To induce or not to induce, that is the question..

Our birth expert Jackie Heffer-Cooke was invited onto Radio Norfolk to talk about why the National and local Norfolk Birth Induction rate is so high and why it matters

Speak to most obstetricians and they will say that Inductions save lives, that’s it, simple. They will guide you towards the Safer Maternity Care action plan which Induction Massageis part of the national ambition to halve rates of stillbirths, neonatal deaths, maternal deaths and brain injuries that occur during or shortly after birth, by 2030.

And that is correct. Any plans to eliminate stillbirth, death and serious injury is of upmost importance and it is why we are proud of our maternity medics.

Normal births are being medicalised, ‘just in case’

However, what is happening is that to eliminate risk, increasingly normal births are being medicalised ‘just in case’ which means that the clear majority of women who are having medicalised births, need not.

Now as a human race we may say it’s worth it. When it comes to such a serious risk lets eliminate it and be on the safe side. But the reality of what this means is that more and more women are experiencing unpleasant intervention birth experiences, some are even traumatised by unnecessary procedures and perhaps some even suffer post-natal depression because of it.

Giving birth naturally is one of the most amazing, rewarding, and challenging experiences of your life. A birth with intervention is not a ‘normal’ birth and women are often ill prepared for the experience, and not given enough information so they can truly make an informed choice about whether or not intervention is really right for them.

It is very difficult to make a truly informed choice

Take the example of inductions. If a woman is almost ready to birth, but the obstetrician is worried about perhaps the size of the baby, or the ‘lateness’ of the baby, he (or very occasionally she), will encourage an induction using the phrases such as “well you might as well, you are nearly ready”, or worse, will threaten the mum “if you don’t do this your baby could die”. In these situations, it is very difficult to make a truly informed choice, and indeed the data isn’t even there to support an informed choice.

Over the past two years the induction rate has become higher and higher. One of the reasons for this is the use of GROW – an online application which calculates birthweight. However, this GROW app seems to be getting it wrong a lot of the time. In a recent Birthing Survey of own my clients, out of 36 mums who responded to whether their baby was scanned as ‘too big or too small’ only 16% actually had a ‘clinically’ smaller or bigger baby. We found that 45% of mums had ‘normal sized babies’, even though the scans said otherwise, and therefore a lot of these women had unnecessary inductions. That left 40% who didn’t know what ‘normal size was’. Yes, that’s the level of confusion going on.

How can we support induction women better?

And all the time women are having inductions. Induction births normally being long, and tiring, and painful, and ultimately challenging, usually resulting in Hypnobirthing refresherepidurals and forceps or ventouse births. Come on, is this really necessary? And if it is then please can we have a proper think about how we can support induction women better with coping mechanisms and comfort at the hospital – rather than being left for hours in semi-labour on a ward.

It continues to shock and amaze me that knowing all we know about how important it is for all birthing women to feel as calm and as comfortable as possible in birthing there are still no significant changes in the way systems cope in the maternity services. I am not saying that it is the fault of the midwives and the medics, they don’t want women to suffer either, but they are often left with little choice as lack of funding means lack of support, and lack of significant important data collection means continuous ignorance for all.

You ALWAYS have choices

To those of you who are pregnant reading this, remember you ALWAYS have choices and these should ALWAYS be explained to you in a kind, mature, respectful, and balanced way by whichever birth professional you are talking to, whether it is a sonographer, a consultant, or a midwife, and you can ALWAYS ask to see someone else if you are unhappy.

*If you have been affected by your birth remember you can ask to go to Birth Reflections –  ran by the local NHS – to talk your birth through. You can of course also talk to MIND if you feel you need some help. If you feel you would like to take any matter further the MSLC will be pleased to support you if needed. If you are pregnant and want some private individual support speak to birthing expert Jackie Heffer-Cooke on [email protected] or attend one of her birthing classes : The Birthing Tool kit, HypnoBirthing, or ask her for more customised birthing support