BirthBlog: To induce or augment, that is the question


The question on whether to go for an induction or to augment labour is a controversial one.  Whether or not one accepts is not really the issue for this blog (so the title may be a bit deceiving).  Instead, it is important for mothers and fathers to keep in mind that this decision is one of the first they will take regarding the well-being of their child (and the mother).  Like with all life choices, it is empowering to make an informed choice / informed decision (which is not the same as informed consent).

To make an informed decision, not only should you do your own research, but also you should ask the right questions.  Questions such as:

  • Why is this being suggested (the reason)?
  • How does the test/procedure happen?
  • Are there or what are the alternatives (including waiting, doing nothing or other)?
  • What are the risks to the mother? to the baby?
  • Are there any side-effects to the treatment (short term or long term)?

To remember these types of questions you can use the acronym BRAIN:

B What are the Benefits?
R What are the Risks?
A What are the Alternatives?
I  What are the Implications? And what does my Intuition tell me?
N What if we do Nothing?

acogstatement

ACOG Statement

What this blog will say with regards to the question of inductions and augmentations is like with all “procedures” these are not done without risk, to both mother and baby.  Often the risks are glossed over and other times the risks and benefits aren’t explained in terms that are easily understood.   Even other times things are well explained but just cannot be absorbed (such as during labour when the mother’s body and right brain are occupied with the birth of the baby, but it’s the left logical brain which has to make an informed decision).  If you do your research in advance, before the point where you have to ask the questions and/or make a decision, you will feel more confident about your choice.

You can research on your own or ask for the help of a doula, independent midwife, or a childbirth educator.  He or she may loan you literature/books or may point you to certain research.   The latest research to come out from the ACOG includes an opinion statement which outlines the only cases when inductions should be attempted as well as a study that concludes that there are adverse effects to the newborn when artificial oxytocin is used (see Box 1 above).  The ACOG also has a FAQ on postdate pregnancies that is worth reading.  Additional resources that might be suggested are the following webpages:

Even when the risks are high, the benefits may outweigh those risks.   Do your research, discuss the options with your healthcare provider and then decide.   By making an informed decision, you take control of your care which is just the first step in becoming an empowered, confident, parent.

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