Wednesday, September 2, 2009

If Only They Knew

In my line of work, I often hear myself and my fellow nurses repeating a few words. And no, it's not "Push!! Push, push, push!!!!", although, now that I mention it, yes, we do say that a lot, too. However, the phrase I'm referring to is, "If only they knew...", the "they" being the patient. The "knew" being the nurses experience.


What I'm gonna talk about, today, my friends, is a little "induction of labor" lesson. Bear with me (just don't bear down...that's an entirely different lesson in labor).

So many times, we have a sweet young mother...she arrives at the hospital for her induction, laden with books and luggage and cameras and baby bags and snacks and the kitchen sink...not to mention, she's also toting her weary husband, who has just lugged everything up from the parking lot (in one trip, of course). We get her settled in, she, who's all freshly washed, make-uped, pedicured, coiffed...and we begin the induction dance.

Nurse, "Hello, Sweet Young Mother! What brings you in for induction today?"

And, more often than not, we hear...(smiling) "Oh, I dunno! My doctor just said to come today, cuz' she was on call."

Okay, let's digress a bit...a quick lesson in "MD Bucks 101", no, scratch that..."Obstetrician Bucks 101". I'm quite certain nationwide (although I could be wrong, so don't take this for gospel...not that, you know, I ever thought you took anything I say for gospel, just sayin'), or for certain in MN, that OB patients are "a bundle charge". Yes, they charge a bundle (for your little bundle), but that's not what I mean. What I mean is that OB's get x amount of dollars for your prenatal care and y amount of dollars for your delivery.

So, a quick math lesson, x + y = a big bundle of bucks.

As in...your OB may think you are the sweetest, kindest, most normal (and let me tell ya, normal is hard to find!!) patient she's ever had, but, alas, she would love to do your delivery because x + y = more bucks than just x.

As in...if one of your OB's partners does your delivery, your OB just gets x.

So, it is in your OB's pocketbook's best interest to do your delivery.

Okay, now back to our "induction" lesson. But first, let me set something straight. There are plenty of reasons (real reasons) for's not growing, low fluid, high blood pressure, crappy placentas (the list goes on and on) and then there are (insert echo-ey voice here) the other reasons. The "my doctor's going on vacation" or "my ankles are swollen" or "I really want my baby to be born on the second equinox in the month of the butterfly when the wind is blowing from the N-NE", reasons.

And let me be frank (can I be frank with you? Will you still like me? Call me Mama Frank for a bit...), those reasons will set you up for failure. C-section rates for "elective" inductions are sky high...wanna know why?

'Cuz your bod's not quite ready, sweet young mother.

39 week inductions are the "norm" in my hospital. I so wish...I so, so, sooooo wish, that our sweet young mothers were more educated about the induction gig. This whole "lesson" is stemming from my delivery tonight...a (say it together now) sweet young mother requested an induction at 39 weeks (and some odd days)...and, subsequently, squished and squeezed and lodged her baby into such a position that she ended up with a c-section.

Tears, disappointment, infection risks, funky baby heads, and probable repeat c-sections ensued...and all in the name of what?


Discomfort? (Heeelllloooo!!! Welcome to month 9 of pregnancy, my dears!)

Great-aunt Beatrice's Birthday?

I dunno...I can never quite figure out a kind (not snarky) way to ask "Why the heck are you requesting this induction, sweet young mother?"

Now, if we were talkin' bonafide reasons for induction...absolutely.

In fact, often, when there is a "real" reason for induction, things go quickly and Mother Nature realizes that "yes, indeed" it's time for the little bundle to be evicted. No more leeching off it's mama, it's time for this baby to do "this life thing" on it's own. (Aside by me...I once heard a doc (not OB...oops, I just parenthesis-ed within a parenthesis) refer to a "fetus" as a parasite! Half-jokingly, he said..."they just take everything from their host"...kinda funny. Just kinda.)

The real reasons are good and kind and well. Even (I know some people will probably crucify me for this) when you are "post dates". Your "Estimated Date of Confinement" (what a great phrase, huh? *snort*!!) is, indeed, an estimate. But, with recent scientific advancements, like, say the ultrasound, for example...this estimate is a pretty darn good guess. As in, if the Powerball came with ultrasonic guesses, I'd take my chances...frequently.

So, being in the field that I'm in, working at a fairly large teaching hospital, seeing the yuckity yuck that I see...I'd not ever let myself, my bestfriend, or you go more than a week past the "Estimated Date of Confinement"...remember above mentioned "crappy placentas"? Yeah, that's what happens when you go too far past your EDC (that's what we nurses call it)...and baby's don't so much like crappy placentas, and their lungs don't do so well with meconium in them. Which is why I prefer babies on the outside after week 41. But, remember, my word is not gospel, 'k?!!

So, in summary (this is a lesson, afterall!) medical induction...yes!! Convenience!!! Any questions?

So, my lovely blog friends...with that I leave you this:

"Wise woman once say: Sweet young mothers must know not what is convenient, but what is best."

Or something...


  1. This made me laugh. I was induced at 38weeks for the "real reasons" of low fluid and high bp. And it still wasn't easy! I cannot fathom why anyone would want to go through it that way.

    Thank you for putting a fun spin on the subject :-)

  2. I had my babies in MN and that's how it works...dr. getting paid per visit, per birth, etc. I was also induced for both births and totally didn't want to be! First one I needed my gull bladder out and second one I was dialated to a 4 for like days (ugh) and not in was labor and things went south, blah blah. Anyway I can see how anyone even close to 40 weeks is miserable and wants it out but it definitely bothers me when people don't have a reason and they're even being TOLD that it's better for the baby to not do it. There's just no reasoning with crabby, huge, sleep deprived women! :)

  3. I had to be induced for high blood pressure... I can't imagine anyone WANTING to go through labor that way...

  4. Funny way of putting a serious truth. You are so right. I hated asking for an induction with my third, but my blood pressure was skyrocketing and my nurse-midwife didn't want to do a darn thing about it. Freaked the hospital nurses out a little when they took it though. Thank God for nurse like you! The world needs more of them.

  5. No induction here! I'm a natural girl...well, natural about going into labor...once in labor- all about managing the pain. Which didn't work for the first...but worked great for the second, but that's another story. I have funny storied about my L&D nurses...loved them. I still remember their names! I'd like to think I was a normal patient...but you never know. :)

  6. Very informative. I will have to keep that in mind if I ever have anymore children and assuming that I won't have to have another c-section since I HAD to have one the first time. there even a wee little inkling of a chance that you could post five question Friday on say....Thursday night =-) Please, please, pretty please. I mean you know...if you aren't too busy helping birth babies and taking care of five children. Ya see my daughter is having surgery on Friday and I'm just not real sure I will be able to make it over here on Friday and that would just be uncalled for to not participate =-)

    In all serious though I TOTALLY understand if it's not possible. Just wanted to check!

  7. You have made my day! Now all I have to do is actually REMEMBER to do it Thursday night. And thank you for the prayers!

  8. I just have to you sing "Happy Birthday" as the baby makes it's descent, crowns, and begins coming out???

    Because I had one nurse that would NOT quit singing that song. After about 5 rounds (I mean, you know, it's kinda a LONG process....and i was in a LOT of pain!!!) I was pretty much ready to kick her in the face! While I appreciate her enthusiam, maybe she could have waited until the baby was totally born before she started singing. Just a thought.

    Totally agree with you, though. People are too impatient, too used to instant gratification. Some things are not meant to be rushed.

  9. great post. i wish all women could here this before giving into doctors or other pressures...convenience isn't always best.

  10. Loved your post! I was on bedrest with my 1st starting at 31 weeks due to frequent contractions (midwife was being super cautious). I ended getting induced at 41w1d and it was horrible. My body was not ready to go into labor yet at all. I pushed for nearly 4 hours! I ended up having a 10lb baby with a really large head. We had no clue he was going to be so big! I tore just about as far as you can tear and it took MONTHS to recover! With my 2nd I had the frequent contractions again, but I refused to do bedrest and went into labor naturally at 37.5 weeks. My birth was so easy and the recovery was a breeze. I am sure my first 10lb baby paved the way!

  11. I was induced once, for "fake" son's first day of Kindergarten was coming up. (No not the one still baking, he wasn't THAT far past his due date!) However I WAS 5 days past my EDC! But it was still super fast and easy, so I must have been ready. :-)

  12. Was induced with child #3. I was only 3 days past my due date. I dind't know what to expect and since everything was still healthy I should've just waited. It was miserably painful! I'd never had contractions like that before. Wish I would've gotten an epidural after that misery!! Definitely NOT a pleasant experience.

    Found you thru the Mom Link Roundup.

    ~Mimi @ Woven by Words

  13. I feel like I'm commenting on all of these, now. LOL!

    This is basically why I decided not to be induced this time, and after more research, decided I didn't want ANY meds unless truly necessary.

    My first two were "convenience inductions" at 39w2d, both of them, and I must have been pretty close anyway, because they both went smoothly. My first was on the long side (for what doctors like to see in a hospital, anyway, NOT for a first-contraction-to-final-push first-time labor) at 17.5 hrs, but both babies came out by the route God put there for them.

    In retrospect, I think I was probably pretty lucky with my first. I'm glad it worked out the way it did.

  14. I found you through a MckMama forum, I believe. And you just spoke the gospel truth!!!!! And if only I had known what I know now!!!! In short....I wanted a vaginal delivery.....I was 40 weeks, 3 days....went to the hospital with false labor.....should have been sent home.....but my doctor offered to admit me....and as a "Sweet young mother".... I went right along with it. About a year later....I was in my Women's Health class in nursing school and found out the, "if only I knew" part. Now having 2 c-sections....still live with a lot of what ifs....still saddened by the fact that I will never know what it was like to 'give birth.'

    Now that I sound like, "Oh poor, pitiful me"....I am richly blessed and at the end of the day....I have 2 healthy girls...regardless of how they were born.

  15. I'm very glad for this post!! Just saw the topic on being induced early on BlogFrog, and came over via that. Thanks for sharing!


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