Did You Know…. Holiday Periods are linked to an increase in elective induction of labour?

Does Your Estimated Due Date Fall Over the Holiday Season?
If so, you may have a chat about induction sooner than you think!

Did You Know….holiday periods are linked to an increase of elective induction of labour?

Choosing a Holiday Induction – Is it Right for You & Your Baby?

42weeks.ie AIMS Ireland

In the weeks before Christmas, there is an increase in elective induction and Caesarean section in order to manage births around the holiday period. This includes elective induction without medical need or maybe even before your estimated due date. Elective induction can be very tempting!! You may feel heavy and tired and maybe finding its hard to get into the festive spirit…. Or maybe you are worried about getting everything done. Or perhaps you have small children at home and are worried about missing Christmas celebrations. There are lots of reasons why you might be tempted to put elective induction at the top of your Wish List this Christmas – particularly if you are encouraged by a health care provider offering, “you and baby could be home for Christmas!!!”.

“Your Baby Doesn’t Know its Christmas”

Induction of labour is a common but serious obstetric procedure. Induction is a big decision that can effect you and your baby. Your baby doesn’t know its Christmas. The research shows that for babies and many women, the best outcomes are when labour starts on its own – when you and your baby are ready. If you are considering induction, where there is no medical reason for immediate birth, it’s important to weigh the benefits and risks in order to make the best decision, for the healthiest birth for you and your baby.

What Women Say

“My 4th baby was due Christmas Day and from 38 weeks I was offered sweeps and/or induction to be home for Christmas. I was told as I had 3 previous spontaneous vaginal births I would be an ‘easy ARM’ – we declined and I went into spontaneous labour the Sunday before Christmas.”

And:

“I gave birth Christmas week a few years ago (7 days before Christmas) … I was the only spontaneous birth in an 8 bed ward – the rest were inductions or planned Caesareans. Many of the induction women were also sections… the midwives were run off their feet”

And:

” I was due December 28th on my 3rd baby but have a history of going a few days early. I was NOT missing Christmas morning! I was induced at 38+6 – it was grand but very very busy!”

And:

“Seriously don’t understand the hysteria! If baby comes Christmas Day then that is when it comes! I think its a lovely day for a birthday – unusual!”

What is induction?

An induction of labour is when a doctor or midwife uses various methods to artificially initiate or accelerate labour such as:

  • a membrane stretch and sweep
  • a pessary or gel
  • artificial rupture of membranes (ARM)
  • a hormone drip

The Evidence Can Help You Make A Decision

“The National Institute for Health and Care Excellence (NICE) in the UK recommends that induction of labour has a large impact on the health of women and their babies, and so needs to be clearly clinically justified. “

If you are considering an induction of labour or have been offered an induction of labour without medical necessity, it is worth looking at the benefits & risks.

Induction of Labour – Benefits

  • You can choose the day/time
  • You can arrange to be home for a specific event
  • Helpful in organising care for other children/work/help when you are home

Induction of Labour – Risks

  • higher rates of Caesarean section
  • increased risk of your baby being admitted to NICU (neonatal intensive care unit
  • increased risk of forceps or vacuum (assisted delivery)
  • contractions may be stronger than a spontaneous labour
  •  your labour is no longer considered ‘low risk’ – less choices in where and how you birth, restricted birth positions, continuous monitoring CTG, time limits for which to labour in.

Special Considerations due to the Holiday Period:

  • It is likely that other health care providers are also planning elective births for women – wards likely to be busier, full wards, you may be discharged sooner, less access to specialists like lactation consultants

santa

Santa Baby! This baby was due Christmas Day but arrived a few days early in her own time! From the 42 weeks Gallery

Risks specific to your baby

Recent research has shown that the use of oxytocin in labour is an independent risk factor for distress in babies. This means that the baby does not tolerate labour as well when oxytocin is used. This can have implications on the way you give birth and on your baby’s condition after being born.

Other research shows that the use of oxytocin increases your chances of asking for an epidural. In a Cochrane Review, both oxytocin and epidural are discussed as having implications on breastfeeding your baby. You can read more about this here

Membrane Sweep

You may be offered a membrane sweep to induce labour. A sweep is a vaginal exam in which a health care professional will sweep their finger between the cervix and bag of waters surrounding your baby. Sweeps may or may not induce labour. Evidence shows us that sweeps are more likely to work if your cervix is favourable for labour already. Sweeps can bring on a bloody show, irregular contractions, and can accidently break your waters.

Related Reading

Births by Day of Year: http://peltiertech.com/Excel/Commentary/BirthsByDayOfYear.html

Saturday Night’s Alright (For Avoiding a C-section). Why Giving Birth on a Monday Makes You 3 Times More Likely to Have an Emergency Caesarean Section

“No Thank You” – A Guide to Informed Decision Making

Induction – Is it Right for You?

ACOG: Study Finds Adverse Effects of Pitocin in Newborns http://www.acog.org/About_ACOG/News_Room/News_Releases/2013/Study_Finds_Adverse_Effects_of_Pitocin_in_Newborns#.UYkdLeDO_9s.facebook

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