Interventions

December 7, 2017

So I currently have an induction date set on the calendar: 12/10/17.  Sunday.

Baby #3 is due 12/9/17.  
There was no clear reason given for this induction other than “that was the date the hospital had available”.  So . . . I think I’m going to cancel it.
I am 100% for epidurals (I do NOT do well with pain and love this intervention!) and for inductions and Cs when indicated, of course.  But I need a reason other than scheduling (or even annoying insomnia, fatigue, or nausea) to justify getting things going medically when it’s a process that (theoretically) should naturally occur on its own.
I was thinking about how this relates to my practice of medicine.  In general, I wouldn’t say I’m a super-non-interventionalist – but I definitely don’t push medications or procedures, either.  I try to give patients all the options, risks, and benefits, and let them make their own decisions.  In many cases (example: mild precocious puberty) there is the option to do nothing (and watch and wait) vs do something (use meds that don’t always have the nicest side effects).  I absolutely offer both, but IF they ask me what I would do, many times the answer is watchful waiting.
SO.  I’m going to follow my gut and my own inclinations.
OF course I hope this rumination is all for naught — C came rather suddenly (water broke the night before the due date) but yeah.  
But I feel more at peace now.  
ON A VERY VERY VERY UNRELATED NOTE:
I ordered pencils from CW Pencil Enterprise(I learned about this shop/online store on the What Should I Read Next podcast and was intrigued by the Lefty Set!) and they came!  It was a lot of fun to try them.  I think I will use them for marking books perhaps?  Because I’m otherwise quite wedded to pens.  HMMM.  Still fun though.

13 Comments

  • Reply Erica S March 10, 2019 at 7:08 pm

    What makes these special for lefties? Are they smear-proof? My mom”s a lefty and she might enjoy these!

    I am also not into interventions for naturally going into labor. I got an epidural with baby 2 and looking back wish I had done it for the first. It was Traumatic.

    I keep thinking about you! I have 12/8 on my mind :).

  • Reply Ashley March 10, 2019 at 7:08 pm

    Thinking of you Shu! This is all a little funny to me, because I loved my induction. I pretty much knew exactly when I’d be going to the hospital (39 6/7), which was great for a planner-in-the-making like me 🙂 I legit went in to my grad student office and worked for a few hours in the morning, left early, ate, and drove to the hospital with my husband. It was nice not to have any panicy SHOULD WE GO NOW OR IN AN HOUR type of emotion and decision making. It also gave me the theoretical option of not having to deal with too many contractions, because I could place my epidural request right after they finally started (which, IMO, is a totally important thing when Pitocin is involved! Unfortunately, anesthesiologist was tied up and it took hours. But man I love epidurals!).

    I should say, though, that my induction was medically necessary, and will likely be necessary for all future kiddos, so there’s that.

  • Reply Chelsea March 10, 2019 at 7:08 pm

    I feel like OB/GYN is one of those areas where things are often NOT presented as choices, or at least it’s hard as a layman to know if you have a choice or not. My oldest son (born 12/10/12!) was both breech and SGA and was delivered by scheduled C-section at 38.5 weeks, and I often wonder if I should have questioned my OB’s decision not to try to turn him. I never asked why or could we just try it, I just took it on faith that that was the only way. Then I wanted to have a VBAC with my second and went past my due date and had a repeat C-section because the doctor "didn’t really like to have women go past 40 weeks." Again, I probably should have pushed back, but I think it can be hard for some people/personalities to question authority figures like that. So now I have 3 babies and no labor, which is kind of funny, and maybe I should be glad, but part of me feels like I missed out on something universal about motherhood. On the other hand, I have 3 healthy kids so what can I really complain about?

    On a completely different subject related to the podcast, Laura mentioned a couple times the idea of women "not writing the great American novel late at night after the kids are in bed" BUT I remember reading an essay by Diana Gabaldon (who wrote the Outlander series, now a TV show on Stars) that she DID write her first novel at night while she had 3 little kids and was working as a college professor. I don’t know if Laura would have any way to get her as a podcast guest, but I think she would be awesome because 1.I love Outlander 2. She seems like an interesting person in general and 3.She’s of our mothers’ generation so she had the perspective of having "come through to the other side" of parenting.

  • Reply Laura Vanderkam March 10, 2019 at 7:08 pm

    Sending you good thoughts as you near your due date! I had three inductions. The first two were because I went so far past my due date. So then with #3 I scheduled an induction at 39 weeks because hey, if I’d have to be induced anyway, I wanted to avoid those last 2 weeks (39-41). I kind of figured my body had no idea how to actually go into labor on its own. With #4, I also scheduled an induction at 39 weeks, and then he came on his own fast and furious the night before. So…who knows how #3 would have played out if I’d waited.

  • Reply Omdg March 10, 2019 at 7:08 pm

    I”ve recently seen some inductions go so fast that had they not electively induced, birth would have occurred on the kitchen floor (no time even to get in the car). Before that I would have agreed with you 100%, but after I was kind of like whoa…. I personally prefer more control than that! However, it probably won”t matter at all. 😊. I”m so excited for you!

  • Reply Morgan March 10, 2019 at 7:08 pm

    I”m def not a doctor but having been through this with my first baby just a few months ago – I say go with your gut! My babe was 12 days late and actually decided to come on his own once we got to the hospital for my scheduled induction, which I held off on as long as possible since I planned to try natural childbirth. Luckily, my doctor respected my choice to wait as long as possible as long as everything looked ok medically (placenta function, fluid levels, etc. ) And everything went beautifully. Good luck!!! This is such an exciting time.

  • Reply ali March 10, 2019 at 7:08 pm

    I’m all for whatever works for you, but just wanted to chime in and say inductions aren’t all that bad (assuming you plan to get an epidural again). My water broke with #1 but absolutely nothing happened, despite hours of walking miles around the hospital, so I wound up getting pitocin. Then for #2, I scheduled an elective induction and it was a good experience. I like predictability! That and my body never had ANY signs of labor/dilation/etc. so my joke is that I would still be pregnant with #1 had they not hooked me up to drugs. 🙂 Definitely do whatever works for you, but don’t be nervous if you need to go the induction route. Best wishes to you and your family!!

  • Reply Irene March 10, 2019 at 7:08 pm

    So fascinating to hear about other people’s experiences on this … with my first I was told induction wasn’t even on the table until 41 weeks (and the baby was measuring plenty big/ ahead of schedule on every ultrasound). If I had had any idea how horrible that last week was going to be I might have pushed them harder on it and maybe I could have gotten my giant baby out without the c section I eventually ended up needing. Any way I am a firmly in the camp of "thank goodness for modern medicine" and any birth that leaves mom and baby alive and healthy is a good birth! Good luck!!!!

  • Reply Cbs March 10, 2019 at 7:08 pm

    Good luck! I was all for waiting for things to happen naturally. My waters partially broke at 41 weeks and I went in for an induction 3 days later and I was already in labour. Because of the gap between waters breaking and labour, I had to have pitocin and the epidural didn”t work….so that was fun. I held out for such a long time on the epidural (24 hours from when contractions started) which was silly, I think I was brainwashed from my childbirth class.

  • Reply Gillian March 10, 2019 at 7:08 pm

    I spontaneously went into labor with #1 and #2. #3 and #4 were induced, both at 39 weeks, one for non-reassuring tracing and the other for unstable lie (#4 was still doing summersaults at 38 weeks and there was concern my water would break when while he was transverse of breech and that would be potentially dangerous). I was also >35 years old with the second two and my OB stood by induction at 40 0/7 for mom’s 35-40 years old. Her opinion was nothing good happens after 40 weeks. That said, especially with older kids at home, I loved being induced. It was organized and civilized and gave me a chance to say goodbye to the big kids and give them a nice heads up about what was going on. Plus, I got those epidurals before things ramped up too far. I would whole heartedly encourage you to keep your induction scheduled. Just my two cents of course!

  • Reply countingdowntildaddy March 10, 2019 at 7:08 pm

    I’m sure it comes as no surprise, but I would definitely cancel an induction scheduled for 40+1 unless there was a good reason for it. Based on your other two I think you should feel confident she will come on her own any day now. Sending good labor vibes your way! My holiday baby was a great gift last year when he basically ejected himself within an hour of arriving at the hospital. My midwife told me she was actually a little surprised because sometimes when a mom has already had twins the uterus is a little less efficient (having been stretched a little extra last time). I know you like your epidurals, but a speedy birth with no time for one wouldn’t be bad 😉 I can’t wait to hear how it goes!

  • Reply Brittnie March 10, 2019 at 7:08 pm

    Your perspective makes sense. Regardless of what others do or their opinions, I think it’s so important to follow your gut. Those feelings are there for a reason.

    And also I’m glad to read your perspective on mild precocious puberty. We had some concerns with Clara and she was checked by a pedi endocrinologist this year and this was our decision, watch and wait and recheck in one year.

  • Reply shellychlan March 10, 2019 at 7:08 pm

    I’m late to post but I wanted to say I hope things are going well.
    With my son I was I think a couple of days late and induced. He was suctioned out as well due to his heart rate dropping. With my second, I really wanted to experience things happening naturally but I was measuring small and they had me totally freaked out. On my due date I went for a check in and had high blood pressure which I had never had during either pregnancy so she gave my 40 minutes to drive home and get to the hospital to be induced. I think it was stress and wish they had let me wait but I also understand that they ere on the side of safety for the mom and baby and felt it was the best course of action. (my daughter came out healthy and all was good).
    I am sending you thoughts for a safe and healthy birth!

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