RE: [ozmidwifery] Induction and third stage labour

[jo]

Hi Karen,   On top of what Karen has said. As soon as an induction is started the ‘normal’ course of labour is changed. Often women end up with contractions on top of each other and have a hard time managing them, which then leads to pain relieving drugs, which can sometimes lead to c/section. Also, if the induction is fast and furious and the uterus in contracting like mad it sometimes causes fetal distress, which then leads to a c/section.   Women that I am supporting in labour are more and more trying to push their inductions to the very last minute, not without a great amount of stress and fear mongering from some staff members about putting their babies at risk, one recently was told in so many words that if she didn’t agree to her induction at 12 days over that she wouldn’t be welcome to birth there – really really scary stuff.   I have since found out that 90 inductions a month are performed at Nepean Hospital – that’s 3 a day!   What on earth is going on? This is ludicrous and I guess the only way it will change is if educated women stand up and say no. I’ve even had clients who have been called by labour ward several times in a day to ask why they haven’t showed for their induction. How a women can relax and go into labour with all the external pressure of ‘you must go into labour’ I don’t know.   Cheers jo   From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Nicole Carver Sent: Tuesday, 4 October 2005 11:56 AM To: ozmidwifery@acegraphics.com.au Subject: RE: [ozmidwifery] Induction and third stage labour   Hi Karen, This is my two bob's worth: 1. Once you start an induction, particularly once you have done an ARM, I believe that you are committed to having the baby within the next 24 hours preferably, (due to the risk of ascending infection in a hospital environment) so if labour does not establish, or fit the parameters the ob is happy with, you are going to have a c/s. Allowing a pregnancy to progress beyond 42 weeks, does have a much higher risk for the baby, as the placenta has a limited life span. How long an individual placenta will last is impossible to say, but perinatal mortality goes up past 42 weeks, and way up from 43 on (of course it helps to be sure of your dates!) 2. If you think of how much syntocinon some babies get when labour is induced, leaving the cord pulsating is not likely to give them any more synto than that, plus it will take a little while to enter mum's circulation (if given IM), and then babes. I was taught to clamp if the synto has been given, but someone at the ICM in Brisbane made the previous point about this, so I am a bit happier about it. I think the placenta probably separates better if it is allowed to drain, and the babe is meant to have that blood, otherwise they wouldn't be designed that way. Cheers, Nicole. -----Original Message----- [Nicole Carver]   From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au]On Behalf Of karen shlegeris Sent: Tuesday, October 04, 2005 11:22 AM To: ozmidwifery@acegraphics.com.au Subject: [ozmidwifery] Induction and third stage labour Dear List, I’m a birth educator and prenatal yoga teacher in Townsville.  I hope these questions are appropriate for this list and would appreciate information from you:   Induction.  Andrea’s Preparing for Birth:Mothers book and the wall poster on cascade of intervention states that induction increases the risks of further intervention and ultimately caesarean, and that’s what I’ve always taught in my Active Birth classes.  However, when challenged for statistics by a client in a recent workshop, I looked up Enkin, Kierse etc. who stated that induction does not increase the risk of caesareans, recommending that induction is recommended soon after a women passes her EDD.  Can anyone clear this up for me?   Third stage of labour.  I was under the belief that if active management of third stage was chosen, the cord had to be clamped and cut quickly to avoid an over-transfusion of blood from the placenta into the baby.  However, an OB recently told a client of mine that even if she had a Synto injection, the cord could be left until it stopped pulsing.  I’ve checked Myles textbook for midwives but it’s not clear on this.    I appreciate your support.   Best wishes, Karen Shlegeris in Townsville