Posted by My OB said WHAT?!?.
Nov
14
Posted by My OB said WHAT?!?.
“…You’re Never Going To Go Into Labor On Your Own.”
“At this point, you’re never going to go into labor on your own.” – OB to mother who was refusing induction at 41 weeks, when all tests indicated everything continued to be normal.
There are 39 comments to this post.
Well, he’s most likely never seen a woman go into labor after 41 weeks…there is that lay in India (I think) that was in her 90′s and they removed a full term calcified baby from her abdomen. She actually did go into labor many years ago, she just never delivered. The baby passed and labor stopped. http://www.channelten.co.uk/afullnews-125.htm
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xanthina Reply:
November 15th, 2011 at 3:08 am (Quote)
It wasn’t really labor, however. The doctors are still not sure what it was. Since the baby was ectopic, and fully out of the womb, it’s an EXTREMELY atypical situation, and shouldn’t be held as a standard of ‘never going into labor’, lol.
If the doctor hasn’t realized that the baby is out of the uterus by 40 weeks, we’ve got other issues!
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Jane Reply:
November 15th, 2011 at 3:29 am (Quote)
There was a case of an African woman who was still fairly young but had been carrying a six-month fetus in her uterus for about three years. The baby had died, labor never started, and over time the baby calcified.
http://web.archive.org/web/20060223231540/http://www.obgyn.net/english/pubs/articles/stone_baby.htm
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The Deranged Housewife Reply:
November 15th, 2011 at 8:01 am (Quote)
I agree – that was not a normal pregnancy situation. I think the woman said she was afraid because labor wasn’t progressing and other women often died from cesareans, and she knew something was wrong – the baby had died and labor stopped. I suppose the body saw it as a foreign object, so to speak, and encapsulated it sort of as a way to contain it.
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Jessica had this to say,
Nov 14, 2011 @ 7:47 pm (Quote)
The woman in India had an unusual ectopic pregnancy which is how she kept the baby inside her for so long. I’m certain this wasn’t the case with the OP and Dr. Impatient is just using ridiculous scare-tactics. Nothing like playing into a mother’s end-of-pregnancy discomfort to get what you want.
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Me at 40w6d: midwife couldn’t even reach my cervix to strip my membranes.
Me at 41w4d (a whole five days later): woke up, water broke, contractions began 15 mins. later, baby was born the next day.
Crystal ball failure there and in the original post, I think.
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PREGNANT FOREVEEEERRRR!!!
Really?
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I hear women saying all the time “I NEVER went into labor on my own. My body just doesn’t know how to go into labor, it seems.”
And I wonder if they have doctors like this, and just how long the doctor defined “NEVER” as????
So, 42+ weeks *felt* like forever, but it wasn’t. And it was absolutely and completely worth the wait for a no-pit, minimal intervention, 4 hour labor both times I went overdue.
But if I’d gone with the doctor’s advice with my first baby (who was my only “on time” baby), I guess I’d also be thinking my body just doesn’t know how to go into labor. Now that I do know, ain’t nobody can lie to me like that anymore. 
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Dreamy Reply:
November 15th, 2011 at 9:50 am (Quote)
And I wonder if they have doctors like this, and just how long the doctor defined “NEVER” as????
Sadly, I’m sure they do, and most likely “NEVER” is after 41w3d or so. Well, we can hope it’s not “diagnosed” before 41 weeks, anyway.
I have heard OBs say “most” women don’t go into labor on their own (yikes). If those docs actually, truly find that MOST of their patients don’t go into labor on their own (because they’re not allowed to wait*), they pretty much by definition have to be inducing all moms by 40w4d or so if they haven’t gone into labor by then. And it would “help” if they saw a disproportionate number of primips– otherwise they may be essentially admitting that they induce everyone who goes over 40w. *sigh*
*Sometimes a good thing, of course, but mostly not.
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Jane Reply:
November 15th, 2011 at 10:07 am (Quote)
If the average woman bears an average of 2.2 children, then they DO see a disproportionate number of primips, and therefore they DO see a disproportionate percentage of women who don’t go into labor by the magic date set by the wheel (and which assumes all women ovulate on day 14.)
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Dreamy Reply:
November 15th, 2011 at 11:39 am (Quote)
That’s true, too!
You know, Jane, I was JUST thinking about this in relation to how the hospitals in the county where I grew up have such a high rate of C/S. It’s one of the wealthiest counties in the US (surprise, surprise– either that or you’d expect it would be one of the poorest urban ones).
Anyway. It sort of occurred to me that the county must see a truly disproportionate number of primips, which makes the high (IMO) C/S rate even more outrageous. (Because we’re not talking as much about CBACs.)
Of course, I’m sure the average primip age is higher, too, which means more multiples and whatnot… But still. That obviously can’t explain all of the disproportionately high CS rate. Because where you have de facto VBAC bans, nearly 100% of multips with previous CS are getting CS. But where you have elderly primips (or multips), it’s not like anywhere NEAR 100% would have twins+ or significant complications that would truly lead to necessary or even nearly-necessary CS. I mean– you can’t even argue that.
I just did a bunch of research, but suffice it to say, based on the 2 of 4 county hospitals that have full stats available (coincidentally the two largest, which also happen to be the 2 with the lowest overall CS rates)…
-84% of births are to primips.
-90% of women with one or more previous CS end up with RCS. And keep in mind VBACs are officially “allowed” at all of these hospitals.
-24% of primips end up with CS.
Sobering. As a society, we’re saying that 1 in 4 women– of women with VERY high average SES, FAR above average pre-pregnancy health/health-care access, etc.– “can’t” give birth vaginally on her first try. And if she gets a second try, she may have as little as a 10% chance of doing so. Sobering.
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Jane Reply:
November 15th, 2011 at 11:49 am (Quote)
Since primips tend to remain pregnant for up to a week longer than multips, you figure they’re being induced more often.
Since primips tend to have longer labors with slower dilation, you figure they’re being augmented at higher rates.
Augmentation and induction both carry a higher risk of c-section.
A multiparous woman is more likely to know what she wants in labor, more likely to insist on getting it, more likely to choose her provider with her goals in mind, and is more likely to progress faster in labor once she’s dilating. But if doctors are seeing fewer second births and almost no third births, fourth births, fifth births, sixth births — then the doctors themselves have a skewed understanding of what’s normal.
How can they help women achieve normal birth when they don’t even know what normal is?
Yeah, very sobering.
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Okay, Doc. It’s time for a vocabulary lesson. Let’s define the word “never.” I do not think it means what you think it means.
I am so thankful that I know better than to believe the doctor I had with my first, who said my body never went into labor (I was 8.5 cm after 20 hours of PROM and “uterine irritability” when she said this). I never would have even tried for a VBAC.
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Heather had this to say,
Nov 15, 2011 @ 9:34 am (Quote)
Harmed, the baby wasn’t delivered because the baby developed outside the uterus and the mom confused pains as labor pains. She was scared by all te screaming women in the labor ward and went home. Obviously if the baby wasnt inside the uterus she can’t be born, but most women have babies inside the uterus so the never going into labor doesn’t work when the baby’s in the right organ 99% of the time!
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I was told I would need to be induced (had SROM and 36 hour labor).
I was told my son would be 8lbs max (9lbs 8oz).
My grandfather has cancer and was told he had 18 months left (that was over 6 years ago).
Dear Doctors,
THERE ARE NO ABSOLUTES ON MEDICINE.
Remember this before you say the words “never” or “always.”
Thanks,
Everyone
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Jespren had this to say,
Nov 15, 2011 @ 5:55 pm (Quote)
In Husband Coached Childbirth Dr Bradley (sp?) Recounts a patient who went 13 months and had a healthy baby (his strong preference is to let babies bake as long as they want). In Jackie Chan’s autobiography he is reported to have been delivered via c-section at 12 months.
40 weeks is an AVERAGE. Which means for every 32 week premie born, there (should be) a pregnancy that lastes to 48 weeks. And for every 38 week baby, there should be a 42 week baby. But ‘stone babies’ and other occurances of labor *never* setting is is exceptionally rare.
My mom had 2 kids, she averaged 40 weeks…I was 38, my brother was 42!
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This one’s mine! (how fun to have a submission posted, btw!)
I teach CB classes, and this was said to one of my students. She went in for non-stress testing during her 41st week; the ultrasound tech was kinda newish and wanted to have the radiologist come take a look at the amniotic fluid level to make sure all was well.
He comes in, says “oh yeah, everything’s looking great in there. But.. oh, you’re 41 weeks? Why don’t we just go ahead and induce you since you’re here already?”
When my student politely declined, she was told “You’re never going to go into labor on your own at this point.”
My student’s midwife was sitting right there and never said a word! Thankfully this woman knows her stuff and held her ground. Labor started two days later
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i very much understand the desire to experience a natural onset of productive labor. i had four pregnancies and four live births, but i did not begin labor on my own any of those births. at 40++ with babies in the 9-10 pound range i was certainly ready to get a pitocin kickstart. it’s not so bad, if the doc knows how to regulate it so it feels like a more natural labor. it doesn’t have to be a three hour rollercoaster so the dr. can get to a ballgame, whatever. had them all over the range, and longer is actually better. and grateful to have avoided c-section. believe me, there is nothing that isn’t “natural” about an induced labor! it’s all you, baby, it aint anybody else doing that hard work after the pitocin nudge. so what i hear that ob/gyn saying is certainly a euphemism. of course it’s unlikely to “never” go into labor. he/she meant “we are getting to the point it could be dangerous to wait; you may or may not go into labor while you still have a living fetus, a healthy fetus, your own life.” i don’t think it’s meant to “scare” anybody; i think it’s a full disclosure of the risks. i believe it is absolutely true there are women who will not go into labor. in the “old days” the baby would simply have died, and then the mother would have died from the necrotic tissue inside her. all that said, it’s important to have all the ducks in a row. elective inductions are ridiculous if they are done before medically indicated. know your dates. trust your medical provider or find one you do trust. and if you have to make a choice about induced labor, weigh the pros and cons very carefully against the odds nature hands out.
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I respectfully disagree that the doctor was using a euphemism. My student repeated it to me, so I was able to get an aural interpretation, whereas in type, you just go with how you interpret the message. Things are easily lost in that. I promise this was not said in a way to make her feel good about her choice to allow labor to start on its own.
Also, did you miss the part in there where he first stated “oh yeah, everything’s looking great in there. But.. oh, you’re 41 weeks? Why don’t we just go ahead and induce you since you’re here already?” — THAT is why it is inappropriate to suggest induction. Just because you’re 41 weeks and already at the hospital is not medical indication. If things were not “looking great in there” then sure, go ahead and suggest it. 41 weeks is not terribly overdue, though.
As for full disclosure of the risks? I know this conversation did not include anything about the risk of other interventions following the start of induction, nothing about the risks of the induction medication itself or medication delivery method, etc. So, not full disclosure.
As an aside, I will say there is something that is not natural about induced labor – the induction.
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Tee Reply:
April 2nd, 2012 at 4:49 pm (Quote)
I agree, it doesn’t sound like a euphemism to me. And while I understand what Joy is saying, I will have to disagree about an induction being called natural. Natural birth means NO medications and an induction requires meds, plain and simple. I know some people get defensive about the terms and I don’t mean to minimize anyone’s experience. I believe that far too often, women that believe in natural birth are quick to judge or put down women that have required some sort of intervention. (like an induction) It saddens me to see women doing that, it really does. I can’t help but think a big part of the reason that some people might be defensive about it is simply because other women put them down for the intervention. ::sigh:: It doesn’t need to be that way on either side but none of this changes the fact that if you are induced, you can not call your birth natural.
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Add Your Comment.
Oh, for pity’s sake! Do people really believe that a woman will be pregnant for the rest of their lives? Seriously? My sister delivered at 46 weeks! You do go into labor eventually! Is it safe to wait that long? No, not necessarily. But that doesn’t change the fact that you will go into labor!!!!
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abba12 Reply:
November 14th, 2011 at 7:39 pm abba12(Quote)
Did she seriously deliver at 46 weeks? Did they mess up her dates? How big was bub?
I’m sorry but I’ve never heard of a pregnancy going past the beginning of the 43rd week because of doctors. That’s really intriguing
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Tee Reply:
November 14th, 2011 at 8:13 pm Tee(Quote)
There was no way that the date is messed up because at the time, her husband was working out of town. There was only one night that could have created that kid, if you know what I mean! Vivi was 11 pounds at birth! And I don’t think that any doctor or midwife would have let her go that long but she went unassisted. Vivi is two now and such a blessing to our family!
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adrienne Reply:
November 14th, 2011 at 8:57 pm adrienne(Quote)
I have a friend who also goes unassisted and she went to and past 45 weeks. she’s pregnant again, and just announced she’s “29 weeks, only 16 to go!”
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Tee Reply:
November 14th, 2011 at 11:15 pm Tee(Quote)
That’s funny! My sister was overdue with some of her other children but not as far over as with Vivi. She told me she was pregnant on New Year’s Day and asked me to calculate her due date. My answer was “Thanksgiving!”
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adrienne Reply:
November 14th, 2011 at 11:18 pm adrienne(Quote)
my friend is due in january. we’re hoping for leap year day!
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Chelsea Reply:
November 16th, 2011 at 8:28 am Chelsea(Quote)
Tehehe, I’m due on March 2 so I might get a Leap Day baby.
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Jade Reply:
November 15th, 2011 at 7:59 am Jade(Quote)
I went to 43+5 with my DD. She was 9lb3oz.
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Heather Reply:
November 15th, 2011 at 10:39 am Heather(Quote)
I have two friends who were born at 44+ weeks–well, one was 44 weeks and her mom was a nurse, 100% on her dates. The other was a calendar month and a day late. The friend whose mom was a nurse was 5lbs and the other friend was 10+lbs (her brothers were 11+ and nearly 12 after her).
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