Natural birth but doctor forcing an Induction at 38wks, why?

I am 31 wks pregnant now and my gynae has said that he only does natural birth with induction. Apparently this is the latest 'method' now in South Africa. They first try and persuade you to have a c-section even though it's not needed and if that fails then they agree to natural birth with induction. Living in South Africa our government hospital services are not very good and for those fortunate enough to afford a private health care can make use of private clinics and doctors. The clinic I will be admitted to is in my area and is convenient as it's close by and is a good clinic. To find another will mean a travel of at least 30 minutes and that is if there is no traffic congestion.

I have contacted 3 other doctors at this clinic and all said they only perform natural birth with induction. I found another doctor that will do natural, but he is at another clinic. I did not feel comfortable with him and I am not happy with the clinic he works at. I am also afraid to change doctors now at this late time in my pregnancy.

However, I feel that I am being forced into something that I don't want. I want a natural birth with no pain medication but my doctor is forcing to induce me with an epidural. This is my second child. My first was born naturally although 4 weeks early and with epidural. I feel that as a result of epidural I have suffered back ache that went on for over 6 years. This time I want a natural birth with no medication, unless it’s absolutely necessary due to unforeseen problems.

The doctor will use an induction medication called Propess slow release pessary. I have read up on this and it can lead to all sorts of complications and most of the time results in them having to perform a c-section as it was not a successful induction. I have also heard that it can make contractions much more severe than normal and you can be in labor for much longer as your body was not ready and it is now being forced. I thought inductions were only preformed as a must especially when you are over your due date. I am very worried and upset that I am being forced into something I don’t want. He has even set the date, which I’m not happy with. Apparently the reason they do these inductions is to prevent you going into labor in the middle of the night when they do not have their whole team available. I personally think this is not true as it is a 24 hour emergency hospital and there are medical teams there at all times. I think it comes down to a matter of convenience for them and it enables them to control their days accordingly. So he wants me to go in the Thursday night when they will begin induction and baby will be born Friday. He says he does all his patients on a Thursday to Friday. If it is a matter of ‘having his team present’ then why do I have to go in on the Thursday and why can’t I choose the day I like, for example Monday.

In the South African private sector clinics the c-section rate is 70 – 80%. The acceptable rate should be 19 – 20%. It is used so much in private sectors as it is convenient for doctors and mothers to know the date and it also means the doctors earn much more than they would for a normal delivery, the cost is doubled. Thus it is the preferred method. I don’t agree with this. I feel it should only be done in emergencies or if your baby is breeched. It is after all major abdominal surgery and the recovery period is much longer than a normal delivery would be.

If anyone has advice or is familiar with inductions using Propess, please let me know, it will be highly appreciated!

Tags: c-section, epidural, induction, propess

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       In the United States many hospitals have put in place policies that prevent doctors from inducing labor prior to 39 weeks. Increasing concern about the baby's health is driving this policy. Babies are healthier and establish breastfeeding better when they are at least 39 weeks gestation. What will happen if you don't keep the appointment on the Thursday? If you continued your prenatal care, kept a copy of your prenatal records and simply went to the hospital when you are in actually in labor, what would happen?

Thank you for your reply Carol. I am extremely interested in knowing that in the US they have introduced policies to stop this and I intend on fighting my doctor using this information and more that I have gathered. That was my plan initially, to just not show up on the Thursday and continue day to day until I go in to labor and then go to the hospital, they will have to call him as he is my attending doctor and surely he cant refuse to treat me. This still seems to be my best solution. I am due for my last check up with him on 13th Feb to see if all is in order to proceed. If he says baby is lying ready and all is well then I will just wait until I go in to labor, without telling him that I will not book in on the Thursday. I'm not sure what will happen but surely they get women that go into labor often way before the set date and they have to deliver the baby. The worst that can happen I suppose is that he says he is not available and I end up having one of the other doctors deliver the baby, there are only 3 others and I have heard bad reports on one of them.  No matter what the outcome, I do intend on taking this further and creating better awareness about this in South Africa. I plan to contact a journalist/ consumer program that will hopefully agree to investigate and air the story. Hopefully all turns out well. Will keep you posted! 

Mirian, I have the url for an article about changing U.S.policy: www.marchofdimes.com/aboutus/49267_61147.asp

In the States the nurses have to hold the doctors accountable. We are the ones that know when a doctor is trying to get around this policy and have been told to refuse.

I have written a number of blogs about healthy birth practices at: www.carolvanderwoude.authorweblog.com

Happy New Year Carol and thank you, these links have very useful information and I have read a lot on your website. I am so glad that I now have more information to face my doctor and tell him why induction is definitely not what I want. I will stall the date and hopefully go into labor soon after without any intervention! Praying for a totally natural and complication free birth! Will update you closer to the time.

One thing I learned when pregnant with my first child was that no matter what they say, they cannot force you to be induced.  Are they saying that they are refusing you care if you do not agree to the induction?  "Natural Birth" does not involve any induction at all.  So many times, people today confuse "vaginal birth" with "natural birth."  A vaginal birth that involves medication, epidural or other medical interventions is not a "natural birth."  

I am so sorry that you're having to deal with this stress.  I completely understand it because I went through something similar with my first child (hospital birth at almost 42 weeks...I had to avoid induction for almost 3 weeks, which entailed going in for regular "Non-Stress Tests" to check the status of the baby).  For my second birth, I had a home birth.  Are there any midwives or doulas in your area that you could contact?

Please also check out my blog for tips on visualizing birth http://visualizingbirth.org/

Best wishes,

Anna

Hi Anna

My doctor basically said: "If you think you are just going to walk in and say I'm in labor then I'm not your guy, I will only agree to vaginal birth with an induction at 38 weeks."

All 3 others that I contacted said the same thing! It makes me very upset and I will not agree to it. I will walk into the hospital when I am in labor. They cannot refuse me treatment. If my doctor refuses to attend to me then they will have to call another and I will not leave it at that. If he refuses or tries to force unnecessary procedures, I will take this to the medical board.

I have been considering home birth and have looked for midwives and doula's but but there are none in my area. They are willing to travel here but the other problem I have is that my medical insurance does not cover home births etc.

Am seeing my doctor again tomorrow, I intend to show him information I have gathered re induction cons etc which I honestly don't think will change anything but if all is well with baby, I will just pretend to go along with his terms and when 17th Feb comes I just wont arrive at hospital. Am so hoping my baby will come just a few days after or before on her own!

Thank you for your support. I will keep you posted on my progress. 

After seeing the doctor early this week and confronting him with all the information I gathered, I decided to look for other options. He was very arrogant in his response and basically told me its that date or I must go elsewhere and he got pretty upset in fact with all my questions. I found a birthing center run by midwives. It's a 30 minute drive away from home but it's worth it! Have been to see it and have pre-booked. The midwives there are fantastic and so helpful. They offer water births too which I am now strongly considering. I am so happy I found an alternative that will enable me to give birth naturally the way I want to! I have sent the story to a local investigative program and hopefully they will investigate and expose this topic. Thank you all so much for your advice and support! Just under 6 weeks to go and so very excited! Will post about the birthing experience.

So sorry for your situation! So happy you found an alternative!! I am very shocked at those doctors!! I look forward to hearing the rest of your birth story!

 So glad that you presented your doctor with information and realized his attitude was unchanging. I'm glad you have found the birth center. Stay rested and keep us posted.

There has been new data on avoiding elective birth before 39 weeks... here is one article that explains more.

So glad you found a birthing center!  

Water broke at 11h00 on 17th Feb. I was 2 days till 39wks. Wasn't sure if it was my water that broke or not so carried on with my day. 15 mins later started having contractions that got more intense and felt gushes of water. Called midwife and she told me to get to the clinic. My husband was not close by and I had no one to drive me so I drove myself! Luckily traffic wasn't too bad, contractions were getting painful and driving was challenging! Arrived at clinic around 12h30 and was rushed to delivery room. Was 6cm dilated already. Everything happened so fast, my husband just got there in time. Our beautiful baby girl was born at 13h58 weighing 3.1kg. It was the most memorable and incredible experience. My midwife was amazing. So happy I made the decision to have a natural birth!

Congratulations! It is so good to hear about the birth of your daughter. 

Blessings to you and your family,

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