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When thinking ‘birth’, you think soft pink (or bluish) blankets, midwives yelling ‘push!’ and a beautiful baby emerging into the world. When preparing for birth, you don’t usually prepare for an induction. And yet, you must. Because three out of every ten women in the UK will be induced, and numbers are similar all over the well-resourced world.
You might say ‘so what? If my doctor thinks I need an induction, he’ll give it to me.' Or ‘When my doctor thinks I need an induction, he’ll explain it to me, and then I can decide’. Wrong, on both accounts.
Wrong, because, as a new book by Dr. Rachel Reed shows, ‘need’ is not always determined medically. A hospital might drive doctors to induce because it reduces the length of the delivery, thereby reducing labor costs and freeing up beds faster. The main goal would be to reduce risk, but the risk statistics, Reed claims, involve short-term, physical and measurable outcomes that impact the organization. These statistics are generated from researching general populations of women, and may not be relevant for a particular woman, with her own unique health considerations and perceptions of risk. ‘Need’, then, is complicated.
Reed claims that the threshold for intervening is very low if the impact of the possible outcome is considered very significant and immediate. Three out of 1,000 women will have a stillbirth if their pregnancy continues beyond 41 weeks. The urge, then, is to say, let’s induce! But then you also need to consider that these numbers don’t apply to women who have already carried a pregnancy to the 41st week. Further, a woman having her first labor induced has more than double the chance of having an emergency C-section. There are many risks associated with C-section for mother, baby and future pregnancies. These risks are usually not considered – or even discussed.
Deciding mid-birth is impossible, at least if by ‘deciding’ we mean a calm, calculated and informed process of risks, benefits, guidelines and alternatives.
Reed's new book, Why Induction Matters, is revolutionary, supportive, and eye-opening. Reed, an experienced midwife, brings women’s experiences with induction, explains the physiology of the process and – this is the revolutionary part – offers a decision aid for women, who may otherwise feel ill-equipped to determine whether, when, and how to induce.
This is less fun than choosing a fuzzy blanket but has far more impact on the woman’s health, and possibly the baby’s too. Such tools are an important way of empowering birthing mothers, not just as lip service of ‘here you go, decide for yourself’, but actually giving them the tools to understand what everything means, and what their options are.
Hospitals, and doctors, have their habits and preferences. To the degree that a medical need arises, it takes precedence over anything else – which is the way it should be. But, when the woman’s preferences can come into play, they should. What better way to make sure this happens than to inform women ahead of time of options and potential divergences in the process.
And who better to do this than Dr. Rachel Reed, who I had the honor of hearing at a birth conference, where she showed the most awe-inducing home-birth films and kept on emphasizing that the midwife’s role was to be with the woman, making sure her voice is heard and her wishes followed.
Dr. Rachel Reed qualified as a midwife in 2001 after completing a BSc (Hons) in Midwifery in the UK. She practiced midwifery in a range of settings in the United Kingdom and Australia. She is a Senior Lecturer in Midwifery and Midwifery Discipline Lead at the University of the Sunshine Coast. Her research focus is on the physiology of birth, women’s experience of birth, and care provider practice during birth. Dr. Reed has published in various formats including journal articles and books. She also presented at many events nationally and internationally.
Meeting her in person is the real deal. She is full of knowledge, compassion, warmth, and a passion for empowering women. Reading the book gets close.
Why Induction Matters by Rachel Reed, published by Pinter & Martin,
