Wednesday, November 25, 2009

"Poop on Due Dates"




There was one line in Martha's birth story that made me laugh out loud. I don't think I include it in the original blog post, so here it is:

"Due dates are a stupid, cruel thing. They mess with your mind and make everyone under the sun badger you about why your baby’s not here yet. Poop on due dates. I’m not telling anyone mine next time."

Normal gestation is 38-42 weeks. Medical practice is to assign you a "due date," right in the middle at 40 weeks. But technically, if your baby comes at 39 weeks, he is not early, and if he comes at 41 weeks he is not late, overdue, overcooked, or doing anything wrong. I have heard that 40 weeks is the magic number because it is the "average." I'm good at math. If seven out of ten babies are born after their due date, or guess date, as I like to call it, how is that an average?

There are slight risks associated with going past 42 weeks (truly overdue), but here is no evidence of a benefit of routine induction at less than 41 completed weeks of pregnancy.

I have to agree with Martha that the rigidity that has developed around guess dates is stupid, and it is cruel for doctors to threaten patients, or entice them, with induction if they don't make it by 40 weeks. Not all practitioners are this rigid, but around here, many doctors will induce the day after the due date and even the day of, if the woman requests it.

I am thinking of a story in 3 Nephi, when the wicked threatened to kill the righteous if the signs prophesied about Jesus' birth didn't happen by a certain date. Essentially, they made up a due date for a woman a hemisphere away that they knew nothing about.

The problems with induction are numerous. First, there is the drug, Pitocin, which the most abused drug in the world today. It was designed and approved by the FDA for helping produce the contractions that close a woman's uterus after delivery in the case of hemorrhage. And for this purpose, it works very well. (Midwives carry it for this purpose.)

Since it was not developed to induce labor, there is no recommended dosage and it is completely unregulated as far as I know. The dangers and side effects of Pitocin, (including fetal distress, increased risk of uterine rupture, c-section, jaundice and more) are not widely know. When I investigated why women in the hospital are not informed of possible side effects the same way a pharmacy is obligated to inform you, I learned this: Not much. Possible reasons are that when you sign in to the hospital, it is assumed that you are being advised by your medical professional.

The second problem with induction is that once you're at the hospital, if your baby/body is not responding, they get annoyed. They have already invested all that time in you, so now they are going to have to try something else, like breaking your water. Once they do that, they won't let you go more than 24 hours or they'll cut you open.

In Natalie's guest post, she raised the question of how doctors get women to come in for induction. It is a good question. Why do we listen to them? They are not the police. They can't physically make us do anything, and yet women have given them that power. When Natalie spoke about her mother's "gravitas" I had to laugh. I know her mother. She is a tiny woman who barely speaks above a whisper. She's not the type one can picture standing up to a doctor, but there is more to her than is at first evident.

I can think of another friend who reluctantly consented to be induced so that she could give birth while a certain doctor was in town. When the induction didn't work, she realized the whole thing was wrong from the beginning, so she went home and told them she'd come back in when she was in labor. The hospital staff was shocked. But she was right, and she was under no obligation to stay.

I understand that there is a lot of pressure to plan. Relatives want to fly in, etc. And I understand not wanting to be pregnant any longer--boy do I. But these are reasons that have nothing to do with your baby. The best advice I ever heard and that I wish I had taken was to lie or be vague about my guess date. For example, if your guess date is March 5, when anyone asks, tell them the baby is due mid-march. If you are vague with others and with yourself on this point, you can avoid much unnecessary stress.

As I said, I understand wanting to get things started based on pure discomfort or impatience. For those who are desperate, as I was, there are many natural methods for getting labor going that are effective, safe and even enjoyable. (Doesn't this make sense that it should be enjoyable to entice the baby out?) Here are the ones I know of. I'm sure there are more.
  • herbal supplements and teas
  • eating spicy food or pineapple
  • walking/other exercise
  • acupuncture, acupressure, or massage
  • enema or Castor oil (Castor oil is not pleasant, but an enema could be if you are constipated)
  • sex (releases oxytocin, and semen has prostaglandins, which soften cervix)
  • nipple stimulation (releases oxytocin)
  • sweeping membranes
  • a long talk with your baby
  • fervent prayer
I was a fan of acupuncture, even before my pregnancy, and my midwife prescribed it weekly after my 35th week for help with my circulation, swelling, and other issues. I begged the woman to induce me the week before my due date, but she made me wait until the day before. I was curious to see what she would do differently to "induce" me. Different practitioners do it differently, but she used a few more needles in my hands legs and feet and she also used a very mild electro-stimulation (it feels awesome) and did cupping on my back to send the energy downward. It worked. Labor started about an hour after I left her office.

There were a few moments during labor, when I wondered if I had done the wrong thing by trying to rush my baby, but my gut feeling, and my midwife agreed, was that just like chemical induction, natural methods won't work if your baby is really just not ready to come.

(Note: If you have never done acupuncture before, you should try it a few times before you try to use it as a method for induction. Also, use a practitioner who has plenty of experience with pregnant women. Ask a midwife for referrals.)

7 comments:

  1. Terrific post. I loved that line in Martha's story too. Hee hee.

    Happy Thanksgiving!!

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  2. Be thoughtful about natural induction as well. Some types are not as mild as they may seem such as herbs. Unless there is a true problem, I like the idea of not fiddling with what we don't understand.

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  3. I refused to tell people my "due date". It was the 6th of December, but I didn't want to deal with people Helpfully Telling Me My Baby Wasn't Here YET??!! So I was like, late November. Early December. WHENEVER.

    My child did actually choose the 5th. :-p

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  4. You are right, Bettie. Some herbs and other forms of natural induction are not mild at all. Some are quite horrible--like castor oil. Waiting and walking are best. There are also some mudras and meditations for releasing and letting go that are safe and lovely. I wish I had been more patient when I was waiting for my little girl.

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  5. Silly Silly EDDs.
    My second pregnancy I padded on a`week. I still got annoyed so my last pregnancy I added 10 days. Everybody left me alone, it was awesome! My sister who was suposed to come and help got confused which one was real and planned to come at the lie date instead. We still needed help then with the other kids so it was still very helpful.

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  6. HA. I just saw this. I knew by the title it was probably from my story. It's a common phrase around our house. If you hate something, just poop on it.

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  7. I know my 'due date' but I refuse to tell anyone, even family, and I just say, "Oh, the end of May." I don't want people harassing me about "When is that baby going to get here?" so I may have (okay, I totally did) exaggerate my 'due date.' Every time the doctor mentions my 'due date,' I tell him that the baby will come when the baby wants to come.

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