http://www.worldmilksharingweek.org/
I'm so excited to be asked to be a representative for the first ever World Milk Sharing Week!!!! From September 24-30, 2011, our goal will be to further the mission of promoting human milk as the biologically normal nourishment for babies and children, as well as to celebrate milksharing itself! Stay tuned for more details!
Monday, July 4, 2011
Monday, June 13, 2011
The Marketing of Marketing, or Why You Won't "Be Wildly Successful if you Just Hire The Right Guru"
I'm from Alberta, a province where young families tend to make a boatload of money thanks to the oilpatch & other industries where skilled trades make 6 figure incomes without blinking. While these families are growing, they want to spend their disposable income on their children, buying them clothes, toys & accessories from businesses selling mainly online & at trade shows. This means we have more than our share of start up businesses aimed at that demographic, with new ones opening daily.
Way back in the day (2006!!), when my partner & I opened our business, there were a handful of local stores where you could purchase a few brands of baby carriers & cloth diapers from, as well as a handful of online Canadian stores. As quickly as we grew, the marketplace did too & there are now more than 20 (at my count) Edmonton-based businesses selling those items.
What's really grown exponentially are the hand made accessories & the trade shows they're sold at. Again, where only a few years ago there were a handful of major trade shows, craft fairs & local markets where companies selling baby & childrens products could exhibit, there are now dozens in the area.
I realise these are local examples, but I think they illustrate the trend really well. No one is making a living doing this because the market is so saturated, so when solicitations for marketing pop up (we get offers weekly!), they're totally tempting to small business.
"Hey Mompreneurs, want to increase sales while looking fabulous & having the dream life you've always dreamed of?!? Subscribe to my blog/e-book/website & attend my momseveningout/wine&cheese/fabworkshop & learn all my secrets!!!"
For no charge, you can often glean some ideas or tips; for a pretty small fee, usually a few hundred bucks, you can hire a marketing consultant to help build your brand. What annoys me as a small business owner is that the marketing of the marketing seems to take precedence over the substance of evaluating the viability of growth of your business.
The tips provided essentially boil down to:
-Network, network, network, at gatherings, trade shows, etc. Get to know other business owners & make sure they know you.
-Tweet, Facebook & Blog so you develop a big fan base
These aren't bad suggestions & they certainly reflect the business plan of most small companies these days. The problem is that to charge for your advice, you should be able to establish that these strategies work. I want to see hard data- increased sales volume, sales to a new customer base, increased market share, etc. Hiring marketing help can be a great use of money, if they can provide results- but I don't think the marketing of marketing offers that. Time & money spent on this kind of marketing is likely wasted, save it for a company with legitimate experience in your industry & ability to prove their effectiveness with increased sales.
Legitimate marketing takes a look at your product, the market, your pricing, customer base etc & establishes a concrete & realistic plan for advertising and growth. It does not suggest you spam other businesses by posting your links on their Facebook wall. It does not see "networking" with similar local businesses competing for the same share of the same market as key to your growth and success.
There's nothing wrong with being a small business, making a nice product and earning income you're satisfied with. There's nothing wrong with dreaming big, either!! In a market like ours, though, where it's quite saturated & we're all fighting for pieces of a shrinking pie, a reality check is needed. At the end of the day, I think we as business owners need to stick to what we do best and avoid the fluffy marketing/happiness/lifestyle gurus. Simple concepts like knowing your customers, listening to their needs and providing them with what they're asking for are what builds business long term.
Way back in the day (2006!!), when my partner & I opened our business, there were a handful of local stores where you could purchase a few brands of baby carriers & cloth diapers from, as well as a handful of online Canadian stores. As quickly as we grew, the marketplace did too & there are now more than 20 (at my count) Edmonton-based businesses selling those items.
What's really grown exponentially are the hand made accessories & the trade shows they're sold at. Again, where only a few years ago there were a handful of major trade shows, craft fairs & local markets where companies selling baby & childrens products could exhibit, there are now dozens in the area.
I realise these are local examples, but I think they illustrate the trend really well. No one is making a living doing this because the market is so saturated, so when solicitations for marketing pop up (we get offers weekly!), they're totally tempting to small business.
"Hey Mompreneurs, want to increase sales while looking fabulous & having the dream life you've always dreamed of?!? Subscribe to my blog/e-book/website & attend my momseveningout/wine&cheese/fabworkshop & learn all my secrets!!!"
For no charge, you can often glean some ideas or tips; for a pretty small fee, usually a few hundred bucks, you can hire a marketing consultant to help build your brand. What annoys me as a small business owner is that the marketing of the marketing seems to take precedence over the substance of evaluating the viability of growth of your business.
The tips provided essentially boil down to:
-Network, network, network, at gatherings, trade shows, etc. Get to know other business owners & make sure they know you.
-Tweet, Facebook & Blog so you develop a big fan base
These aren't bad suggestions & they certainly reflect the business plan of most small companies these days. The problem is that to charge for your advice, you should be able to establish that these strategies work. I want to see hard data- increased sales volume, sales to a new customer base, increased market share, etc. Hiring marketing help can be a great use of money, if they can provide results- but I don't think the marketing of marketing offers that. Time & money spent on this kind of marketing is likely wasted, save it for a company with legitimate experience in your industry & ability to prove their effectiveness with increased sales.
Legitimate marketing takes a look at your product, the market, your pricing, customer base etc & establishes a concrete & realistic plan for advertising and growth. It does not suggest you spam other businesses by posting your links on their Facebook wall. It does not see "networking" with similar local businesses competing for the same share of the same market as key to your growth and success.
There's nothing wrong with being a small business, making a nice product and earning income you're satisfied with. There's nothing wrong with dreaming big, either!! In a market like ours, though, where it's quite saturated & we're all fighting for pieces of a shrinking pie, a reality check is needed. At the end of the day, I think we as business owners need to stick to what we do best and avoid the fluffy marketing/happiness/lifestyle gurus. Simple concepts like knowing your customers, listening to their needs and providing them with what they're asking for are what builds business long term.
Monday, February 21, 2011
I don't believe in Unassisted Childbirth AKA a rose by another name
By Lee-Ann Grenier
Two months ago I gave birth to my third child at home in what many would describe as an unassisted childbirth (UC) or freebirth. Throughout the pregnancy and up to his birth this is how I thought of it as I prepared for the arrival of our second son. I felt uneasy with the terminology and others I spoke to felt the same way. "Unassisted Childbirth" sounds reckless and cavalier; to some it implies a complete disregard for medical care even in the event of a true emergency. No one I know who has had a planned unassisted birth would avoid seeking appropriate medical care when necessary. In fact many women attempting freebirth have transferred to hospital when they felt it necessary. Sometimes it can be hard to separate from those who plan to birth without professional assistance and those who have their babies at home (or in the car, or Wal-Mart) by mistake. Media portrayals of these births where everyone is "miraculously fine" often confuse the issue.
The term itself causes some dissension among the families who choose this type of childbirth. The discussion usually centres around what qualifies as UC. Does having an unregistered midwife or a traditional birth attendant count? What if you have a doula, family member, or friend attend the birth? Some people even go so far as to define an unassisted birth as one where no one is present but the mother. Does a birth where one hires a midwife but doesn't call them count, or one where the couple camps out in the vicinity of the hospital qualify? These discussions can become very heated and polarizing.
The term Freebirth can be equally confusing but on a more emotional level. I find this wording invokes feelings of easy painless birth that, in my experience, can be quite deceiving. Free- from what, and for what, were concepts that I wrestled with both during the pregnancy and after the birth. Although a couple that chooses this type of birth might find freedom from the medical establishment, it comes with the heavy price of taking complete responsibility for the birth. There is the freedom to choose how one labours and delivers in this type of birth, but that can also be experienced by a strong woman in a hospital setting (with the right kind of support ;). There is the freedom to provide ones own care and comfort, but there is cost of doing so. The more I wrestled with these concepts the more apparent it became to me that the terms didn't fit.
My son's birth was not unassisted. We had friends come to help in the way that one needs with a homebirth. They dealt with the older children, fetched food and drink, provided warm towels, warmed up the pool and took pictures. We had friends light candles and provide us with their warm thoughts throughout the labour day. My husband supported me both physically and emotionally. We called upon the sage advice of a doula friend over the phone. At the moment of my son's arrival his birth was assisted by me; pushing him into the world, my husband; holding my body, and my dear friend Kirsten providing pushing support and calling the play by play. I suppose the biggest assistance came from the force or energy that created me and gave my body the ability to birth my baby (I call it God, but you have your name for it). So the question that came to my mind after he was born was how could I call this unassisted? Many asked and I felt hesitant to use these words in reply. I felt that if I said Elijah's birth was unassisted it would be very unappreciative of all the people who gave us their love and support on that day.
Elijah's birth was also not free. It was hard work, mentally and physically. It took a whole 12 hour day, and the toll on my body was (understandably) high. We paid a price for operating outside the system (imagine how hard it is to register this kind of birth) in terms of providing our own care and dealing with the feelings other had about our birthing choices. I will admit that we did have the freedom to let my son's birth unfold unhindered.
In the reflective moments since his birth I struggled to come up with the right words to describe the way in which we chose to bring our second son into the world. Eventually it came to me, what we had was a traditional homebirth. We called upon the support we needed to have the birth unfold in the way we wanted it too. If we had required it we would have sought the care of a midwife or the services provided at our local hospital. But we didn't, and this is how birth happened, traditionally. Sisters, mothers and women friends have been birth assistants for eons and at these births more experienced midwives or doctors were only called in when things got tricky, and in this way birth worked, assisted appropriately. So the next time someone asks me if I had an unassisted birth I'll say "No, I had a traditional homebirth." and leave it at that.
Two months ago I gave birth to my third child at home in what many would describe as an unassisted childbirth (UC) or freebirth. Throughout the pregnancy and up to his birth this is how I thought of it as I prepared for the arrival of our second son. I felt uneasy with the terminology and others I spoke to felt the same way. "Unassisted Childbirth" sounds reckless and cavalier; to some it implies a complete disregard for medical care even in the event of a true emergency. No one I know who has had a planned unassisted birth would avoid seeking appropriate medical care when necessary. In fact many women attempting freebirth have transferred to hospital when they felt it necessary. Sometimes it can be hard to separate from those who plan to birth without professional assistance and those who have their babies at home (or in the car, or Wal-Mart) by mistake. Media portrayals of these births where everyone is "miraculously fine" often confuse the issue.
The term itself causes some dissension among the families who choose this type of childbirth. The discussion usually centres around what qualifies as UC. Does having an unregistered midwife or a traditional birth attendant count? What if you have a doula, family member, or friend attend the birth? Some people even go so far as to define an unassisted birth as one where no one is present but the mother. Does a birth where one hires a midwife but doesn't call them count, or one where the couple camps out in the vicinity of the hospital qualify? These discussions can become very heated and polarizing.
The term Freebirth can be equally confusing but on a more emotional level. I find this wording invokes feelings of easy painless birth that, in my experience, can be quite deceiving. Free- from what, and for what, were concepts that I wrestled with both during the pregnancy and after the birth. Although a couple that chooses this type of birth might find freedom from the medical establishment, it comes with the heavy price of taking complete responsibility for the birth. There is the freedom to choose how one labours and delivers in this type of birth, but that can also be experienced by a strong woman in a hospital setting (with the right kind of support ;). There is the freedom to provide ones own care and comfort, but there is cost of doing so. The more I wrestled with these concepts the more apparent it became to me that the terms didn't fit.
My son's birth was not unassisted. We had friends come to help in the way that one needs with a homebirth. They dealt with the older children, fetched food and drink, provided warm towels, warmed up the pool and took pictures. We had friends light candles and provide us with their warm thoughts throughout the labour day. My husband supported me both physically and emotionally. We called upon the sage advice of a doula friend over the phone. At the moment of my son's arrival his birth was assisted by me; pushing him into the world, my husband; holding my body, and my dear friend Kirsten providing pushing support and calling the play by play. I suppose the biggest assistance came from the force or energy that created me and gave my body the ability to birth my baby (I call it God, but you have your name for it). So the question that came to my mind after he was born was how could I call this unassisted? Many asked and I felt hesitant to use these words in reply. I felt that if I said Elijah's birth was unassisted it would be very unappreciative of all the people who gave us their love and support on that day.
Elijah's birth was also not free. It was hard work, mentally and physically. It took a whole 12 hour day, and the toll on my body was (understandably) high. We paid a price for operating outside the system (imagine how hard it is to register this kind of birth) in terms of providing our own care and dealing with the feelings other had about our birthing choices. I will admit that we did have the freedom to let my son's birth unfold unhindered.
In the reflective moments since his birth I struggled to come up with the right words to describe the way in which we chose to bring our second son into the world. Eventually it came to me, what we had was a traditional homebirth. We called upon the support we needed to have the birth unfold in the way we wanted it too. If we had required it we would have sought the care of a midwife or the services provided at our local hospital. But we didn't, and this is how birth happened, traditionally. Sisters, mothers and women friends have been birth assistants for eons and at these births more experienced midwives or doctors were only called in when things got tricky, and in this way birth worked, assisted appropriately. So the next time someone asks me if I had an unassisted birth I'll say "No, I had a traditional homebirth." and leave it at that.
Thursday, October 7, 2010
Babywearing Caregiver!!!
Christina Dawn Monroe
What babywearing has meant to Lennox this our journey:
Lennox is 11 months old. He came into my care at 6 months of age. He is exclusively breastfed; his mom was the only one to ever put him to sleep. He is a boob man, for bed time. I was also warned he was not a stroller fan.
I have worked in the childcare field for 15 years (have a degree in early childhood education). As I just recently went back to having a day home. I had not owned a carrier for years. I ordered a babyhawk with my first pay check from Lennox’s parents. Then we waited a further 2 weeks for it to arrive. For one whole month we were carrierless. It was a pretty shitty month.
We had the challenge of dealing with transitioning to reverse cycle breast feeding. You see Lennox does not like bottles (regardless of how many different kinds I tried) and the same went for sippy cups. For liquids we went to feeding with a spoon and mom coming to feed at lunch if needed. Then there was the whole I do not sleep without a breast thank you. Apparently dad had never had any luck either. Did not matter that I walked around with him, he was not left alone to cry. He was only going to sleep because he screamed himself out. Then there was the strollers 3 different kinds. He screamed even louder, with summers so short here we had to go out regardless of the yelling.
The day the package came is the day everything went up hill. It changed everything for the better.
I opened my pretty package and strapped him in and he just relaxed. He was calm for the first time in a month. He quickly learned to sign for his carrier if he needed to be up instead of on the floor exploring. If he needed to be closer to me. We figured out that if we are close and feel safe we can fall right to sleep. He kind of just gives a sigh and passes out. I can then transfer him to a mat or keep in there if we are out. We learned by watching closely that straws are cool (I have an addiction to iced lattes) He would watch me intently, so focused as it is so close to his face. We got him a litter-less juice box and away we went! He snuggles the juice box full of breast milk right between my breasts and drinks it all down! No more spoon feeding milk! We no longer have to use a stroller to go out so we can go many more places; he has a bird’s eye view. We can climb rocks and he can see! He can choose not to wear mittens and be inside my coat instead! Life is wonderful.
Mom thought this was cool borrowed my carrier then ordered herself her very own. Now dad can put him to sleep too!
Babywearing has made Lennox into a much happier little person.
What babywearing has meant to Lennox this our journey:
Lennox is 11 months old. He came into my care at 6 months of age. He is exclusively breastfed; his mom was the only one to ever put him to sleep. He is a boob man, for bed time. I was also warned he was not a stroller fan.
I have worked in the childcare field for 15 years (have a degree in early childhood education). As I just recently went back to having a day home. I had not owned a carrier for years. I ordered a babyhawk with my first pay check from Lennox’s parents. Then we waited a further 2 weeks for it to arrive. For one whole month we were carrierless. It was a pretty shitty month.
We had the challenge of dealing with transitioning to reverse cycle breast feeding. You see Lennox does not like bottles (regardless of how many different kinds I tried) and the same went for sippy cups. For liquids we went to feeding with a spoon and mom coming to feed at lunch if needed. Then there was the whole I do not sleep without a breast thank you. Apparently dad had never had any luck either. Did not matter that I walked around with him, he was not left alone to cry. He was only going to sleep because he screamed himself out. Then there was the strollers 3 different kinds. He screamed even louder, with summers so short here we had to go out regardless of the yelling.
The day the package came is the day everything went up hill. It changed everything for the better.
I opened my pretty package and strapped him in and he just relaxed. He was calm for the first time in a month. He quickly learned to sign for his carrier if he needed to be up instead of on the floor exploring. If he needed to be closer to me. We figured out that if we are close and feel safe we can fall right to sleep. He kind of just gives a sigh and passes out. I can then transfer him to a mat or keep in there if we are out. We learned by watching closely that straws are cool (I have an addiction to iced lattes) He would watch me intently, so focused as it is so close to his face. We got him a litter-less juice box and away we went! He snuggles the juice box full of breast milk right between my breasts and drinks it all down! No more spoon feeding milk! We no longer have to use a stroller to go out so we can go many more places; he has a bird’s eye view. We can climb rocks and he can see! He can choose not to wear mittens and be inside my coat instead! Life is wonderful.
Mom thought this was cool borrowed my carrier then ordered herself her very own. Now dad can put him to sleep too!
Babywearing has made Lennox into a much happier little person.
Friday, October 1, 2010
Wearing My Son Through His Withdrawal
by Stacey Freeman
I am a mom of 5 and foster mom to 3, and huge fan of baby wearing!! My foster baby was dropped off at 10 days old extremely small, sick looking and going through withdrawal. At the same time he was arched backwards and impossible to hold he would just scream. After the first horrible night I went and dug through all by baby boxes in desperate need of my sling (he had been dropped off with only half hour notice, so I had no baby supplies handy. Honestly within 5 minutes he was asleep and content!! For the next 3 weeks he lived in that sling until the withdrawal symptoms had passed only coming out for diaper changes. I slept sitting up on the couch with him snuggled against my chest even.
I am adopting this baby now and he is the most precious happy little boy. I am SO thankful I had that sling!!
I am a mom of 5 and foster mom to 3, and huge fan of baby wearing!! My foster baby was dropped off at 10 days old extremely small, sick looking and going through withdrawal. At the same time he was arched backwards and impossible to hold he would just scream. After the first horrible night I went and dug through all by baby boxes in desperate need of my sling (he had been dropped off with only half hour notice, so I had no baby supplies handy. Honestly within 5 minutes he was asleep and content!! For the next 3 weeks he lived in that sling until the withdrawal symptoms had passed only coming out for diaper changes. I slept sitting up on the couch with him snuggled against my chest even.
I am adopting this baby now and he is the most precious happy little boy. I am SO thankful I had that sling!!
Wednesday, September 8, 2010
On Consent
Vyky Staples
(professional body piercer and fierce mama)
Informed consent is something I see discussed ad infinitum on blogs, message boards and in print in magazines. Informed consent is a powerful tool to have in our journeys as Fierce Mamas- being able to make an educated decision in regards to our health and wellbeing and the health and wellbeing of our babies. We are their advocates, and it's a duty I hold with utmost importance. We choose for our babies who are not able and ready to choose for themselves.
I want to share with you an event I experienced recently that radically shook me and cemented my beliefs. I was shopping. Seeking retail therapy, actually, as a way to relieve myself of some pent-up stress and to soften the blow of leaving my baby in the care of someone else as I am enrolled in school. My shopping trip was winding down, and I was making my way to the food court to grab a coffee to enjoy on the way home. I was approaching a jewelry store and as I neared it, I witnessed something that made my heart jump into my throat.
A very young baby, I'd guess to be around 3 months old, thrashing and screaming as her mother held her arms with one arm and immobilized her head with the other as a store employee was piercing her earlobes. I noticed the mother herself had tears in her eyes.
I was absolutely shocked and appalled. The whole scene had reduced me to tears, an I quickly had to flee the building where I sat in my car and sobbed over what I had just seen. I couldn't make sense of why the mother of that poor baby would subject her to such a thing. She was clearly acting against her maternal instincts- she herself was in tears- she knew what she was doing to her child was wrong.
Yes- WRONG.
It is absolutely, without a doubt wrong to modify the body of a person unable to consent- whether it be female genital mutilation, male circumcision or piercing the earlobes of a young girl. When a child or baby is unable to make informed consent, you are violating their bodies and you are violating their trust. Children are vulnerable and inherently rely on their parents to make decisions on their behalf. And by making permanent changes to their bodies when they are unable to understand the risks, the procedure, the aftercare and the permanent affects, you are revoking their right to choose for themselves.
Furthermore, the stress respond to the stimulus in question can have devastating effects on the infant. When put under extreme duress, the hypothalamus excretes cortisol. When the brain excretes large amounts of cortisol or is forced to excrete it chronically (such as when a parent allows the child to "cry it out"), it can increase the risk of SIDS, and can, in the long term, affect the memory, attention, and emotional wellbeing of the child. Studies also suggest that this can manifest in adulthood into anxiety and depressive disorders.
This brings me to the question of why anyone would subject their child to such a procedure? Is it that important that complete strangers that you'll never speak to or see again know the sex of your baby? Children are not born with a sense of vanity- that is instilled in them by their surroundings as they grow. Baby girls have no need for bedazzled earlobes- they have a need for parents she can trust unconditionally to make sound decisions on her behalf until she is able to utilize informed consent of her own accord.
(professional body piercer and fierce mama)
Informed consent is something I see discussed ad infinitum on blogs, message boards and in print in magazines. Informed consent is a powerful tool to have in our journeys as Fierce Mamas- being able to make an educated decision in regards to our health and wellbeing and the health and wellbeing of our babies. We are their advocates, and it's a duty I hold with utmost importance. We choose for our babies who are not able and ready to choose for themselves.
I want to share with you an event I experienced recently that radically shook me and cemented my beliefs. I was shopping. Seeking retail therapy, actually, as a way to relieve myself of some pent-up stress and to soften the blow of leaving my baby in the care of someone else as I am enrolled in school. My shopping trip was winding down, and I was making my way to the food court to grab a coffee to enjoy on the way home. I was approaching a jewelry store and as I neared it, I witnessed something that made my heart jump into my throat.
A very young baby, I'd guess to be around 3 months old, thrashing and screaming as her mother held her arms with one arm and immobilized her head with the other as a store employee was piercing her earlobes. I noticed the mother herself had tears in her eyes.
I was absolutely shocked and appalled. The whole scene had reduced me to tears, an I quickly had to flee the building where I sat in my car and sobbed over what I had just seen. I couldn't make sense of why the mother of that poor baby would subject her to such a thing. She was clearly acting against her maternal instincts- she herself was in tears- she knew what she was doing to her child was wrong.
Yes- WRONG.
It is absolutely, without a doubt wrong to modify the body of a person unable to consent- whether it be female genital mutilation, male circumcision or piercing the earlobes of a young girl. When a child or baby is unable to make informed consent, you are violating their bodies and you are violating their trust. Children are vulnerable and inherently rely on their parents to make decisions on their behalf. And by making permanent changes to their bodies when they are unable to understand the risks, the procedure, the aftercare and the permanent affects, you are revoking their right to choose for themselves.
Furthermore, the stress respond to the stimulus in question can have devastating effects on the infant. When put under extreme duress, the hypothalamus excretes cortisol. When the brain excretes large amounts of cortisol or is forced to excrete it chronically (such as when a parent allows the child to "cry it out"), it can increase the risk of SIDS, and can, in the long term, affect the memory, attention, and emotional wellbeing of the child. Studies also suggest that this can manifest in adulthood into anxiety and depressive disorders.
This brings me to the question of why anyone would subject their child to such a procedure? Is it that important that complete strangers that you'll never speak to or see again know the sex of your baby? Children are not born with a sense of vanity- that is instilled in them by their surroundings as they grow. Baby girls have no need for bedazzled earlobes- they have a need for parents she can trust unconditionally to make sound decisions on her behalf until she is able to utilize informed consent of her own accord.
To Induce or Not to Induce?
Tegan Vanden Bosch
It was my ten-week pregnancy check up. Being the nervous new-to-be mother, I had a lot of questions for my OB when I went to my appointment. One of many questions asked, and answered, was as follows:
“So at what point in the pregnancy do we start talking about the labor and delivery process?” I was just curious, I looking for answer akin to “Oh, about 30 or 35 weeks”. I’m a planner; I just wanted a time-line for myself to mentally prepare for every step in the pregnancy and birthing process. Instead I got something quite different.
“Well, we’ll probably induce you at thirty-eight weeks, most likely on a Thursday.”
What?!? Induction? What in the world for??? “I don’t really believe in being induced for a non-medically necessary reason . . .” I started timidly, completely taken for surprise. I hadn’t really been prepared to defend myself in such a manner at this point in my pregnancy.
In a very brisk, business-like manner, the doctor replied “It really is best, that way your husband will know ahead of time and can get off work (she nodded her head to my husband who was sitting in the chair next to the exam table), you’ll be able to get a full night’s rest before the baby comes . . .” and she continued to rattle off another half dozen or so reasons of why she wanted to induce me.
I couldn’t believe it, and at the same time that I was forming an argument in my head for every single reason, I felt powerless to respond. I felt as though my beliefs had just been trampled upon. From previous visits and conversations with this doctor, I knew that she and I stood on the same ground on many issues including contraception, natural family planning and God’s presence in the entire process of marital bliss, including conception. And here she was telling me she was going to induce me? I was only ten weeks pregnant; I wasn’t carrying twins, I didn’t have two uteruses or a uterus with a septum, I didn’t have any reason for being high risk and needing to have my labor induced. This OB had delivered three of my good friend’s babies and they all were able to have completely natural labors (without ever mentioning induction). Why did she suddenly say she wanted to induce me? Why didn’t she listen to what I wanted to say about being induced? Aren’t I the one who will have to carry and birth this baby and live with the choices and decisions and consequent life long memories, not her? I left her office that day stunned, disappointed, ignored and bewildered. I knew that I had a lot to think about.
My attributing factor to this news was that she had recently moved into a solo practice, away from a group practice. In a group practice, an OB is freed from being on call twenty-four/seven; an OB in solo practice doesn’t have that luxury. So for strictly business reasons of pure convenience, it is not unusual for an OB in solo practice to try to schedule as many inductions as possible, whether they are medically necessary or not.
I am not saying I am against inducing women into labor; there are certainly a number of reasons where a woman should be induced for her safety and/or the safety of her child. For example, preeclampsia or eclampsia (where the mother’s blood pressure is extremely high due to the baby), if the baby has had their first bowel movement prior to the water breaking and/or prior to being born, being two weeks past the due date (greater than 42 weeks), and the list of reasons goes on. For the purpose of this paper, I would like to explore medical induction of labor and the reasons for and against doing so. Personally, I think that a healthy baby being born to a healthy mother should be able to arrive in their own time and that the convenience of the mother, or especially the doctor, should not come into play at all.
Therefore, to be induced, or not to be induced, that is the question. The answer, ultimately, will depend on the beliefs of the mother, the beliefs of the doctor, and hopefully foremost, the health of the baby and the mother evaluated together. Technology has progressed a long way in our society, which has given many babies a chance at life whereas before the technology existed, they, and mostly likely the mother as well, might have died in labor. Unfortunately our society has taken that technology and used it for a purpose that is not its original intent: personal convenience.
According to Wilson, the onset of labor, once considered a naturally occurring event, has become one of timing, control, and convenience for both obstetrical providers and expectant women, with nearly two thirds of all labor induction in the US now initiated for non-medical reasons (208). Is this the best practice for the baby and the mother? The induction of labor for non-medically necessary reasons is one of the most controversial issues in maternity care in this country today (Amis 16). The National Center for Health Statistics wrote that in 2002, the rate of labor induction in the United States had a 129% increase from 1989, the first year that data on induction was collected (Simpson and Thorman, 135). Wilson writes that because labor induction is a relative new event, data collection was not routinely collected for induction until 1989 (208).
In the last few weeks of pregnancy, the mother’s body and the baby are preparing for the birthing process. These last weeks are vitally important for a mother and her baby, writes Lothian (43). For a first-time mother, the baby often “drops down” into the pelvis in the weeks before birth (Amis 16). This is part of the preparation for labor by the fetus. The last weeks also allow the baby to prepare for his or her entry in the world by allowing the baby to gain weight and strength, store iron, develop more coordinated sucking reflexes and swallowing ability, develop lung maturity further and also allow for important antibodies to be passed on from the mother to the infant (Lothian 44). Also according to Lothian, waiting for labor to begin on its own is the best way to determine if the baby is ready to enter the world and if the mother is ready to begin the birthing process (44).
Normal term labor is the culmination of a sequence of interrelated hormonal shifts that are mediated primarily by the fetus, the placenta, the fetal membranes, and the mother’s endocrine system (Romano and Lothian 94). In an article by Amis, she states that researchers now believe that when a baby is ready for life outside his mother’s uterus, his body releases a tiny amount of a substance that signals the mother’s hormones to begin labor (16). When a woman goes into labor naturally, there are hormones called prostaglandins, which cause the cervix to soften and ripen. The quantity of prostaglandins released increases when the body is ready to deliver the baby (Moran and Kellem, p 32). There are also hormones released that stimulate uterine contractions to begin. According to Romano and Lothian, spontaneous onset of term labor signifies the fetus’ readiness to be born as well as the mother’s physiological receptiveness to the process (94). As the birth approaches, the mother may have a surge of stress hormones that may aid in the birth of the fetus (Romano and Lothian 95). All of these phenomena’s are completely natural and doctors and midwives agree that the natural onset of labor is the best way to deliver the baby.
To define what exactly labor induction is: labor induction is the intentional initiation of uterine contractions before their spontaneous onset. According to ICEA (International Childbirth Education Association), labor induction is a process using various mechanical methods and chemicals to initiate uterine contractions before the onset of spontaneous labor with the goal of accomplishing a successful birth (31). According to Wilson, “an indicated induction is recommended as a therapeutic option when the benefits of birth outweigh the risks of continuing the pregnancy, as seen in certain high risk conditions with fetal compromise. Such conditions include eclampsia, preeclampsia (hypertension in the mother that is directly related to the pregnancy), premature rupture of the membranes, and suspected intrauterine fetal growth restriction” (208). Labor may be induced if it is more risky for your baby to remain inside your body than to be born. According to the American College of Obstetrics and Gynecologists, labor may be induced if: you water has broken and labor has not begun; your pregnancy is post term (more than 42 weeks), you have high blood pressure caused by your pregnancy, you have health problems such as diabetes that could affect your baby, you have an infection in the uterus, your baby is growing too slowly (Amis 16-17).
When labor is brought on artificially, a number of events are not allowed to occur or occur prematurely. When labor is induced artificially, the drug Pitocin (oxytocin) is given intravenously in the hospital setting. Two main functions of prostaglandins are to regulate hormone activity and to contract the smooth muscle of the uterus (ICEA 36). Sometimes drugs called “ripening agents”, such as Cervidil or Cytotec, are given to soften the cervix and prepare it for labor (Amis 17). Pitocin is given after the cervix has ripened (ICEA 37). “Interfering with or replacing the natural hormones that orchestrate labor, birth, breastfeeding, and maternal attachment may have consequences that we do not yet understand,” writes Amis (19).
As with all obstetric conveniences, there is growing evidence that the decision to induce for non-medically necessary reasons increases risks of interventions and complications, including, but not limited to: a longer labor compared to spontaneous labor, artificial rupture of membranes, significant discomfort, epidural anesthesia or increased need of other types of analgesia, maternal fever, hypotension, prolonged second stage of labor, operative vaginal birth, episiotomy, vacuum or forceps assisted vaginal birth, fetal heart changes, shoulder dystocia (where the baby’s shoulder gets stuck behind the mother’s pelvic bones), babies born with low birth weight, need for birth by cesarean section, need for admission to the Neonatal Intensive Care Unit (NICU), jaundice that required treatment and a lengthened hospital stay (Simpson and Thorman 135) (Amis 18) (Romano and Lothian 96). “Medical induction of labor also nearly doubled the risk of overall cases of amniotic-fluid embolism, and the association was stronger for fatal cases” (Kramer et al 1444). Because due dates are not an exact science, and there can be up to a two week error window for the actual due date, a medically induced baby at 38 weeks can actually only be 36 weeks old. This is one of the reasons that babies born after elective induction can have poor outcomes such as low birth weight or jaundice requiring treatment. They were accidentally born before they have reached full maturity, which is defined as reaching 37 completed weeks (Amis 8).
Besides, adverse maternal outcomes, such as cesarean sections, there are other reasons that might warrant waiting for spontaneous onset of labor, such as the addition of escalating health care expenditures, including additional supply and labor costs, added lengths of hospital stay, and increased neonatal and maternal morbidity and mortality. Delivery with spontaneous onset of labor is significantly lower than the cost of delivering following induction, particularly those ending in a cesarean birth (Wilson 212). There is also the chance that the mother may have to an intravenous line and continuous electronic fetal heart monitoring. In many settings, the mother must stay in bed or very close to the bed, and this does not allow the mother to walk freely or change positions in response to labor contractions, possibly slowing the progress of labor. The mother may be unable to take advantage of a soothing tub bath or a warm shower to ease the pain of labor contractions. Artificially induced contractions often peak sooner and remain intense longer than natural contractions, increasing the mother’s need for pain medication (Amis 8). The afore mentioned natural interventions all help the mother to have an “easier” labor and to help the labor progress along at a natural rate. A tub bath or a warm shower can be relaxing to the mother and may even help with pain distraction. Being artificially induced removes the ability to utilize these techniques, which can lead to an increased need for pain relief in the form of medications.
When it comes to the increased cost that is associated with elective induction of labor, Romano writes that women with induced labors were twice as likely to end up having their baby by cesarean delivery and in addition to this, their baby was more likely to need to be admitted to the Neonatal Intensive Care Unit (NICU). These factors resulted in a significantly high increase in the average cost of labor (53).
The matter of convenience is often brought up as a reason to induce labor artificially. According to Amis, hospitals can provide extra nurses on during shifts when inductions are scheduled, the family can prepare for the birth by making work and family arrangements and the physician can schedule the birth on days and during hours that are convenient for them (17). However, the benefits must be weighed with the risks (Simpson and Thorman 135). What is not convenient about artificial induction is when the induction doesn’t go as planned: for example, the induction does not work and the mother is sent home only to return another day and try again, when there are delays in the hospital and when the induction leads to a cesarean birth, consequently leaving the mother to recover from major abdominal surgery rather than vaginal birth, or if the baby has breathing problems and/or has to be admitted to the Neonatal Intensive Care Unit (NICU) (Amis 17).
What are the alternatives for the impatient healthy mother who wants to induce? Do chemical and mechanical interventions have to be used to bring about labor? No, labor can be induced by natural means, such as sexual intercourse or nipple stimulation. In ICEA’s statement, they state that sexual intercourse and nipple stimulation are natural methods that may help to stimulate contractions and improve the inducibility of the cervix. During the act of intercourse, prostaglandins are released into the bloodstream and may act on the uterus and the cervix. Prostaglandins are also contained in semen and may act directly on the cervix after ejaculation during intercourse. Nipple stimulation increases oxytocin that may also act on the uterus to start contractions (34).
If these methods do not work, and the mother is still considering elective induction when there is not a medically necessary reason, then elective inductions for primiparous (first time) women should be offered with caution, particular for women with advanced maternal age (Wilson 213). Furthermore, studies have indicated that medical procedures, such as “epidural analgesia, induction, augmentation of first stage of labor, instrumental vaginal delivery and emergency caesarean section, and a prolonged labor” were all associated with a negative experience of labor and birth (Waldenstrom et al 22). Kramer writes that the “substantially raised risk in women whose labor was medically induced should be a cause for concern, in view of the increasing tendency for clinicians to induce labor, and especially for routine induction at term or after term” (1448). Both the mother and the practitioner should take all of these things into consideration when making the decision for elective induction. The mother should be fully informed of all the risks and possible complications, as well as the comfort techniques (walking, tub bathes, etc) that a medical induction does not always allow.
Ultimately, waiting for labor to begin on its own increases the likelihood that you will have positive lifelong memories of your birth experience and decrease the possibility of complications for both you and the baby (Amis 6). Though I did not have all of the knowledge that is contained in the paper at that ten-week OB appointment, I knew in my heart that waiting for my baby to be born in her own timing was the best way to go. Instinctually, I felt that inducing my baby when there was no medical reason present was not what was best for her, and for me. Having reviewed the literature in the writing of this paper, along with taking birthing classes and reading various birthing books and non peer-reviewed journal articles, I can now say that my instincts were right on. As for the OB that wanted to induce me, I decided not to continue with her for the duration of my pregnancy and found a midwife who has treated me with much more respect for my wishes, for which I am truly grateful.
Works Cited
Amis, D. "Care practice #1: labor begins on its own." Journal of Perinatal Education 16.3 (June 2007): 16-20. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Amis, D. "Care practices that promote normal birth #1: labor begins on it own... including commentary by Gaskin IM." Journal of Perinatal Education 13.2 (Mar. 2004): 6-10. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
"ICEA position statement and review: induction of labor." International Journal of Childbirth Education 18.1 (Mar. 2003): 31-40. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Kramer, MS, et al. "Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study." Lancet 368.9545 (21 Oct. 2006): 1444- 1448. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Lothian, JA. "Saying "no" to induction." Journal of Perinatal Education 15.2 (Mar. 2006): 43-45. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Moran, DE and Kallam,GB The Gift of Motherhood: Your Personal Journey Through Prepared Childbirth. Customized Communications, Inc: Arlington. 2008.
Romano, AM. "Research summaries for normal birth." Journal of Perinatal Education 15.1 (2006 Winter 2006): 52-55. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Romano, AM, and JA Lothian.. "Promoting, protecting, and supporting normal birth: a look at the evidence." JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing 37.1 (2008 Jan-Feb 2008): 94-105. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Simpson, KR, and KE Thorman.. "Obstetric "conveniences": elective induction of labor, cesarean birth on demand, and other potentially unnecessary interventions." Journal of Perinatal & Neonatal Nursing 19.2 (Apr. 2005): 134-144. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Waldenström, U, et al. "A negative birth experience: prevalence and risk factors in a national sample." Birth: Issues in Perinatal Care 31.1 (Mar. 2004): 17-27. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
Wilson, BL. "Assessing the effects of age, gestation, socioeconomic status, and ethnicity on labor inductions." Journal of Nursing Scholarship 39.3 (Sep. 2007): 208-213. CINAHL with Full Text. EBSCO. 7 Mar. 2009.
It was my ten-week pregnancy check up. Being the nervous new-to-be mother, I had a lot of questions for my OB when I went to my appointment. One of many questions asked, and answered, was as follows:
“So at what point in the pregnancy do we start talking about the labor and delivery process?” I was just curious, I looking for answer akin to “Oh, about 30 or 35 weeks”. I’m a planner; I just wanted a time-line for myself to mentally prepare for every step in the pregnancy and birthing process. Instead I got something quite different.
“Well, we’ll probably induce you at thirty-eight weeks, most likely on a Thursday.”
What?!? Induction? What in the world for??? “I don’t really believe in being induced for a non-medically necessary reason . . .” I started timidly, completely taken for surprise. I hadn’t really been prepared to defend myself in such a manner at this point in my pregnancy.
In a very brisk, business-like manner, the doctor replied “It really is best, that way your husband will know ahead of time and can get off work (she nodded her head to my husband who was sitting in the chair next to the exam table), you’ll be able to get a full night’s rest before the baby comes . . .” and she continued to rattle off another half dozen or so reasons of why she wanted to induce me.
I couldn’t believe it, and at the same time that I was forming an argument in my head for every single reason, I felt powerless to respond. I felt as though my beliefs had just been trampled upon. From previous visits and conversations with this doctor, I knew that she and I stood on the same ground on many issues including contraception, natural family planning and God’s presence in the entire process of marital bliss, including conception. And here she was telling me she was going to induce me? I was only ten weeks pregnant; I wasn’t carrying twins, I didn’t have two uteruses or a uterus with a septum, I didn’t have any reason for being high risk and needing to have my labor induced. This OB had delivered three of my good friend’s babies and they all were able to have completely natural labors (without ever mentioning induction). Why did she suddenly say she wanted to induce me? Why didn’t she listen to what I wanted to say about being induced? Aren’t I the one who will have to carry and birth this baby and live with the choices and decisions and consequent life long memories, not her? I left her office that day stunned, disappointed, ignored and bewildered. I knew that I had a lot to think about.
My attributing factor to this news was that she had recently moved into a solo practice, away from a group practice. In a group practice, an OB is freed from being on call twenty-four/seven; an OB in solo practice doesn’t have that luxury. So for strictly business reasons of pure convenience, it is not unusual for an OB in solo practice to try to schedule as many inductions as possible, whether they are medically necessary or not.
I am not saying I am against inducing women into labor; there are certainly a number of reasons where a woman should be induced for her safety and/or the safety of her child. For example, preeclampsia or eclampsia (where the mother’s blood pressure is extremely high due to the baby), if the baby has had their first bowel movement prior to the water breaking and/or prior to being born, being two weeks past the due date (greater than 42 weeks), and the list of reasons goes on. For the purpose of this paper, I would like to explore medical induction of labor and the reasons for and against doing so. Personally, I think that a healthy baby being born to a healthy mother should be able to arrive in their own time and that the convenience of the mother, or especially the doctor, should not come into play at all.
Therefore, to be induced, or not to be induced, that is the question. The answer, ultimately, will depend on the beliefs of the mother, the beliefs of the doctor, and hopefully foremost, the health of the baby and the mother evaluated together. Technology has progressed a long way in our society, which has given many babies a chance at life whereas before the technology existed, they, and mostly likely the mother as well, might have died in labor. Unfortunately our society has taken that technology and used it for a purpose that is not its original intent: personal convenience.
According to Wilson, the onset of labor, once considered a naturally occurring event, has become one of timing, control, and convenience for both obstetrical providers and expectant women, with nearly two thirds of all labor induction in the US now initiated for non-medical reasons (208). Is this the best practice for the baby and the mother? The induction of labor for non-medically necessary reasons is one of the most controversial issues in maternity care in this country today (Amis 16). The National Center for Health Statistics wrote that in 2002, the rate of labor induction in the United States had a 129% increase from 1989, the first year that data on induction was collected (Simpson and Thorman, 135). Wilson writes that because labor induction is a relative new event, data collection was not routinely collected for induction until 1989 (208).
In the last few weeks of pregnancy, the mother’s body and the baby are preparing for the birthing process. These last weeks are vitally important for a mother and her baby, writes Lothian (43). For a first-time mother, the baby often “drops down” into the pelvis in the weeks before birth (Amis 16). This is part of the preparation for labor by the fetus. The last weeks also allow the baby to prepare for his or her entry in the world by allowing the baby to gain weight and strength, store iron, develop more coordinated sucking reflexes and swallowing ability, develop lung maturity further and also allow for important antibodies to be passed on from the mother to the infant (Lothian 44). Also according to Lothian, waiting for labor to begin on its own is the best way to determine if the baby is ready to enter the world and if the mother is ready to begin the birthing process (44).
Normal term labor is the culmination of a sequence of interrelated hormonal shifts that are mediated primarily by the fetus, the placenta, the fetal membranes, and the mother’s endocrine system (Romano and Lothian 94). In an article by Amis, she states that researchers now believe that when a baby is ready for life outside his mother’s uterus, his body releases a tiny amount of a substance that signals the mother’s hormones to begin labor (16). When a woman goes into labor naturally, there are hormones called prostaglandins, which cause the cervix to soften and ripen. The quantity of prostaglandins released increases when the body is ready to deliver the baby (Moran and Kellem, p 32). There are also hormones released that stimulate uterine contractions to begin. According to Romano and Lothian, spontaneous onset of term labor signifies the fetus’ readiness to be born as well as the mother’s physiological receptiveness to the process (94). As the birth approaches, the mother may have a surge of stress hormones that may aid in the birth of the fetus (Romano and Lothian 95). All of these phenomena’s are completely natural and doctors and midwives agree that the natural onset of labor is the best way to deliver the baby.
To define what exactly labor induction is: labor induction is the intentional initiation of uterine contractions before their spontaneous onset. According to ICEA (International Childbirth Education Association), labor induction is a process using various mechanical methods and chemicals to initiate uterine contractions before the onset of spontaneous labor with the goal of accomplishing a successful birth (31). According to Wilson, “an indicated induction is recommended as a therapeutic option when the benefits of birth outweigh the risks of continuing the pregnancy, as seen in certain high risk conditions with fetal compromise. Such conditions include eclampsia, preeclampsia (hypertension in the mother that is directly related to the pregnancy), premature rupture of the membranes, and suspected intrauterine fetal growth restriction” (208). Labor may be induced if it is more risky for your baby to remain inside your body than to be born. According to the American College of Obstetrics and Gynecologists, labor may be induced if: you water has broken and labor has not begun; your pregnancy is post term (more than 42 weeks), you have high blood pressure caused by your pregnancy, you have health problems such as diabetes that could affect your baby, you have an infection in the uterus, your baby is growing too slowly (Amis 16-17).
When labor is brought on artificially, a number of events are not allowed to occur or occur prematurely. When labor is induced artificially, the drug Pitocin (oxytocin) is given intravenously in the hospital setting. Two main functions of prostaglandins are to regulate hormone activity and to contract the smooth muscle of the uterus (ICEA 36). Sometimes drugs called “ripening agents”, such as Cervidil or Cytotec, are given to soften the cervix and prepare it for labor (Amis 17). Pitocin is given after the cervix has ripened (ICEA 37). “Interfering with or replacing the natural hormones that orchestrate labor, birth, breastfeeding, and maternal attachment may have consequences that we do not yet understand,” writes Amis (19).
As with all obstetric conveniences, there is growing evidence that the decision to induce for non-medically necessary reasons increases risks of interventions and complications, including, but not limited to: a longer labor compared to spontaneous labor, artificial rupture of membranes, significant discomfort, epidural anesthesia or increased need of other types of analgesia, maternal fever, hypotension, prolonged second stage of labor, operative vaginal birth, episiotomy, vacuum or forceps assisted vaginal birth, fetal heart changes, shoulder dystocia (where the baby’s shoulder gets stuck behind the mother’s pelvic bones), babies born with low birth weight, need for birth by cesarean section, need for admission to the Neonatal Intensive Care Unit (NICU), jaundice that required treatment and a lengthened hospital stay (Simpson and Thorman 135) (Amis 18) (Romano and Lothian 96). “Medical induction of labor also nearly doubled the risk of overall cases of amniotic-fluid embolism, and the association was stronger for fatal cases” (Kramer et al 1444). Because due dates are not an exact science, and there can be up to a two week error window for the actual due date, a medically induced baby at 38 weeks can actually only be 36 weeks old. This is one of the reasons that babies born after elective induction can have poor outcomes such as low birth weight or jaundice requiring treatment. They were accidentally born before they have reached full maturity, which is defined as reaching 37 completed weeks (Amis 8).
Besides, adverse maternal outcomes, such as cesarean sections, there are other reasons that might warrant waiting for spontaneous onset of labor, such as the addition of escalating health care expenditures, including additional supply and labor costs, added lengths of hospital stay, and increased neonatal and maternal morbidity and mortality. Delivery with spontaneous onset of labor is significantly lower than the cost of delivering following induction, particularly those ending in a cesarean birth (Wilson 212). There is also the chance that the mother may have to an intravenous line and continuous electronic fetal heart monitoring. In many settings, the mother must stay in bed or very close to the bed, and this does not allow the mother to walk freely or change positions in response to labor contractions, possibly slowing the progress of labor. The mother may be unable to take advantage of a soothing tub bath or a warm shower to ease the pain of labor contractions. Artificially induced contractions often peak sooner and remain intense longer than natural contractions, increasing the mother’s need for pain medication (Amis 8). The afore mentioned natural interventions all help the mother to have an “easier” labor and to help the labor progress along at a natural rate. A tub bath or a warm shower can be relaxing to the mother and may even help with pain distraction. Being artificially induced removes the ability to utilize these techniques, which can lead to an increased need for pain relief in the form of medications.
When it comes to the increased cost that is associated with elective induction of labor, Romano writes that women with induced labors were twice as likely to end up having their baby by cesarean delivery and in addition to this, their baby was more likely to need to be admitted to the Neonatal Intensive Care Unit (NICU). These factors resulted in a significantly high increase in the average cost of labor (53).
The matter of convenience is often brought up as a reason to induce labor artificially. According to Amis, hospitals can provide extra nurses on during shifts when inductions are scheduled, the family can prepare for the birth by making work and family arrangements and the physician can schedule the birth on days and during hours that are convenient for them (17). However, the benefits must be weighed with the risks (Simpson and Thorman 135). What is not convenient about artificial induction is when the induction doesn’t go as planned: for example, the induction does not work and the mother is sent home only to return another day and try again, when there are delays in the hospital and when the induction leads to a cesarean birth, consequently leaving the mother to recover from major abdominal surgery rather than vaginal birth, or if the baby has breathing problems and/or has to be admitted to the Neonatal Intensive Care Unit (NICU) (Amis 17).
What are the alternatives for the impatient healthy mother who wants to induce? Do chemical and mechanical interventions have to be used to bring about labor? No, labor can be induced by natural means, such as sexual intercourse or nipple stimulation. In ICEA’s statement, they state that sexual intercourse and nipple stimulation are natural methods that may help to stimulate contractions and improve the inducibility of the cervix. During the act of intercourse, prostaglandins are released into the bloodstream and may act on the uterus and the cervix. Prostaglandins are also contained in semen and may act directly on the cervix after ejaculation during intercourse. Nipple stimulation increases oxytocin that may also act on the uterus to start contractions (34).
If these methods do not work, and the mother is still considering elective induction when there is not a medically necessary reason, then elective inductions for primiparous (first time) women should be offered with caution, particular for women with advanced maternal age (Wilson 213). Furthermore, studies have indicated that medical procedures, such as “epidural analgesia, induction, augmentation of first stage of labor, instrumental vaginal delivery and emergency caesarean section, and a prolonged labor” were all associated with a negative experience of labor and birth (Waldenstrom et al 22). Kramer writes that the “substantially raised risk in women whose labor was medically induced should be a cause for concern, in view of the increasing tendency for clinicians to induce labor, and especially for routine induction at term or after term” (1448). Both the mother and the practitioner should take all of these things into consideration when making the decision for elective induction. The mother should be fully informed of all the risks and possible complications, as well as the comfort techniques (walking, tub bathes, etc) that a medical induction does not always allow.
Ultimately, waiting for labor to begin on its own increases the likelihood that you will have positive lifelong memories of your birth experience and decrease the possibility of complications for both you and the baby (Amis 6). Though I did not have all of the knowledge that is contained in the paper at that ten-week OB appointment, I knew in my heart that waiting for my baby to be born in her own timing was the best way to go. Instinctually, I felt that inducing my baby when there was no medical reason present was not what was best for her, and for me. Having reviewed the literature in the writing of this paper, along with taking birthing classes and reading various birthing books and non peer-reviewed journal articles, I can now say that my instincts were right on. As for the OB that wanted to induce me, I decided not to continue with her for the duration of my pregnancy and found a midwife who has treated me with much more respect for my wishes, for which I am truly grateful.
Works Cited
Amis, D. "Care practice #1: labor begins on its own." Journal of Perinatal Education 16.3 (June 2007): 16-20. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Amis, D. "Care practices that promote normal birth #1: labor begins on it own... including commentary by Gaskin IM." Journal of Perinatal Education 13.2 (Mar. 2004): 6-10. CINAHL with Full Text. EBSCO. 7 Mar. 2009
"ICEA position statement and review: induction of labor." International Journal of Childbirth Education 18.1 (Mar. 2003): 31-40. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Kramer, MS, et al. "Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study." Lancet 368.9545 (21 Oct. 2006): 1444- 1448. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Lothian, JA. "Saying "no" to induction." Journal of Perinatal Education 15.2 (Mar. 2006): 43-45. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Moran, DE and Kallam,GB The Gift of Motherhood: Your Personal Journey Through Prepared Childbirth. Customized Communications, Inc: Arlington. 2008.
Romano, AM. "Research summaries for normal birth." Journal of Perinatal Education 15.1 (2006 Winter 2006): 52-55. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Romano, AM, and JA Lothian.. "Promoting, protecting, and supporting normal birth: a look at the evidence." JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing 37.1 (2008 Jan-Feb 2008): 94-105. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Simpson, KR, and KE Thorman.. "Obstetric "conveniences": elective induction of labor, cesarean birth on demand, and other potentially unnecessary interventions." Journal of Perinatal & Neonatal Nursing 19.2 (Apr. 2005): 134-144. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Waldenström, U, et al. "A negative birth experience: prevalence and risk factors in a national sample." Birth: Issues in Perinatal Care 31.1 (Mar. 2004): 17-27. CINAHL with Full Text. EBSCO. 7 Mar. 2009
Wilson, BL. "Assessing the effects of age, gestation, socioeconomic status, and ethnicity on labor inductions." Journal of Nursing Scholarship 39.3 (Sep. 2007): 208-213. CINAHL with Full Text. EBSCO. 7 Mar. 2009
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