Why do so many women need inducing?

[flameprincess]

Just something I've been pondering recently during my pregnancy insomnia riddled nights! My due date is looming, with DC1 my waters broke but never went into labour, wondering with this one if I will ever experience it.

A lot of the chat on here and other forums women mention being booked in for an induction - why is it so common for a woman to not go into labour? I'm not sure of the percentage but seems a high rate just from reading threads here (though I accept you probably don't get as many people posting 'average' delivery stories).

Before we had the medical know how would women have just been left even longer than 42 weeks and been ok or were there more casualties as a result of this?

[rorosemary]

Two decades ago they let type 1 disbetics stay pregnant for too long resulting in more stillbirths. They now tend to induce around 38 weeks and more babies survive. So those will also be mums you might hear about being booked for induction. Medical knowledge is teaching us all the time how to save babies. If more inductions are the answer then that is what they will propose.

[NameChange30]

@bluemoon2468

All women would go into labour naturally if left long enough... the baby wouldn't just stay in there forever! But women are sometimes induced earlier than they would go into labour naturally for various medical reasons which mean that it may be safer that the baby is out ASAP. Having said that, the high number of inductions is also due to lots of women being offered inductions unnecessarily. I was offered an induction at 37 weeks because of one episode of reduced movements, even though baby was absolutely fine on the monitor. Another example is big babies - the NICE guidelines state that women should not be offered induction just because their baby is suspected to be big (without any other risk factors) but women are induced for this reason all the time. A lot of women will just accept induction the first time it's offered without doing their research or questioning it, when their baby would have been absolutely fine without one.

This

[confusedandeatingcheese]

They don't "let" you go overdue. They don't "make you" book an induction. The language they use is very forceful but there is no way that medical professionals can make you have a procedure. That would be assault. They risk assess and offer the options available to you push for inductions to clear beds .
In France women go three weeks overdue and only then do they discuss inductions.

[LeaderoftheAteam]

I would strongly suggest that all pregnant women read the "Am I allowed" book written by AIMs and research absolutely everything said to you by health professionals. Whilst they may think they are doing the right thing they often aren't following the NICE guidelines for many recommendations and throw around lots of made up statistics not backed by data. When challenged further they can't support any risks with facts a barely explain any negative cons for any interventions they offer. During my previous four pregnancies I have researched more in each one and some of the brutal treatments and experiences women have at the hands of so many midwives, consultants ect is horrific. I would suggest many interventions are offered unnecessarily which then leads to a cascade of interventions and a very traumatic birth experience. I strongly suspect birth partners, doulas ect are not being allowed back into maternity with their partners (until 4cm) is to allow women to be coerced more easily without an advocate.

[Fredthespider]

I’ve discovered that my local trust have a Facebook maternity page where each month they post the previous months maternity stats.

I was fascinated to see that in my trust the induction rate is around 35%, but in a trust about an hour away it’s only 20%. Why is there such a difference? There must be some policy influence coming through. The stats don’t contain stillbirth numbers (although they do include them in the total number of births) so it’s difficult to see if there’s a difference there.

[Bentoforthehorde]

I think that without medical intervention I would be one of those women who dies in childbirth.
I've had 4 babies, all c sections.
I laboured with 3, the first was induced at 38 weeks because they were worried that his abdomen seemed distended but he was fine. Labour was all over the place ending in c section.
Second baby natural Labour went on for days and he went into distress, I could feel something was wrong. Without the c section he probably wouldn't have made it.
3rd one 40 weeks and no signs of labour.
4th one went into labour, he was transverse and stuck hard, traumatic birth with alarms and a J cut to my uterus.
I wish I was like my sister and could have beautiful water births, but I think the trusting your body/you won't stay pregnant forever thing really doesn't work for everyone.

[Dinosauraddict]

I had gestational diabetes and severe polyhydramnios by the end - they wanted baby out at 38 weeks!

[Dinosauraddict]

To add - I'm youngish (late 20s) and weight wasn't a factor.

[Bubblebox]

It certainly does seem to be on the rise. digital.nhs.uk/news-and-events/news/nhs-maternity-statistics-2017-18
I find the reasons behind it interesting.

[Heyha]

The inductions in my little social circle were two for IVF babies and two for (genuine) slowed growth. All in trim and healthy women in their mid to late 30s. One more was booked in for one for being overdue but had a 'natural' birth a couple of days before. When I had mine the other ladies on the ward were mainly gestational diabetes, IVF, reduced movements or slow growth. Very small sample though!

[RandomMess]

We don't have standard placenta monitoring like countries with lower stillbirth rates do. Improved monitoring in the last trimester would reduce the number of inductions needed as there would be more confidence that everything was ok.

I waited until I was 42+3 with DC2 to be induced and there was grade 3 meconium and I was really quite unwell afterwards. My other inductions were 41, 40, 42 weeks.

I have friends that had still births both before 42 and after 42 weeks. It's devastating and many maternity units don't have the experience and facilities to offer daily monitoring and as in discussion with my consultant- 24 hours between monitoring is too long.

Preventable stillbirth rates have come down in the UK recently.

[twilightermummy]

I was induced with my first child when I was aged 25 and of a normal weight. With my second, three years later (still normal weight), waters broke but had to be induced. In my case the older, overweight mum wasn’t the cause.

What I will say is that I had my third child naturally and it was such a lovely, fairly pain-free, fast labour, that it has made me question induction. Both experiences, particularly my first where they had to do numerous things for me to labour, were quite frankly awful.

[RandomMess]

Thing is mid to late 30s is biologically old to be having DC especially if it's a first.

I think the prime physical age to have them is around 18/19!

[Avery7]

@Fredthespider It could also be related to the patients' choice of hospital. The one I gave birth in last time has a very high rate of inductions and c-sections, but it's a highly specialist unit with a top quality NICU, so high risk patients are more like to choose it or be transferred there.

[NameChange30]

Long but informative and interesting read
www.aims.org.uk/journal/item/induction-care-bundles

[Fredthespider]

@Avery7 you might be onto something there, although the trust with lower induction has two hospitals with NICUs compared to one in the higher rate. I'm not sure how they compare in terms of care levels though so higher risk mothers may move out of the trust area.

[timeisnotaline]

You’d need to categorise the induction stats by overdue, baby reasons - movement or growth, and mum reasons - pre eclampsia cholestasis etc etc to even start to have a picture.
I was induced at 11 days over, baby born at 12. Midwife showed me my placenta (cord snapped so it needed extracting manually, I assume that kind of fun is more common with an older cord) and she pointed out some unusual features, also could be due to older. Made me quite glad they hadn’t waited. (Waited any longer- they had already bumped from the list for a couple of days running)

[timeisnotaline]

And I was 32 which I don’t think is that old, not at all overweight.

[Heyha]

@RandomMess that is very true and actually another one I can think of was for OC and she was also late 30s.