Tuesday, July 21, 2009

Inductions


Ok, so I'm posting about inductions, again. Yes, I'm irritated about them, again. So, here are my lists.

Reasons to induce:
  • Preeclampsia (or worsening preeclampsia/HELLP)
  • Eclampsia (life threatening, usually means a c-section)
  • Chronic high blood pressure that is difficult to keep under control or is affecting the baby's growth
  • Intrauterine growth restriction
  • Gestational diabetes - induction can be indicated at 40 weeks for this, to prevent complications related to the diabetes (risk for stillbirth goes up, blood glucose out of control)
  • Mom has an illness or medical condition that continuing the pregnancy would make the condition worse, or could endanger mother or baby's health.
  • Very low amniotic fluid levels (below 6) - usually confirmed by a 2nd ultrasound -- first ultrasound could have been wrong.
  • Fetal distress or health concerns for the baby based on prenatal screenings (NSTs, biophysical profiles)
  • Post dates (beyond 42+ weeks)
  • Amniotic sac has ruptured but labor hasn't started within 24-48 hours.
NOT Reasons to Induce:
  • Large for gestational age
  • Maternal discomfort
  • Hypothyroidism
  • History of short labors
  • Live more than 30 minutes from the hospital
  • Family will be in town
  • Want to pick the birth date
  • Edema
  • Tired of being pregnant
  • Husband in the military
  • Patient convenience
  • Doctor convenience
  • One or two days past your due date

About one out of every five pregnant women in the U.S. has their labor induced, according to the CDC. You can't honestly tell me that 1 in 5 women have the above medical indications for induction.
“It's really become an epidemic,” said Dr. Mildred Ramirez, an author of the American College of Obstetricians and Gynecologists guidelines and professor of ob-gyn at the University of Texas Medical School at Houston.

The overall induction rate doubled from 1999 to 2006.

Ladies!!! Wait it out. Be firm.

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