Posted by My OB said WHAT?!?.
Jul
6
Posted by My OB said WHAT?!?.
“I Like To Get You In Here At 37 Weeks & Induce You, So I Can Be In Control Of Your Labor.”
“I like to get you in here at 37 weeks and induce you, so I can be in control of your labor.” -OB
There are 76 comments to this post.
It keeps getting earlier and earlier doesn’t it? It used to be 42 weeks before they’d talk about induction. Then 41 and so on. I wonder if the OB doesn’t care about induction induced prematurity because then the baby will suffer on somebody else’s watch.
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37 weeks?! my daughter was 6.13 at 40 weeks! At 37 weeks she may have been a low-birthweight baby, and I bet she wouldn’t have come so peacefully! It’s criminal that obs with this mindset are allowed anywhere near pregnant women.
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Amelia Reply:
July 6th, 2010 at 9:46 am (Quote)
This, exactly. My daughter was 7 lbs. 10 oz. at 41 weeks 5 days. She would have been a peanut at 37 weeks!
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Serene Reply:
July 19th, 2010 at 6:44 am (Quote)
*jealous*
My 37wk son (baby number 1) was 8lb7oz
37+3wk daughter (2) was 8lb even
36+4wk daughter (3) was 6lb2os, and the only one I think I would have worried about if she was born earlier. But, my Sons dad was 6’9″ tall so I guess that explains the size of him, and my first daughter (new husband…) I was an undiagnosed diabetic. Funny though I was on steroid treatment with number 3 for 6 months of the pregnancy, and we expected her to be the biggest!
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Sheva had this to say,
Jul 6, 2010 @ 5:41 am (Quote)
Apparently, the closer the baby gets to its due date, the more likely a stillbirth is. Or so people with numerous ABCs after their name like to say. I have yet to see a study that supports such drivel.
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Rebecca Reply:
July 6th, 2010 at 5:52 am (Quote)
of course. that makes total sense given the number of zombie post-dates and on-dates babies that have been had by women who frequent this site. total sense. *gag*
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Cynthia Reply:
July 6th, 2010 at 6:52 am (Quote)
I suppose technically that’s true (in the sense that we’re all one day closer to dying every day). But news flash, doc. The odds are, that baby is going to come on his own some day in between now and when he would not be able to survive in the womb. God designed the system pretty well.
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Cmat Reply:
July 6th, 2010 at 7:44 am (Quote)
I suppose technically that’s true (in the sense that we’re all one day closer to dying every day). But news flash, doc. The odds are, that baby is going to come on his own some day in between now and when he would not be able to survive in the womb. God designed the system pretty well.
I’d say so. God designed our bodies to carry a bab, God designed our bodies to give birth vaginally (though, yes, I know c-sections are sometimes necessary) and to give birth when baby is ready…
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Jane Reply:
July 6th, 2010 at 8:11 am (Quote)
Actually, there’s a bell curve. Assuming all labors happen spontaneously, a baby’s chances of survival start out low, rise, PEAK at the due-week, and then drop off again with a significant drop in positive outcome after 42 weeks.
(One OB threatened me that if she didn’t induce, I could carry to 55 weeks. I kid you not. I can’t submit that here because no one would believe it if it showed up on the main page.)
But that bell curve tells us there’s a “very safe zone” between 38 weeks and 42 weeks. Doctors in attempting to reduce the risk of “beyond 42 weeks” begin shaving off the far end of the bell curve, but for some reason they don’t see a problem with the near end of the bell curve.
Since it’s a nice even curve, if 41 weeks is dangerous, then by logic, 38 weeks should be EQUALLY dangerous and they should take measures to stop labor if it starts then. But they don’t.
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Bonita Reply:
July 6th, 2010 at 9:14 am (Quote)
Good point. I hadn’t even thought of the bell curve for that.
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Heather Reply:
July 6th, 2010 at 9:51 am (Quote)
Funny, but I know plenty of people who were born at 44-45 weeks and moms who’ve given birth in that range with perfectly healthy babies. One friend was 5lbs with no signs of IUGR or “overcooking” at 44 weeks, without any question on the EDD.
The amount of protein you eat matters more than how far along you are, as far as the placenta, which is what’s supposed to “overcook” the baby.
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Kyra Reply:
July 6th, 2010 at 10:29 am (Quote)
Good point on the bell curve. My grandma gave birth to my aunt at 47 weeks. Her “due date” was beginning of December, and Aunt was born February 9th. After week 40 the only thing her doctor told her to do was take extra vitamins and an iron supplement. My grandma gave birth naturally to a 13 lb baby.
My aunt is now a healthy 50 yr old engineer in California.
I know its not like that now, a dr would NEVER let a woman go as far as 47 weeks, but inducing at 37 weeks is ridiculous, when a baby could healthily spend another month in the womb.
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Translation. “I want to induce you early enough to nearly guarantee a c/s for failure to progress. We’ll do that around 4pm, so that I can make sure I’m home for dinner.”
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As a mom of preemies, this terrifies me.
I know SO many people whose dates were either off or just needed longer. Their babies would have wound up in the NICU if induced at 37 weeks.
I wonder if this OB works at a hospital that even has a NICU. I know a local doctor who does this and I’m heartsick for the moms who use her because the hospital where she works doesn’t have a NICU. So you know a good percentage of those babies wind up being taken away from their mamas to another hospital equipped to handle their special needs.
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They do get a few points for telling the truth so that the OP is able to run screaming.
I do agree with Beth’s translation though. It stinks of c-section anticipation.
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Sarah Dorrance-Minch Reply:
July 6th, 2010 at 1:45 pm (Quote)
I wonder what would happen if the mother said, “If I don’t show signs of ripeness, an induction has a fifty percent chance of failure – at least. Maybe we should just schedule a c-section instead?”
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Jen Reply:
July 7th, 2010 at 5:28 am (Quote)
I think I can answer that. She’s get a scheduled C-section.
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Kat Reply:
July 7th, 2010 at 7:01 am (Quote)
And then, the next thing to say is “OK, next week doesn’t work for me, how about (date after 41-42 weeks)?”
Hee hee.
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Sarah Dorrance-Minch Reply:
July 8th, 2010 at 8:19 am (Quote)
Sigh. Note to self: never play a game of “chicken” with an obstetrician.
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mystic_eye had this to say,
Jul 6, 2010 @ 6:21 am (Quote)
So hospitals “ban” VBACs because of the risks but don’t ban unnecessary inductions before 39 weeks despite the drastically increased risks and increased NICU days?????
I hate the world.
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Kyra Reply:
July 6th, 2010 at 10:22 am (Quote)
My Ob, although a great guy, and I really like him, his clinic offered optional induction after 37 weeks. I think there should be bans on optional inductions. Inductions should only be medically necessary.
My friend, bless her heart, got an optional induction JUST BECAUSE her sisters wedding was a week after her due date, and she wanted to look good in a dress. I don’t judge, but convenience shouldn’t be a factor in inductions.
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Heather P Reply:
July 6th, 2010 at 2:10 pm (Quote)
My sister-in-law’s wedding was a few days after my oldest baby’s due date. I was quite peeved at her for scheduling the wedding so close. My hubby told her there was no way he was missing his daughter’s birth to go to the wedding. My daughter ended up making her appearance (on her own time) at 38+4.
A few weeks more did not make me look good in a dress.
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Danielle Reply:
October 3rd, 2010 at 1:53 am (Quote)
I agree that optional inductions should be banned but I also think optional cesareans should be banned. Too many women are choosing to have a c-section because it’s “easier” (the hell it is!) without realizing how dangerous the unnecessary surgery can be 
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Once again, this is evidence of the culture of fear. If the body is in control of labor, the doctor doesn’t know what will happen. Whereas if the doctor is Doing Things, the doctor maintains the illusion of control because the doctor is making decisions.
People who like control should go into podiatry, not obstetrics.
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Cynthia Reply:
July 7th, 2010 at 5:21 am (Quote)
Exactly my thoughts.
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Sarah Dorrance-Minch Reply:
July 8th, 2010 at 8:22 am (Quote)
The malpractice insurance premiums are a lot lower, and the hours are more regular. I hear podiatry is becoming a hot new field for the next generation of med school graduates. Also the eye/ear/nose/throat specialty, and plastic surgery. I read it in a newspaper a few years ago.
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My youngest was 6 pounds 2 ounces at 41 weeks 5 days. I was charting my cycles and I am as certain as I can be of when she was conceived.
If she had been forcibly evicted at 37 weeks, I have no doubt she would have been “low birth weight” and who knows how many other struggles she would have faced?
She was ready at 41 weeks 5 days, not before, not after. That was her birthday!
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Heather Reply:
July 6th, 2010 at 9:53 am (Quote)
What I find sad is a culture that induces so many babies that 6.2 is no longer considered “low birth weight” like it was just 50 years ago. That’s a freaking TINY baby and yeah, at 37 weeks, your little girl would have probably been in the 4lb range! Egads, doctors!
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mystic_eye Reply:
July 6th, 2010 at 4:38 pm (Quote)
Agreed.
Babies born at less than 6lbs 8oz are at increased risk of anemia and other problems and you people think babies should be 6-7 lbs and everyone thinks 8lbs is *huge* when its actually average.
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Kat Reply:
July 7th, 2010 at 7:10 am (Quote)
I know, it’s extremely frustrating. Thankfully, my breasts are super-producers so she was getting more milk than she could handle by 36-48 hours PP, her cord was not cut early, and she has been the picture of health.
My sister’s MIL is a tall, large framed woman, married to a tall muscular construction worker. I don’t know if she’s ever birthed a baby under 9 pounds. I know she’s had at least four 11-12 pound babies (at home) since I’ve known her. It would probably be more surprising if she had a seven pound baby. At one point we were due within 4 weeks of each other. My baby was born 7lb. 15oz. which is a good size for a 5′ tall 130 pound petite woman. She went past 40 weeks, and when her baby was born he was bigger than my baby was at 6 weeks old.
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mystic_eye Reply:
July 19th, 2010 at 2:46 pm (Quote)
I know some claim the parents height has something to do with how big their babies are, but I’m only 5’2″ and mine were 8lbs and 8lbs 2oz, and one was only 38 weeks.
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Some people don’t even consider a baby to be full term until 38w (even though 37 isn’t premature either). Its a really murky week.
PLEASE someone explain to me how anyone is actually ‘in control’. Knowing what is going on and being in control of a situation are two different things. You can’t control mother nature.
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Now this one absolutely infuriates me. I was induced at 37 weeks because I developed preeclampsia that couldn’t be cured by the Brewer Diet (started 34 weeks). I absolutely would not consent to a CSection under the condition of preeclampsia alone, and by son was born vaginally after 17 hrs of labor at 5lbs 10oz and spent 13 days in the NICU, I suffered severe PostPartum Depression because I couldn’t take my newborn home. It was a rollercoaster ride and was awful!
Why a OB would want to subject a mother to that just because he “wants to be in control” is beyond me!!
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mystic_eye Reply:
July 6th, 2010 at 4:43 pm (Quote)
((((Kyra))))
4 days in NICU because they hate homebirth, then screwed up meds and made the baby sick.
I’m not saying I understand 100% but the awfulness of having a baby in the NICU, particularly once you’ve been discharged, is something its hard to understand unless you’ve gone through it.
I *still* can’t discuss it or even type it past a certain brief overview.
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Sarah Dorrance-Minch had this to say,
Jul 6, 2010 @ 1:48 pm (Quote)
Wow, that reminded me, I’m thirty seven weeks as of today. Or maybe it’s tomorrow. Anyway, I’m getting close. Cool. (Can’t find my twinkle lights, though, which is a bit worrisome.)
Anyway.
I don’t give two fuzzies and a flying fruitbat what YOU like, Doctor. My body, my baby, my birthing. Learn to wait.
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Yvonne Reply:
July 6th, 2010 at 2:12 pm (Quote)
Congratulations, Sarah! I want to hear your birth story… but preferably on Thoughtful Thursday, not a regular MOBSW post. LOL!
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Sarah Dorrance-Minch Reply:
July 8th, 2010 at 8:28 am (Quote)
Friend me on Facebook (I’m Sarah Minch; there are several, I’m the one with the fundus in my profile shot, big surprise, eh?) and you get pictures.
Right now my big news is that I seem to have gained two pounds almost overnight (according to a cheap, unreliable bathroom scale that I consult every now and then) and cankles. I hope Catharine doesn’t get impatient to come out before the next two weeks are up, though. We still have to get a few things (like a mattress protector for the bed; I’m a bleeder) and besides, I’m trying to fatten her up. Because I know that if I’m not in the dead cockroach position, a little extra weight from baby fat will HELP her come out more easily. Gravity and all that. 
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Sarah Dorrance-Minch Reply:
July 8th, 2010 at 8:34 am (Quote)
PS. I wrote a book for my children about the upcoming homebirth, because I wanted them to have something that straightforwardly explained the birthing and let them know that if I got a little loud or if there was a bit of a mess from pee, poop, blood, etc it shouldn’t be anything to worry about.
That’s another reason I’m hoping Catharine will wait – my husband is illustrating the book, and I don’t think he’ll have the time or energy to draw the pictures after she’s born. (We’re thinking of self-publishing it and marketing it on Amazon, when it’s finished.)
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Elizabeth R. had this to say,
Jul 6, 2010 @ 5:02 pm (Quote)
Yikes. My middle daughter was a 40w medical induction. She was only 6 lb. 12 oz. and had some trouble maintaining body temp and had a TON of vernix. I feel bad for forcing her out at 40. At 37 I would guess she would have been a 4-lb. NICU baby
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No-one knows if there was an underlying problem here. It is so hard to judge the tone of voice, the circunstances, and what else has happened BEFORE the comment. I was induced at 37 weeks, and my doctor said the same thing to me…because I had pre-ecclampsia. Yes, he wanted me induced at 37 weeks, yes he wanted to monitor me..because my baby and I were at risk! And it was a good thing he did because if I had gone much longer my 7lb 13ou baby would have died. As it was she had an APGAR of 4 at birth and needed assistance to get breathing.
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Kate Reply:
July 6th, 2010 at 5:53 pm (Quote)
While I understand the whole “individual situations vary” approach. Chances are pretty good that because the comment was submitted here, it was for a good (or rather not a good) reason. If the doctor had expressed concern over a specific condition and then said the above statement, I don’t think the OP would have submitted the comment. Your story is an excellent example of my point.
“I like to get you in here at 37 weeks and induce you BECAUSE …”
As it stands here, the BECAUSE is purely for the doctor’s comfort of thinking he/she actually is in control of anything.
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This was my submission. I never even mentioned an induction since my last was born at home. The second SHE said this I knew I’d never go back.
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Cmat Reply:
July 6th, 2010 at 6:08 pm (Quote)
Was there a reason for that little piece of insanity?? I’m just curious.
Glad you ran screaming! Have you had your baby yet?
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Christi Reply:
July 6th, 2010 at 9:20 pm (Quote)
Nope, no reason, that’s just her “protocol” for ALL of her patients. She said it so matter-of-factly, like I’d appreciate it!
Yes, she is now 2 – I had her at home with a midwife.
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Nicole Reply:
July 6th, 2010 at 10:01 pm (Quote)
Yikes! And I thought my friend’s doctor’s “protocol” of inductions at 39 weeks was bad.
I am glad you had the confidence to leave and had a wonderful (I am assuming) home birth.
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Sarah Dorrance-Minch Reply:
July 8th, 2010 at 8:36 am (Quote)
Definitely not a doctor I’d want for shadow care (I’m glad you had your baby at home without her help).
Protocol, eh? I wonder if it has anything to do with hairdressing appointments? And what her rate of C-section is, since I bet most of the patients of this impatient OB have unfavourable Bishop scores when she induces them?
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Krista Reply:
July 8th, 2010 at 9:09 am (Quote)
For some reason I got the feeling this was a woman. Not that it matters, but that’s what I was picturing. We assume that many times men want to be in control of our births because otherwise we have no need for them in birth (in a physical sense – many men don’t realize how much we need them emotionally). Women who want the control make me think they have no control in the rest of their life. Either way, doc, not your birth. If you want control, become a plastic surgeon and leave birthing mamas alone.
And, Christi, glad to hear you ran away and congratulations on your home birth!
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What sad is the fact that women put up with this all the time. We so want our “rights”, but yet we turn over control to the most important thing we will ever do in our lives, bring a human into this world through the most private part of our bodies. We just hand it over, open our legs and let the OB decide. It is all because we are uneducated! If we would research the birth as much as we do buying a car we would tell these OBs get your hands off my birth and my baby!
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Sarah Dorrance-Minch Reply:
July 8th, 2010 at 9:10 am (Quote)
It’s one of the things I found baffling about the feminist movement (I’m a rabid feminist, btw, I cried when I heard the ERA was repealed by Congress – and I was only a toddler when Nixon signed it into being!)
The feminist movement is quick to defend reproductive rights when it comes to matters of contraception and abortion access. But pregnancy, birth, and baby-tending? Hmm. Silence.
Mostly. There is a site called RH Reality Check that is very comprehensive and does cover birth choice issues, midwifery bills, breastfeeding, child care, etc that I’ve fanned on Facebook, and then there’s the classic book _Our Bodies, Our Selves_, which covers the right to birth in a manner of the mother’s own choosing. That book was my first introduction to the idea that mothers should have a right to do things like eat and move around in labour, that such things were even possible.
Still, the more common emphasis seems to be on a mother’s right to her epidural, or even her choice of an elective c-section, although the movement does qualify that by saying it’s a right better kept in the abstract than made concrete, since c-section is riskier than vaginal birth; and on a mother’s right to choose formula over breastfeeding if she wants, and to have access to a greater variety of quality day care if she wants or needs to go back to the work force. Oh, and the need for fathers to get more involved.
The day care issue and the paternal contribution are indeed important, but it seems like the womens’ movement hasn’t changed its attitudes about birth and baby care since the Roaring Twenties, when twilight sleep and formula feeding were the rallying cry of that generation of activists.
Most of the homebirth activists, lactivists, and intactivists I know, OTOH (and this could be because I live in Indiana, I admit – it’s a very culturally conservative state) are fairly conservative and would neither call themselves strongly feminist nor pro-choice. The right to homebirth isn’t even framed as a reproductive choice issue, under such circumstances. It’s about having a healthier birth, and a birth that is a family event rather than a medical emergency and thus affirms family values as a whole.
If the womens’ movement were less equivocal about crusading for birth choices and more support for nursing mothers (especially those who can choose to stay home for the first year as opposed to those who return to work almost immediately, and need pumping support) imagine how much more power we might have.
I find it sadly ironic that the women who are powerhouses in other aspects of their life are often all too easily sold on the notion that birth is not tolerable without an epidural, and that if they do not hire the services of an obstetrician (or at least a certified NURSE midwife with hospital privileges) then they will die in childbirth like so many mothers in places like Sierra Leone and Afghanistan where maternal/foetal mortality rate is so high due to lack of sanitation, malnutrition, and other factors we don’t even face here.
We really need to stop being at cross-purposes. Otherwise, it’s all too easy for the medical establishment to divide and conquer. (Also the formula industry, but that’s a whole different tangent.)
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o m g.! I cannot believe this
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