A new March Of Dimes campaign was launched today called, “Healthy Babies Are Worth The Wait.”
The March Of Dimes is an organization devoted to reducing premature births through helping women quit smoking and ensuring they get prenatal care and the like. But a more recent focus of theirs has not been not just on what pregnant women do and don’t do, but on what doctors are doing.
Too many labors are being induced artificially before the baby is ready to be born.
There’s a persistent myth that babies do little else in the last few weeks than gain weight making delivery harder for mom. What is actually happening is some important brain development and lung maturation.
“Some women mistakenly think that the only thing a baby does during the last weeks of pregnancy is gain weight, making labor and delivery more difficult,” said Judith Nolte, a member of the March of Dimes national Board of Trustees. “When the moms in our focus groups learned about the important brain and organ development that occurs, they were more than willing to put up with their own discomfort so their baby could get a healthy start in life.”
Babies almost always do well when they are born at 37 weeks as opposed to 40 weeks, but the risk of death is still double. The research clearly shows that in healthy pregnancies risks go up for babies induced before their time. The March Of Dimes want women to be aware of this but they also have a message for care-providers:
“For professionals, we encourage participation in quality improvement initiatives aimed at preventing premature birth, including use of the toolkit Elimination of Non-medically Indicated (Elective) Deliveries Before 39 Weeks.”
As a patient advocate I feel strongly that pregnant women need to be better educated about the risks of induction for convenience. we have a strong induction culture right now and it’s not always in the mother or baby’s best interest.
Believe me, I love the idea of scheduling a birth. The waiting and wondering can be a nightmare. But there is a logic to this process and unless we have a really good reason for inducing– and convenience is not one of them–research clearly shows that we’re better off letting the baby lead the way. Pregnant women also need to be wary of warnings that the baby is getting “too big.” I hear this all the time, but the evidence does not support induction for *suspected* big babies in almost all cases. First of all, the weight estimate can be off a pound in either direction. Statistically, fetal size appears to level off after 40 weeks. Officially a baby is only considered big at 9 pounds and 14 ounces or more–only 3.5% of babies are actually born at or above this weight. The concern with a large baby is shoulder dystocia– where the shoulder gets stuck, basically–but half of all shoulder dystocia cases happen in babies under 8 pounds 13 ounces. Shoulder dystocia can often be resolved by getting mom on all fours to push.
But the main point here is this: In almost all cases, we don’t know how the baby is going to fit through the pelvis UNTIL mom is in labor. Big babies come out of slim-hipped moms all the time, and big moms can push forever with a tiny baby, we can’t predict how it will work out. Labor is dynamic, a lot of it has to do with how the labor progresses. Check out this story about Miranda Kerr’s nine pound vaginal delivery and the many comments from moms who had big babies.
I hope the March Of Dimes’ new focus on preventing unnecessary early induction will have a real impact. I obviously think it’s a worthy effort! Here is where you can read the release for the “Healthy Babies Are Worth The Wait” campaign.
And here’s a very clear breakdown from Childbirth Connection of the best evidence on labor induction.
In the meantime, kick back and let your body set the timer– it knows things we don’t.