A friend of mine who is having a baby any day now wrote to me. She is due tomorrow. When checked last week, she was 1 cm dilated. Her doc said that they would induce about 4 days after her due date if no progress has been shown. She does not want to be induced and would like ideas about how facilitate a natural labour. Below is part of my response.
So about induction….I have a few thoughts about this. I think it’s awesome that you wish to have a natural labour and let me assure you, you can do it. Your body was made for this. I have a few presuppositions about pregnancy and childbirth which inform my outlook and my practice. On a side note I think it’s a very useful exercise for women to identify their underlying beliefs at the beginning of pregnancy (if not earlier). Why? Because your beliefs will ultimately inform your decisions and impact the course of your pregnancy and subsequent labour.
Some of my presuppositions are as follows:
You can probably see where I am going regarding an answer to your concerns about induction.
I feel that inducing labour, in many cases, is medically unnecessary. It can often be what kick-starts a cascade of interventions which can have serious consequence. Some women have been known to go to 44 weeks and they and baby were just fine. So why is inducing labour an unnecessary thing in a normal birth? For several reasons:
1) Unless you know the exact moment you conceived, gestational age of the baby is actually arbitrary. It is the best “guess”, or an estimate, of the expected arrival of baby. We get so fixated on dates unnecessarily. As a Christian, I believe the scriptures which say that God has our days numbered. He is control of when we are born and when we die. So I feel that the baby comes when God says “Ok, Go now!” And I’m OK with that.
2) There might be a valid reason why the baby is chillin’ in the womb a little longer than what health-care practitioners would like. We don’t really know if we are doing some sort of damage to development in the long run by forcing the baby out prematurely.
3) Labour is a beautiful process between mother and baby. The baby trusts you and has developed a relationship with you over the past 40 weeks. The mother’s job is to be open (in every sense of the word) and provide a safe passage; and the baby’s job is head down in the correct orientation. To induce labour is to artificially start a process that perhaps neither mother nor baby is ready for – which can have negative physical and emotional consequence.
4) There are serious health risks to inducing labour. I will provide some links at the end which explain this better than I can here.
Don’t be worried that you’re only 1 cm dilated right now. That is not a valid reason to induce. (I will include a link to the Society of Obstetricians and Gynaecologists of Ontario with clinical practice guidelines for inducing. But keep in mind it is a medical guideline…which means that the presuppositions about birth may be different from mine or yours.) Remember that the cervix has to be fully effaced AND fully dilated before stage 2 labour (active pushing) can begin. Every woman is different. Some women get to 100% effacement (which is a thinning of the cervix) and are only a few cm dilated. Then after they reach that stage, they dilate very quickly. Some women dilate very quickly but are not fully effaced. Some progress linearly through both processes. My point is that there is not set rule about how or when a woman should dilate and efface. Everyone is different and it’s all variations of normal.
If your health care provider is recommending induction, especially before 42 weeks which is still in the range of "normal gestation", then I would suggest the following:
About facilitating a natural birth – here are some things you can try:
Here are some links you can check out:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1804305/ - this is the article I posted on FB
Do a google search for birth and labour positions and see what you find.
Anyway…this is quite long, but I hope it is helpful. Love you lots. Wish you were here and can't wait to meet your new little addition.
What about you? What are your thoughts on inducing labour? What are your strategies for faciliating a natural labour? If you could do it all over again, what would you do differently this time around?
The Mama's Physio
We are a team of experienced physiotherapists with a passion for women's health and well being. We focus on pelvic health in the context of the whole body. We care for pregnant and post-partum mamas and women at all life stages from teens to the young at heart. We are mothers ourselves and we are women. We love what we do and we are here to serve you.