Why is my due date that big a deal?
Well, because for the first time in my life, I will have to figure out how to handle getting four children — including a breastfed newborn — out the door to be at school by 8:24 a.m., then I have to go back up to school at 11:30 for preschool pickup and then back, yet again, at 3:35 for regular school pickup. All while trying to also recover from childbirth.
I'm exhausted just thinking about it, to be honest with you. I have no idea how I will handle it all, even assuming that this little one comes by her expected due date.
Which is why I'm considering an induction at 39 weeks.
Without a medical reason.
Let's face it — babies don't adhere to a schedule of any kind, especially in those first few weeks (months). And I'm petrified of trying to navigate a schedule-free life working from home and doing school runs that will undoubtedly make the day zoom away faster than I can ever hope my postpartum belly will.
So, would it be fair to impart my own schedule on the little one still inside of me? Is it responsible parenting to weigh the risk of delivering her a week early with my own health and well-being in trying to recover and parent my three other children? Or does nature always know best?
Now, we all know that inductions without a medical reason before 39 weeks are a bad idea. The American College of Obstetricians and Gynecologist firmly states that all inductions without a very valid medical reasons before 39 weeks are highly discouraged, even in the cases of suspected "large" babies. (Because that diagnosis is often wrong.) Premature birth carries along all sorts of negative ramifications for the baby and doctors have listened — for the first time ever, induction rates have been falling in the U.S.
Working in labor and delivery, I saw many supposed "medical" inductions that led to negative outcomes for both the mother and baby, such as prolonged labors and eventual C-sections. In fact, I'm pretty adamantly anti-induction, especially for first-time mothers, and understand that they come with a lot of extra risks, such as increased respiratory problems for the baby, higher chances of having a C-section and more nursery admissions for babies born before they may have been ready. There is also a horrifying study that showed that women are twice as likely to develop an amniotic fluid embolism, a nearly always fatal complication, if they have been induced.
But on the flip side of all the risks of an induction is the reality that "elective" or "social" inductions, the kind that occur for no medical reason whatsoever, happen all the time in labor and delivery units. Usually on the day that a patient hits 39 weeks, so there are no red flags from the powers that be that track these sort of things, and usually during a weekday, so it's more convenient for the doctor to pop in after office hours to deliver the baby. In fact, it's not that uncommon for a doctor to name a medical reason for the induction, even if it's not exactly accurate.
So why does it happen?
Put simply, inductions are convenient. Not only for doctors who keep already-erratic schedules, but also for mothers like me who are exhausted from pregnancy, miserable from being so huge and anxious to time the delivery optimally in order to care for their other children as well. The lure is understandable. In fact, I can remember trying to talk one anxious first-time mother out of her elective induction when I first became a nurse, but she would have nothing to do with me. She was adamant that she was done.
And wouldn't you know it?
Her induction went smoothly and she was holding her baby by the end of the day, with nary a complication in sight. (A rarity for first-time inductions, I might add.)
While inductions don't always mean doom and gloom, there is always a risk and I can't discount that, especially because as an OB nurse, I definitely know better. But then again, my baby may also be at risk if I deliver late, don't have enough time to recover and wind up sick. (Like I did with my last birth.) Like any mother, I am trying to balance what is best for all of my family and that unpredictability of labor and postpartum recovery is a huge stressor.
So what's your opinion?
Does Mama always know best? Or does Mother Nature take the cake on this one?
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