Birth & Beginnings: childbirth conversations

Hello mothers and mothers-to-be! This blog focuses on pregnancy, childbirth, children, and parenting. Along with providing helpful information and resources, it is also a place to discuss choices and trends in these areas. The blog will inform and encourage mothers as we share and learn from each other. It is not a place to say that one opinion is better than another; instead it is a forum for camaraderie and for sharing personal experiences. So feel free to read, respond, and absorb information on a daily basis as together we traverse this world of motherhood.


Laura Tolman, CCE, LSP

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Laura Tolman is a local certified childbirth educator and labor support professional. She also works as a postpartum doula. She and her husband are long time Alaskans and are the parents and forming relationships with families while learning about other cultures. In her free time Laura enjoys writing freelance articles, poetry, and the performing arts. Her favorite pastime is being with family and coaxing uproarious laughter out of her young son.

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Hello Baby, Goodbye Pregnancy - 9/2/2008 11:31 pm

Pre-natal Exercise - 8/22/2008 10:35 pm

No Fear - 8/17/2008 12:02 am

Symphysis Pubis Dysfunction (SPD) - 8/14/2008 10:20 pm

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The Chronic Whiner - 8/6/2008 10:55 pm

Last month of pregnancy - 8/1/2008 10:41 pm

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How many children? - 7/16/2008 11:38 pm

Go For the Full 40 - 7/11/2008 11:41 pm

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Happy 4th of July - 7/4/2008 9:18 pm

Dealing with an Unexpected Birth Outcome - 7/1/2008 10:02 am

Another Breastfeeding Benefit - 6/25/2008 10:16 pm

Affirmations and Birth - 6/22/2008 10:53 pm

Inductions and the Bishop Score - 6/14/2008 5:03 pm

Pelvic Floor Muscle Myth - 6/8/2008 12:01 am

Mom, the Ultimate Multi-tasker - 6/3/2008 10:00 pm

Mommy and Baby Separation - 5/29/2008 10:00 pm

Open Blog - 5/18/2008 4:30 pm

How long to exclusively breastfeed? - 5/15/2008 4:56 pm

The “Business of Being Born” Review - 5/13/2008 8:32 am

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Inductions and the Bishop Score

Posted by mamas

Posted: June 14, 2008 - 5:03 pm

Labor induction rates continue to climb in the United States for a variety of reasons. Whether it is because the mother has requested a “social induction” or the physician has stated that it’s medically necessary, the risks are still present.

The potential medical implications of inductions remain tangible, but are often overlooked. Inductions have been found to increase the possibility of a cesarean section. This is especially true of women who have had a previous vaginal birth, if their cervix is not ready for labor. It is possible that the agents used for inductions can cause uterine hyper-stimulation. Also the induction of labor will probably require multiple other interventions such as I.V. use, fetal monitoring, and sometimes movement may be restricted. Induced labors can be more painful due to the lack of endorphins being released by the body with the natural onset of labor.

There are sometimes medical reasons for inductions which should not be ignored. Non-reassuring fetal heart tones, uncontrolled pregnancy induced hypertension, diabetes, maternal cardiac disorders, congenital anomaly of infant, and placental insufficiency are a few of the more frequent causes. The American College of Obstetricians and Gynecologists state that labor should only be induced when there are more risks for the baby to remaining inside the uterus than being born.

Regardless of your reason for being induced, it is a good idea to get your Bishop Score prior to the induction date. The Bishop score is used to determine the potential success/necessity of an induction and how ready your body currently is for labor. It looks at five key components and the resulting number will help you to know how you will respond to being induced, and ultimately if the induction will be successful or not.

The five components of the Bishop score are: position of the cervix, consistency, effacement, dilation, and fetal station. Each aspect is given a number and then you add in the modifiers. You add an additional point for each of the following: preeclampsia and prior vaginal birth. Then subtract a point for each of the following: post dates, first pregnancy, or premature/prolonged rupture of membranes (water breaking). The higher the number, the better the chances of a successful induction. A very low score could indicate an increased chance of a cesarean section or failed induction. For printable Bishop score cards, click here.

How do you feel about inductions? Have you had an induction and how did your body respond?


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  1     June 15, 2008 - 10:20am | Beth_451

Interesting

I had never heard of the Bishop score. I have had lots of friends get inductions though. It absolutely seems to neccessitate pain killers. My mother had three children naturally and then was induced with her last (gestational diabetes combined with a possibility of a very short labor and an hour commute to the hospital). She said that it was much more painful and was forced to take some pain killers because it was so unbearable.

On the other side, I've been reading about natural things to do to encourage labor to begin naturally. I was interested to learn that the drugs used to soften the cervix during a hospital induction contain active ingredients that are also present in sperm, so having sexual intercourse can encourage late term labor. I have also read that nipple stimulation and certain herbs also can get contractions going. Since even midwives have to turn pregnant women over to a hospital to get an induction when a woman is two weeks overdue, I hope to have a list of natural labor inducers up my sleeve to prevent this from happening without significant cause.

Overall, I have to believe that our bodies know what's better for baby than the hospital schedule.

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  June 24, 2008 - 6:49pm | akvalleygirl74

It's interesting you mention

It's interesting you mention the nipple stimulation and lovemaking as ways to induce labor. Since I was pregnant with multiples I read a lot about premature labor, as I was at a much higher risk. Many women that are at risk of premature labor are told to only have intercourse with a condom because of the properties in sperm that can encourage labor to begin.

I was 5 days overdue with my first, and being a young first-time mom I was also clueless. The Dr asked me if I wanted to be induced, and I recklessly (and enthusiastically) said "YES!" because I was tired of being pregnant. After maxing me out on Pitocin (EVIL stuff) for 24 hours and forcing my water to break I had to have a C....I'm convinced Katy was not ready to be born. She was healthy, but only weighed 7 lbs and could have easily stayed in another few days to a week and I'd still have been able to have her vaginally.

That in turn paved the way to having an elective C with the twins. I know I'd have been much more enclined to attempt a vaginal with them if I'd have had one with Katy, but the risk of a uterine rupture wasn't worth it to me so I took the route I knew and was familiar and comfortable with. :sigh: What's done is done, and I'm thankful for 3 healthy children, but there's a lot to be said for researching options and being a good advocate for yourself in the birthing process. I was too ignorant to know any better.

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  June 24, 2008 - 10:54pm | mamas

Agreed

Thanks for being so candid with your thoughts and experiences. I meet so many moms, that are just "tired" of being pregnant and agree to an induction (often days or weeks before they are due). They don't realize that the changes of having a cesarean are so much higher and that the complications from surgery can be extensive. I completely agree with you about being a good advocate for yourself and doing your research in advance. I recommend the "Thinking Woman's Guide to a Better Birth" by Henci Goer to my doula clients for informational purposes.

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  June 25, 2008 - 12:03pm | akvalleygirl74

Definately

I would also add that I didn't even read the section in "what to expect when you are expecting" that dealt with C's because I thought I would never have one. I had a completely healthy pregnancy and was a young, fit woman who walked every day and watched her diet. Why would I ever need a C? I wish now that not only would I have refused the pitocin and asked to go home instead to wait for Mother Nature to do her thing, but that I would have read ALL of the possibilities of what could happen, including surgery and recovery. Knowledge is power.

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  June 15, 2008 - 10:04pm | mamas

Natural Labor Induction

I agree that the natural measures are better....and ultimatly your body/baby should dictate the start of labor if possible.

Some other natural labor inducers: cumin, spice, or raspberry leaf teas. Some women take natural prostaglandin oils such as borage oil, evening primrose oil, flax seed oil, and black current oil to soften the cervix. They either take them as vaginal suppositories or orally. Pressure point massage of the feet or inner thighs has been said to help start labor. Some women try blowing up balloons, taking walks, swinging at the park, and all kinds of other natural methods. However, sometimes it just plain isn't time yet.

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  June 16, 2008 - 9:03am | Beth_451

Natural

It's frustrating that it could be "just not time yet", but yet doctors can force an induction. I know first babies tend to be later. I hope this does not become an issue with me down the road.

About the herbs and oils you mentioned, should a pregnant woman avoid them all together? Only in the third trimester? Is there danger of premature delivery in these natural things? Thanks.

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  June 16, 2008 - 9:38pm | mamas

herbs and oils

Not necessarily. Some things are okay in moderation. However, others you should avoid completely during pregnancy. For instance, red raspberry leaf tea is sometimes recommended by midwives to help with morning sickness, even in the first trimester. But in late pregnancy, it is also recommended to help induce labor (greater amounts usually). As a rule of thumb, you should be okay if it’s an herb that you would normally ingest, but if it’s something that you wouldn’t regularly eat, than it’s better to hold off until you know more. Your best bet on the herbs and spices, is to do a lot of research before taking any of them or to talk to an herbalist. Here is one site on some definite herbs to avoid all during pregnancy because they can cause uterine stimulation. herbs in pregnancy

I would stay away from the natural prostaglandin oils during early pregnancy, because they can soften the cervix. Our body will get some of these in our regular diet anyway, but you probably wouldn’t want to up the dosage or take additional supplements unless you are closer to delivery.

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