Do I need an induction
Induction. It’s like one of those claw machines, hanging ominously over all the pregnant women deciding which one will be next.
I know, that’s a particularly cynical personification. It’s because I am cynical.
My first introduction to the process of induction of birth was from stories of my mother. She was induced with my sister. The medication (I think it was a pessary) did not work as quickly as they would have liked. So they gave her another one. All of a sudden, it was working too well, and the contractions were coming on frequently and painfully. Some ‘orphine’ was administered to make it all more manageable.
Three physiological, uninduced, unmedicated births later, my mother’s words of advice were do not have the induction.
I have a lot to say on this, so here’s the plan. I’m going to share my own story and the details of just how powerful the threat of induction is. Then, I’m going to speak more widely to the how do I know if I need one question that most pregnant women are faced with.
My story
As you now know, I had my mothers strong words of advice with me while I was pregnant. Following that, I had done my hypnobirthing course that gave me confidence that birth could happen naturally, and for physiological birth to unfold, as little interference as possible was optimal.
I also had what felt like a natural instinct to want to birth my baby out my vagina, without medication, and in connection to my body.
I utilised my connection to god, myself, and my intuition to make decisions as I moved through the latter stages of my very normal and healthy pregnancy. When I was offered a membrane sweep at 37 weeks, I paused, I prayed, and I said no thank you. In no way did it feel necessary for me.
I waltzed into my 39-week appointment full of confidence; I had even told my partner to stay home, I didn’t need him. Another routine check up, just waiting for the baby to come. Oh, how mistaken I was. I can feel the bubbles of anger boiling in my chest as I write this.
Midwife: “We’ll just book you in for your induction, do you want it at 41+3 or 41+5?”
Me: “Uhhh [WTF!?], no, I don’t want an induction at any time, thank you”
Midwife: “We just need to book it in, just in case. You can be an outpatient so you can go home after.”
Me: “[help!] I really don’t want to book an induction, I want to choose at the time”
Midwife: “It’s protocol we book it in now, so there is space available for you”
Me: “41+5, outpatient”.
Talk about coercion. I didn’t even really know it was coercion at the time. I went home, literally dumbfounded, and sheepishly told my partner that I really had needed him there.
The energetics of having that induction booked and hanging over me like a claw in a claw machine was wild.
40-weeks came and went. Despite me banging on to anyone who would listen about how the due date meant nothing, it wasn’t true. The due date did mean something. It meant I was creeping day by day closer to my booked induction. It meant I was creeping day by day closer to the 42-week birth cliff that exists.
I wasn’t booking anything nice for myself because I was either afraid of getting Covid and the weird repercussions that would have on my birth, or I was hoping I would be in labour.
I had my final appointment with a midwife at 41 weeks, at which time I was told I was being discharged by the community team, and that any further conversation about my induction needed to happen with an elusive consultant (doctor) who I had to go and seek out myself in the maternal assessment unit. Which I could only do on a weekday. It was Wednesday, my induction was booked for Friday.
I could have gone into the unit on the Thursday or Friday and simply cancelled my induction, I really could.
But the fear had a hold of me. What if Monday came and I wanted the induction. I didn’t truly know how I was going to feel. This felt like the hugest weight of responsibility. I cannot even begin to imagine how I might have felt if I had had full support for my choice to await spontaneous labour; had I never had the induction booked in.
By the Saturday (t-2days to induction) I was SO overwhelmed. I woke up early. My brain was whirring and whirring. Should I go for a sweep? Should I try and relax and hope I go into labour? Should I have the induction? Should I just not go in? Am I going to be wasting everyone’s time? Who’s going to be angry at me?
When I say birth SHOWS us our wounds and our conditioning, this is what I mean. Really, who gives a f**k who is angry at me? It’s not their body, their birth, or their baby. I don’t OWE the NHS something for forcing me to book an appointment I said I didn’t want.
I decided to go into the labour ward for a membrane sweep. It was a decision made out of both fear, and needing to do something. Sometimes, that is simply the best we can do. The midwife was about to tell me that my body was already progressing towards birth, and that it wouldn’t be long now.
I bounced out of that appointment, finally free in the knowledge that my baby was on their way, and there was no way I would be accepting the induction. I gave birth that night.
This is one person’s (my) story. My induction was booked in straightforward terms: to end my pregnancy, and stop me getting to 42-weeks. There was no medical reason for the induction, it has simply become routine procedure to interfere with pregnancy.
Do you need an induction?
We are nuanced human beings. While I cannot give you a black and white answer, I can give you some information and suggestions that might help you in that in-between place.
The in-between place could the responsibility of the decision to induce or not based on the following:
Your baby is big
You baby is small
Your blood pressure is raised
You have gestational diabetes
Your BMI
You’re over 41-weeks pregnant
These days, inductions are handed out like sweets for any reason to be found. I’ll be upfront here, because we may have different opinions on this - my personal view is that the majority of inductions offered or given are not necessary and reinforce a lack of trust and need to control women’s bodies.
What has become very grey is being able to know whether you are in the necessary category, or the unnecessary category.
For context on why you might not unnecessarily want an unnecessary induction:
It can cause hyperstimulation of the uterus, leading in rare cases to uterine rupture, and less rare cases, distress of the baby
Inductions may not work and result in emergency or unplanned caesareans
Increased pain due to a lack of the natural pain relief of the hormones oxytocin and beta-endorphins. This tends to lead to an increase in opioids and epidurals, which can both have side effects for women and babies
You may be left waitings hours or even days for you induction to start if you are de-prioritised, leaving you feeling confused why you’re there in the first place
If you would like to read more on the prospect of overuse of inductions doing more harm than good, Dr. Sara Wickham is the expert on this topic.
So how do you know if you’re in that category of people who truly needs an induction, or the category where it’s an attempt to control or speed up your birth?
The informational & research approach
The things that you can ask for that may support or inform your decision:
What are the reasons induction is being suggested?
What is the evidence to support that recommendation?
What are the alternative options?
Is it the view of the professional that an induction is necessary or is it being offered as a standard procedure?
The felt sense & intuitive approach
No one else in the entire world can know if something is right for you and your baby, truly. You are the most connected person to your baby and your own wellbeing. Spending intentional time grounding, tuning into your body, and asking it the question about whether this is the right step for you, is a great place to start.
I’m not promising that if this is the first time you’ve ever intentionally connected with your body’s sense, that you will get a super clear answer.
Fear is powerful, it shows up in the body in a big energetic and felt way. It can be incredibly hard to feel anything beyond the fear. Taking steps to feel relaxed, and supported by the space your in, will help to dilute some of the fear. As will taking time to speak to a trusted person in your life about how you’re feeling and your dilemma.
You may find it useful to come back to a practice of connection, and inquiry several times, to start to attune to how your body may be responding to you.
If you would like to support with attuning to your felt sense, and inner wisdom, you can connect with me via message or @embodied.birth.and.motherhood
My suggestion for anyone in that grey area would be to use a combination of the above two approaches. Information can be supportive of what the rational mind needs, and may even be enough to make your decision. For many it isn’t, and in highly emotive decisions, rationale can only get us so far; the body holds the wisdom available to make these decisions.
If you do find yourself in this position, I wish you nothing but love, clarity, and a blessed birth.
As a somatic therapist, I work with spiritual women who are traversing conception, pregnancy, and motherhood. Through an intention based no-touch somatic modality, I enable clients to listen to their body, to move beyond conditioned thinking, resolve trauma, and connect to their inner wisdom.
