Avoiding Holiday Inductions & Understanding Due Dates

It's true that having a due date around the holidays may increase the chance of an unnecessary induction. You may also be surprised to hear that both moms and providers have their own reasons for recommending induction. So how do you know when it's a good idea to induce? We are going to provide some insight on that and dive a little bit deeper into the science behind the "due" date.

REASONS WHY A MOTHER MIGHT WANT AN INDUCTION

-Family being in town during a certain period of time and wanting to have their help with the new baby.

-Knowing when baby will be born makes it easier to plan for the holiday season.

-If the provider of their choice is going on vacation close to their due date.

-To take advantage of the tax break/deduction.

-If they've already met their insurance deductible for the year.

-Weather. Winter weather & distance to the birthplace may lead to concerns about a safe trip and making it in time.

REASONS A PROVIDER MIGHT OFFER AN INDUCTION

-Not wanting to deliver a baby on a weekend/holiday/during family time or during unfavorable hours of the day. 

-If they're planning a vacation close to the mother's due date and know that she wants them at her birth.

-Personal concerns/preferences about covid outbreaks and wanting to get you in and out of the hospital when they know there are fewer COVID patients.

-You’re coming up to your “due” date or are approaching 41 weeks.

-Medically necessary reasons such as gestational diabetes, preeclampsia, deterioration of placenta (diagnosed via ultrasound), issues with placental bleeding, etc.

LET'S CHAT ABOUT DUE DATES.

They're often based on the first day of your last missed period. However, many providers assume a 28-day cycle and fail to adjust the due date for women who have longer/shorter cycles, or who ovulate early/late. They can also be determined by ultrasounds and by measuring fundal height. Of those dating options, the most accurate is an ultrasound done during the 1st trimester between 11-14 weeks. Even an 11-14 week ultrasound has a give/take of about 11 days according to a study done in 2013. *see link to study below

Later ultrasounds are less accurate! Moving your due date in the 3rd trimester is really not evidence-based and can be harmful because it could lead to BOTH preterm OR post-term babies.

Studies show, consistently, that gestation for first-time mothers is closer to 41 weeks. Even for multiparas, (women who have given birth before), the average is still closer to 41 weeks! The keyword here is AVERAGE! Babies can be born before and after this timeline and be healthy and well.

INDUCTION

With this info in mind, here are some other things to consider...

 When talking induction, you need to understand your Bishop’s Score. With a Bishop's Score, you are assigned points in each of the 5 categories with a total of 13 points possible:

-3 possible each for dilation, station, and effacement.

-2 possible each for consistency (firm/softness of cervix) and the position of the cervix.

 If your score is greater than an 8 you are said to be favorable for induction. If you are at 6 or less, you are unfavorable for induction. This matters because the more work that needs to be done medically to get your body dilating & contracting the more interventions you are likely to have and also the greater risk for a cesarean birth.

NATURAL WAYS TO INDUCE LABOR

 -Castor oil (requires a professional but on the natural side)

 -Walking/exercise

-Intercourse/nipple stimulation

 -6 dates per day ( starting at 34-36 weeks in pregnancy)

-Clary sage essential oil

 MEDICAL WAYS TO INDUCE LABOR

-Membrane sweeps 

-Pitocin

-Cervical ripener

-Foley bulb

 OUR PARTING THOUGHTS

The truth is that there is much to consider, not the least of which is your personal preferences for birth. Trust your body and your intuition. Induction conversations should happen EARLY during your prenatal visits- well before your 3rd trimester! If you are considering an induction, whether because that's your preference or because your provider is pushing for it, consider your due date, Bishop’s score, and the reason (medical or elective) for induction. Good communication and good instincts will help you make an informed and empowered decision and empowered decisions are ESSENTIAL to a happy birth experience!