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“If a Woman Chooses to be Induced, it May Be the Last Choice…”

At the recent Lamaze conference, I heard lots of positive buzz about the session of Marilyn Hildreth, a labor nurse, doula, and childbirth educator. Her session, Welcome to My World, explored the reality of being a labor nurse today. One of her quotes has been published in numerous tweets, “If a woman chooses to be induced, it may be the last choice she makes.” We all know that this is true. With induction most often comes a cascade of interventions that doubles her risk for cesarean surgery. Expectant women may like the idea of the baby being born on Valentine’s Day or whatever date they have chosen, but most often they do not realize the full consequences of their choice – both for themselves and for their babies. Is there anything that the childbirth educator can do?

The answer is YES. Last year at the Lamaze conference in Louisville, I attended a session presented by Gloria Newman and Kathleen Rice Simpson from St. John’s Mercy Medical Center in St. Louis, MO. They did an excellent study at St. John’s in which they compared induction rates between women who attended childbirth classes with a special curriculum on the risks and benefits of elective induction and women who attended childbirth classes without the added special curriculum. The special curriculum made a difference and resulted in a decrease in the induction rate. The researchers found (not surprisingly) that the health care provider also had a powerful effect on the woman’s decision on whether to be induced. The “special curriculum” included detailed information about the risks to both the baby and the mother with induction and about the increased risks to both the mother and the baby with cesarean surgery. The researchers used recommendations and quotes from ACOG (the American College of Obstetricians and Gynecologists), the March of Dimes, and current research from medical journals. Newman and Simpson are hoping to have their study published in one of the major medical journals for maximum impact. If not, the study most likely will be published in the Journal of Perinatal Education. We will be sure to let you know when the study appears in print.

Some excellent resources for more information about elective induction include the Lamaze Healthy Birth Practice Paper #1 (written by me), the Mother’s Advocate Healthy Birth Your Way Let Labor Begin on its Own video, and Mother’s Advocate Healthy Birth Your Way: Let Labor Begin on its Own pamphlet. As hospitals look for ways to decrease their induction rates as the result of new Joint Commission perinatal quality measures (see blog on July 27th), childbirth educators need to be ready with a plan.

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