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'Tis The Season... For Inductions

Christmas is such a magical season, who wouldn’t wish for their baby just a little early so they don’t have to be in the hospital for Christmas, and can be home with their new baby for the holiday?  More women than you would think, but is this a safe trend?

In chatting with a friend of mine this week, who is due any day now, her OB/GYN brought up induction almost two weeks ago. She declined. A mother of three, on her fourth child with no reason for an induction, why force it?  Well it turns out her OB/GYN’s office will be closed from today, the day before Christmas eve, till the end of next week. The induction wasn’t because she truly needed it. It was because her provider didn’t want to get called off to deliver her baby during his time off.

Of course this cannot be an isolated incident, because if you look at the numbers, they speak for themselves. Though many online blogs, high profile childbirth educators, and writers like Robin Elise Weiss have taken the time to break down the numbers, and of course the birth dates showing an increase not only the week days before Christmas, but also the week days before New Years, some may assume for tax break babies.

Robin said:

One of the things I’ve noticed year after year is that there is an increase in the induction rates just before holidays, but truly a lot of them occur before the winter holidays, oh and the end of the tax year. I remember one year I had three women due around Thanksgiving. One went into spontaneous labor the Sunday before Thanksgiving. One choose to be induced Monday morning so that she could be home in time for Thanksgiving (She was 38 weeks.) and the third choose to be induced that Tuesday for the same reason. I was crazy busy – but so were the hospitals. My clients who were scheduling induction kept getting bumped by others in the same situation. The real kicker here is that none of these women had medical reasons to be induced.

Even the National Center for Health Statistics have broken down your chance for actually having a baby born on Christmas.

The short answer is, not as high as in other months. Still, the possibility is there. In fact, if you look at the seasonally adjusted birth rates by month, your chances in December are just as good as having a baby in March or May. The lowest rate is April (13.7 live births per 1,000 population), compared with the highest rate in August (14.6). December comes in at 14.2 births per 1,000 population.

But this year, Christmas is on a Friday. How does that figure in? Well, the average number of births in 2006 (most recent data available) ranges from 7,587 live births on Sundays compared with 13,482 on Wednesdays. Fridays come in at a respectable 13,151, although Tuesdays and Thursdays, along with Wednesdays, have a higher average.

But why are all these inductions a problem? I mean, inductions are being done so routinely that they shouldn’t be looked at as a problem… right?  Wrong! Contrary to what we are told and believe, there are a lot of risks in inductions, so many that ACOG or the American Congress of Obstetricians and Gynecologists has placed strict guidelines on induction, excluding elective induction altogether.  Taken from the 2009 revised induction guidelines:

According to ACOG, there are a number of health conditions that may warrant inducing labor but physicians should take into account maternal and infant conditions, cervical status, gestational age, and other factors. Some examples in which labor induction is indicated include (but are not limited to) gestational or chronic hypertension, preeclampsia, eclampsia, diabetes, premature rupture of membranes, severe fetal growth restriction, and postterm pregnancy.

In so many words, medical reasons are the only reason women should be induced, not because Dr. Hatchet has to be on the golf course in Boca.

While this graph isn’t the best, it is the closest thing I could find that clearly showed the birthday trends around Christmas, but dropping drastically on Christmas eve, as well as Christmas day, then jumping drastically in the days after Christmas approaching the new year.

Some of the risks of induction include:

  • Increased risk for c-section (40-50%)
  • Increased risk for fetal distress, heart rate complications, and shoulder dystocia.
  • Increased NICU admission
  • Increased risk for a vacuum assisted delivery, or forcep delivery
  • Increased risk for a premature baby, or jaundice.

While many do not sound very serious, the risks of a cesarean delivery are enough to worry any mother who truly understands the complications that come along with that.

Personally, my first son was induced, I didn’t know any better then, and it was not medically necessary although I was certainly lead to believe it was at the time. That ended up in a c-section which lead to another cascade of problems from then on.

Please ladies, take some time to become educated on induction, especially if there is no medical reason for it!

photo: flickr.com.aaron_anderer

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