(#8) Patience is Key: On Spontaneous Labor & Avoiding Unnecessary Induction

Did you think I forgot to finish the “11 Ways to Prepare for Your Best Birth” series? I promise I didn't! I just went on vacation and decided to take a pause and post some birth stories written by my students so I could truly vacation. Now I'm back from Lake George and feeling refreshed. So, let's finish these last few points on the list over the next few weeks!

#8 Allow labor to begin on its own & avoid interventions that are not medically necessary

I admit, the first part of this one is hard. It's so incredibly common to have a sense of wanting the pregnancy to be over and meet your baby already—largely because baby is getting uncomfortably cozy in there as he grows and is kicking you in the ribs, making it hard to get enough rest and the like. It's quite common for one of these things to happen around or soon after passing the (estimated) due date:

  • A pregnant woman requests induction
  • A care provider simply says, "it's time" (insinuating there's a need to synthetically initiate labor, even in the absence of an evidence-based reason to induce).
  • Or, a care provider uses the words "getting big" in referring to the baby's size—which undoubtedly instills a good deal of fear in any woman who ever hears this!

Not good reasons to induce, my friend.

I encourage you to resist the temptation to request or agree to an induction (solely based on dates or size) as you approach or pass your due date.

Here's why. Did you know that baby initiates labor when she is done "cooking", so to speak? There is a protein that is sent out from baby's lungs when they are finished developing and ready to breathe the ex-uterine air (throughout the pregnancy, baby gets her oxygen through the umbilical cord). This triggers an inflammatory response in the pregnant parent that triggers labor. Additionally, March of Dimes says babies aren't fully developed until at least 39 weeks, and also points out that important in-utero brain development happens between 35-40 weeks. Therefore, in the absence of any unusual medical indication to start labor, it seems logical and optimal to wait for baby to trigger labor rather than getting unnecessarily involved in ways that could put baby at risk.

Keep in mind a couple of other things:

  • The estimated due date is just that—an estimate. There is a 5-week window (37 weeks-42+ weeks) that falls within the (large) range of normal for baby being ready to be born. Dating is often inaccurate, unless you know exactly when you conceived.
  • Even if you have the accurate date of conception, also remember that both baby and mom are organic, unique beings who weren't created according to nor behave in line strictly with textbook-rigid timing. Therefore, everyone's optimal timing is different.
  • We live in a litigious environment, so care providers will often intervene (induction + many other interventions) because that is their best defense in the event of lawsuit from a bad outcome. There's also just an unfortunate general sense of impatience in a clinical/hospital setting. It is therefore up to us to move through the perinatal period as informed consumers so as to know the difference between this scenario and legitimately wise uses of interventions.

So, the bottom line in a healthy pregnancy is: it's best to wait for baby to initiate labor.

A bit more on the "avoid interventions that are not medically necessary". Your best strategic tools along these lines are:

  • Labor at home as long as possible
  • Buying yourself time as many times as needed if/when interventions are suggested (assuming the suggestions are not emergencies; and never assume an urgent tone in your care provider's voice equals emergency as it rarely does. Probe, ask questions!). In case you could use some clarity on what your rights are in childbirth, check out the Rights of Childbearing Women from Childbirth Connection.
  • Take birth classes in order to learn about the good vs. questionable reasons for the many interventions as well as the current state of your local birth environment and facilities. This way, you'll know the questions to ask and how to make informed decisions

A little bit of patience goes a long way. You can then use that time, while waiting for baby, to study up or simply rest and enjoy the quiet in your last few pre-newborn weeks and days.

Further Reading