Tag Archives: induction

Tired of Being Pregnant? “One Should Not Fool With Mother Nature, Say Best-Practice Physicians at Dartmouth-Hitchcock Medical Center

28 Mar

A normal pregnancy can last up to 42 weeks. However, the number of elective deliveries before term is increasing. Nine out ten mothers believe that scheduling birth before 39 weeks is perfectly safe despite the fact that multiple studies have shown that early non-medically indicated induced labors increase risks for the baby and a routine repeat cesarean increases risks for the mother.  To help educate expectant parents and health professionals about the risks of elective deliveries the Northern New England Quality Improvement Network (NNEPQIN) has produced Risk: Consequences of a Near Term Birth, a twenty minute poignant educational DVD which highlights the importance of carrying a baby to full term.

“There is some wisdom within the body that if the body decides its time  to go into labor after 34 weeks, we should listen to it,” cautions Michele R. Lauria, MD, MS, Professor of Obstetrics & Gynecology and Radiology and NNEPQIN’s Medical Director at Dartmouth Hitchcock Medical Center. “If the body hasn’t decided to go into labor, then maybe there’s a good reason why not.”

Intended to help pregnant women and their providers understand the potential outcomes of late preterm delivery, the movie is told through the stories of two mothers who experienced an unexpected late preterm birth. The medical perspective is provided  by Dr. Lauria and Dr. Bill Edwards, Professor of Pediatrics and clinician at Children’s Hospital at Dartmouth-Hitchcock.

A normal pregnancy lasts 37-42 weeks.  Most premature babies are born at 34-36 weeks.  These are termed late preterm births or near term births. Although most late preterm births are healthy some babies experience both short- and long-term complications. They may include hypoglycemia, fever, infection, respiratory distress syndrome (RDS), and transient tachypnea of the newborn (TTN). Babies may have difficulties with vision and hearing, feeding and digesting their food, regulating their body temperature and are more likely to need phototherapy to treat jaundice. Babies born too soon are more likely suffer long-term consequences such as neurological problems and learning difficulties at school age.

Many expectant mothers are not aware that an elective induction doubles their risk for a cesarean section.

The Northern New England Quality Improvement Network feels strongly that consumers should be educated about the potential risks of late preterm elective delivery so that they can make an informed decision. Unlike clinicians who schedule their patients’ deliveries for convenience or readily acquiesce to their patients’ request to end their healthy pregnancy  Elective Induction of Labor Guidelines from the Northern New England Quality Improvement Network encourage physicians and hospitals to wait for labor to begin on its own.

In the movie, Dr. Edwards explains that the transition between being in utero and the outside world is a difficult one for newborns. “Most of the time nature gets it right. It’s hazardous if we try to figure out how to do a better job than nature.”

The message  is not new states NNEPQIN but the manner in which Eric Ewers, the movie’s writer and director delivers it touches the heart and opens the mind. This evidence-based educational  film can be used to inform both health professionals and expectant mothers about the risks, costs and burdensome consequences of elective deliveries.

The film can be viewed online on the NNEPQIN website and copies of the DVD can be obtained at the nominal cost of $10.

Additional resources for elective deliveries

See blog post from January 14, 2011,  Induction of Labor: Exposed and November 20, 2010, Elective Inductions, Cesareans and Preterm Birth.

Childbirth Connection, What You Need to Know about Induction of Labor

Injoy Birth and Parenting, If You Have Been Induced

Lamaze International, Let Labor Begin On Its Own