inductions

The other day I realized that I now mark time in terms of babies born. July 2008 brought Maryam, Omar, Julian, and Sofia. If I want to think back to say November 2009, I think of Asiya, Malachi, and Caroline. Living in a season-less California, births mark times and seasons more concretely than weather can. It would be a lie to say that they always arrived at the most convenient times, when my cold was gone, on the weekends when babysitting is free, or at a civilized hour. No. Babies come when they are meant to come. As much as I would like, I have no control over when that hour descends. Even now as I write this, a sunny weekend approaching, I am hesitant to make plans as I am waiting on a baby.

If I were another type of practitioner, maybe I would consider inducing this client. It would be nice to have it out of the way, with a free weekend sprawling before me. If so, I wouldn't be so off the mark. In 2007, a large study of 18,000 deliveries found that 9.6% were early births ('early' was not defined in this study), and the reasons for them being early were non-medical, i.e. practitioner or patient convenience. Indeed according to the Center for Disease Control sources, the average length of pregnancy has fallen by seven days since 1992!

No one really knows what kicks off labor. What I understand is that their is a complex interplay of mother and baby hormones that each tell the other that the time is near. Mom's cervix softens, telling baby's lungs to mature. Baby's lungs mature and mom's uterus develops more receptors for oxytocin, the hormone that makes the uterus contract among other things. Like all other bodily processes, it is hard to isolate it from the whole, and interference often shows up in other ways later.

This thought provoking look at early elective births by California Watch looks at the reasons why inducing early for non medical reasons is now thought to be contributing to poor maternal and infant mortality rates in America. There is a reason babies play a major role in deciding when they are born. A 2009 New England Journal of Medicine study found that elective cesarean sections resulted in respiratory and other adverse outcomes for neonates. The brain, eyes, and nervous systems all are formed in the third trimester. According to California Watch babies born early through C-section and/or induction are nearly twice as likely to spend time in the neo-natal intensive care unit.

How can women prevent this scenario? Show any of the above information to your doctor. Like an old college friend of mine threatened with induction at 41 weeks asked, "How can I go nine months with perfectly health pregnancy, and NOW all of a sudden I'm high risk?!" Good question. She answered it by delivering at 41 and a half weeks, a perfectly healthy baby girl, au natural. Here are some tips for preventing post-dates.

• Drink lots of red raspberry leaf tea throughout the pregnancy. I can't say enough on this wonderful uterine tonic. It provides all of the minerals a healthy uterus needs to do it's job.

• Walk, especially hills. I'm not sure what it is about hills, but many women claim that this helps them deliver a baby. Being fit, a side effect, may be what helps to prevent post dates.

• Have sex. Yes, as the old adage goes, what gets the baby in gets the baby out. Semen contains prostaglandins which help soften the cervix. An orgasm cannot occur without oxytocin, once again, the hormone which causes contractions.
  

• Visualization can help relax you and allow your mind to turn off. Sit in a quiet, undisturbed place and visualize a head down baby, distending the cervix and rotating down and out of the pelvis.

• I haven't seen research on this, more of a hunch, but I think that adequate healthy fat intake in the third trimester can cook a baby just right! We know that healthy fats are needed for baby's brain development and that the most brain development happens in the waning weeks of the third trimester. It would seem to me that if baby is getting what he needs in terms of development, there will be no need to leave early, or hang on too late in order to soak up the nutrients. Eat lots of eggs, fish, meat. Supplementation of fish oil will do in a pinch, but best to get it straight from the source.
  

Sometimes inductions are unavoidable, even necessary. I suggest these final things only as a means to naturally induce labor when an induction is unavoidable. Use with wisdom.

• A homeopathic induction of Cimicifuga and Caulophyllum is a gentle way to start labor. Take one remedy every half hour for three hours, alternating the remedy each half hour. Do this every morning until labor commences. The strength should be 200C

• Herbal inductions can be used as well. Black and blue cohosh along with cottonroot are a potent mix of uterine stimulating herbs. A half dropper of each every hour for three hours. I have heard some herbalists comment that this isn't enough because our bodies metabolize herbs quickly. Consult with a person who knows if my recommendation isn't enough.

• Acupressure points that you can squeeze yourself are also effective. The two I like are located in the webbing between your thumb and index finger and the other four finger widths above the inside of your ankle bone.
  

• And finally, there is the dreaded castor oil. This is a last ditch resort. Castor oil makes for a messy birth. In fact, that the whole reason it works, it irritates your bowels, thereby irritating your uterus, or so the theory goes. I have seen it work many times. A castor oil milkshake is one way to tolerate it. 2oz of castor oil, some ice cream, and some juice. Drink it up!

As the Bible says (I'm paraphrasing), to everything there is a season, this includes babies. I rather like that my years and seasons are marked by a soul's entrance and not by my vacations or plans. Inductions can have long lasting effects on mother and baby. It's best to wait for the dance of hormones to begin. Just like we can't force the long days of summer, or rush the chill or winter, neither should we unduly force a baby's birth. To everything there is a season. I can't think of a better reason to put off my plans than a birth, so for this weekend, I'll stick around here and maybe next year I'll think back to February 2011 and remember the particular way the sun fell as a baby, for now nameless, was born.