One Thing Leads To Another {interventions}

Cascade of Interventions

{For a larger diagram go here. I couldn't quite figure out how to make it bigger}

The leader of my ICAN chapter posted this on facebook a few days ago. I think it is amazing how one intervention {namely induction} can result in several others. How many times have you heard, "they gave me pitocin, and my contractions got strong so fast that I had to have an epidural " {and so forth}? I have to say that I haven't met very many women who weren't induced or given any type augmentation to speed up or start their labor. Many ended up needing even more interventions because of it. While induction is necessary in some situations, it seems to be the norm for any mom giving birth in the hospital whether they really need it or not.

Induction of Labor

(from the ICAN website)

The International Cesarean Awareness Network strongly advises women and health care practitioners to avoid induction of labor unless a true medical indication exists. Induction of labor frequently leads to further intervention in birth including the need for fetal monitoring, epidural anesthesia, instrumental delivery and cesarean section. Each of these interventions increases risks to babies and mothers.

First time mothers are especially vulnerable: Induction itself doubles a first-time mother’s risk of having a cesarean section.

A cesarean puts a woman’s entire reproductive life, including subsequent pregnancies, at higher risk.

For all women, induction of labor increases the use of forceps and vacuum extraction as well as rates of shoulder dystocia.

Women with a prior cesarean who are induced have a 33-75% risk of having another cesarean.

Induction of labor has been shown to increase the risk of uterine rupture for women with a prior cesarean scar.

Babies whose births are induced more often experience resuscitation, admission to the intensive care unit, and phototherapy to treat jaundice, which generally require separation from the mother.

*This is why it scares me to hear women going in to be induced in situations where it is not medically necessary.

At Your Cervix {a L&D Nurse} recently blogged on intervention refusal here. She also included situations that would warrant an induction.

Taking Charge of Your Fertility {book review}

To be able to take charge of your pregnancy and birth, you must do several things including educating yourself in regards to the process that your body naturally goes through. This is the same when it comes to taking charge of your fertility. Now you might be wondering how fertility ties into birth etc, but in my mind it truly does. It starts at the very beginning of what could lead to birth, and has everything to do with how a woman's body works.

I am sharing this with you because I think out of the many things that women aren't educated about (which could include pregnancy,birth, risks, interventions etc), fertility and knowledge of how a woman's body works throughout a cycle is right up there.

After experiencing a lot of negative side effects from my birth control pills, I began looking into different options. I contacted my OB/GYN and tried a few different brands that she recommended, but nothing seemed to help. Then a friend of mine mentioned what most people know as Natural Family Planning. After asking around for more information, a very kind lady mailed me a book called "Taking Charge of Your Fertility." I was immediately hooked. It is based off the the FAM method which stands for the Fertility Awareness Method. While similar to NFP, it has a few differences. This method takes you step by step through charting your temperature, and changes in cervical fluid, position etc which can potentially tell you everything about your fertility.

Once again, I am sharing this with you because I have to admit that I didn't understand a lot of things about my body, even after getting pregnant and having children. I had no clue that not every woman ovulates on day 14, as most OB's assume and that there are specific signs to show whether a woman is ovulating (fertile) or not. I didn't know there was such thing as cervical fluid and that a woman could check her own cervix (whoa!).

While I understand that charting isn't the birth control method for everyone, I think it is so beneficial for a woman to know her cycle, especially when attempting or avoiding conception. For those who aren't a fan of their birth control pills, IUDs, etc. it is nice to have another option, because honestly I felt I was at a dead end.

When TTC for the first time, I just figured I would ovulate on day 12-16, as most websites will tell you. Assuming this can be detrimental as not all women are fertile around these days. You might think something is wrong with you, when in reality you are TTC at an infertile time.This can also have a big effect on the estimated due date that your doctor will give you. Most OBs go off of the 14 day rule, which can be off for those who don't ovulate on that specific day. This could potentially push your due date forward or behind what it should be, and cause unnecessary inductions when it seems that your baby is "late". Boy was I surprised when after charting for one month, I didn't ovulate until Day 22. If I wouldn't have known this, and would have gotten pregnant at this time, my EDD could have been set for more than a week earlier then it should have been. For someone like me who is trying to avoid being induced or c/sectioned due to post dates, a week can make a world of difference!

The other benefit to charting and knowing your cycle is learning that you are pregnant without having to wait for a pregnancy test. After charting your waking temperature for an entire cycle, you should be able to tell whether you have achieved pregnancy by looking at how many high temperatures follow in the luteal phase (or final phase) of your cycle.

There are so many benefits to knowing this information and I would highly recommend this book. It has really been eye-opening to me and I am sure it would be to other women out there too.

{I should note that I am not at all bashing the use of birth control pills (or other contraceptives) as I used them for several years and found them to be extremely effective}

"Pit to Distress" {it's no joke}

I just read some shocking information on Birth At Home in AZ, about how some OBs are using a tactic called "pit to distress." Pit, which refers to Pitocin, is the drug commonly used to augment labor and increase contractions, making them stronger and more consistent. These doctors are ordering that their patients be given unsafe amounts of Pitocin intentionally, in order to "prove" whether the baby is going to be born vaginally or not, or better yet to get them home by dinner time {by way of a quick c-section}. Many of these situations end up in c-sections due to {can you guess?} fetal distress, which is brought on by the over usage of this drug.

This is a real problem that is going on right now. Jill at The Unnecesarean blogged about this a few days ago here, mentioning that it is also referred to {by RNs} as the “pit to distress, then cut” routine . This dangerous practice has been witnessed first hand by mothers, doulas and OB Nurses. One OB Nurse {NursingBirth} blogged about it here, and included details of one birth she attended where she was specifically asked to use this tactic. It's hard to think that this is actually happening to women, and that medical professionals are getting away with putting these women and their babies in danger, but it's true. This is yet another reason why women need to take charge of their births, and become more aware of the risks involved with these commonly used drugs.