to say “no” or “I will wait”, or even to seek another professional opinion.
How does the cascade of intervention impact breastfeeding?
Being rushed through labour and birth (itself a tremendous and highly personal undertaking), receiving strong pain medication, possibly undergoing the ordeal of a c-section, and enduring the standard delays to her first breastfeed as her newborn baby is handled for non-urgent routine checks – not only takes its toll on the overwhelmed mother who has just given birth, but can also start her breastfeeding journey off on the wrong foot and set her up for more difficulties postpartum.
You may not know this, but your breastfeeding journey doesn’t start the first time you breastfeed your baby – it starts with the decisions you make before your labour even begins. This is why it is so important to go into your labour armed with knowledge and a solid birth and breastfeeding plan – and, ideally, a strong advocate by your side who you can trust to make sure your wishes and plan are respected as your labour unfolds.
And it’s also why we designed The Thompson Method Prenatal Sessions, because we believe that pregnancy is the perfect time to prepare for breastfeeding and prevent problems from occurring once you’ve already started breastfeeding. In these sessions, we not only look at the ins and outs of pregnancy and break down the different stages of labour, but we also discuss the law of consent and what that means for how you and your baby are handled in a hospital setting, and what you should expect during and immediately after the birth of your baby, as well as what to do if anything unexpected does happen.
Much of your success with breastfeeding will depend on what happens right after you give birth, during the critical time window Dr Robyn refers to as the ‘3 Golden Hours’. This is the time when your maternal instincts and your baby’s natural instincts to feed for survival kick in. Given the time and space you and your baby (in the absence of an urgent or emergency situation) are more than capable of working things out and settling into a breastfeeding rhythm that will set the tone for the rest of your journey.
What doesn’t work is a cascade of intervention that delays and disrupts this precious time frame, which often prevents you and your baby from finding your natural flow together as mother and baby, increasing the risk of experiencing common breastfeeding complications. Please be reassured, that this doesn’t mean that you won’t be able to breastfeed. Understanding the principles of breast milk production will help navigate around early breastfeeding challenges. But we encourage women to aim to reduce the risk of unnecessary interventions in the first instance, with the aim of side stepping painful complications that may otherwise have been avoided.
Let your labour go your way
Your transition through your pregnancy, your labour, the birth of your baby and breastfeeding is a deeply personal and unique part of motherhood. Every stage is directed by the innate wisdom of your body’s (and your baby’s) natural timing. We cannot underestimate the importance of your need to be well-informed and confident as you make decisions along the way.
Avoiding unnecessary interventions is not just about getting through your labour without complications – it’s about respecting this perfect timing and allowing your baby to arrive when he or she is ready, by trusting your body’s natural process and letting it all unfold in your own good time. As we like to say at The Thompson Method: it’s your body, your baby, and, ultimately, your unique journey. Make sure it goes your way.
Ready to arm yourself with the right knowledge to navigate your childbirth journey with confidence, on your own terms? Explore The Thompson Method program here.