The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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It’s common knowledge within the medical community that in response to their busy lives, many celebrities, sports stars, high-powered executives and their partners quietly schedule their babies’ births. Why? Often so that mother and father can ensure they will be together on the big day.
The trend to control when and where a woman gives birth extends beyond the rich and famous as more pregnant women across the country choose their dates for labor inductions and even Cesarean sections. Women make this decision for many reasons: fear of the unknown, school-vacation schedules of older children and work considerations being among them. But while scheduling birth might sound convenient for those who want to have their babies at a certain time or comforting for those who are terrified of labor, scheduling an induction or a first-time C-section isn’t without risk—or debate. If a scheduled birth is an option you are considering, you should understand the hazards involved in order to determine whether the procedure can provide the peace of mind you’re seeking.
Inducing labor> Inducing labor with drugs is one way to help ensure that childbirth occurs in a specific 24- to 48-hour period. In 2000, nearly 20 percent of babies were delivered after labor was induced—up significantly from 8 percent in 1989, according to the American College of Obstetricians and Gynecologists (ACOG). Does this increase indicate that inductions are always safe? No.
“ACOG is four-square against inducing labor just because you want the baby to be a Sagittarius,” says Michael F. Greene, M.D., director of maternal-fetal medicine at Massachusetts General Hospital in Boston. “It should be for medical reasons.” Inductions should only be done when the risk of continuing the pregnancy exceeds the risk of induction of labor, according to ACOG; such risks include high blood pressure or a pregnancy two weeks past due. Still, doctors do induce women who don’t fit into these categories.
Anne Boris of Chicago accepted her doctor’s offer to induce her because she was bloated and uncomfortable and feared that her water would break while she was at work. “I was opposed to the chaos of labor in public,” she says. “[The induction] gave me a sense of control and security.”
While Boris experienced no major complications, women who are induced should be aware that they are increasing their chances of a C-section by 50 percent, according to Greene. “If a woman and her physician decide to induce, they need to accept that there might be a more difficult labor that may result in a C-section,” he says. “And if a woman is planning a vaginal birth after Cesarean, there is an increased risk of uterine rupture after induction.”
Inductions aren’t always successful. True, doctors can see if a woman’s cervix is “inducible,” or softened and positioned correctly, but that doesn’t guarantee a smooth labor. Hormones such as oxytocin are released when a woman goes into labor naturally. But just because a doctor can administer Pitocin, the synthetic version of oxytocin, does not mean that labor will necessarily begin or progress easily. In fact, if Pitocin is given too aggressively, labor can be more unpleasant, with contractions that are too forceful and frequent.
Robert Katz, M.D., of Cedars-Sinai Medical Center in Los Angeles, has performed many inductions. He says that one patient, whose husband is a well-known basketball player, was induced to make sure the spouse could be there for the delivery. All went smoothly. “I have no problem inducing under safe circumstances,” Katz says, “when the cervix is ready and it’s past 39 weeks.”