'Tis the Season... Not to Be Induced: Avoiding the Holiday Induction

It's that time of year again! The time when we offer up important information on induction -- why and when it's medically necessary and how "the holidays" is not a complication of pregnancy requiring induction.

Around the holidays, many pregnant people experience pressure from family or healthcare providers to schedule their baby's birthday around festivities and travel plans. Be aware, however, that scheduling birth without a compelling medical reason can put your baby at risk. Few doctors want to be pacing the halls on Christmas or New Year's, so it's not uncommon to see a surge of people with healthy pregnancies being told that there might be an issue and that they should consider scheduling an induction, coincidentally, right before a holiday.

It's not just your healthcare professional who may try to rush your baby's arrival. Families often can feel stressed about the uncertainty of the baby's arrival and feel it may compromise the celebration of holidays. Some also fear that their preferred healthcare provider won't be available and will agree to a scheduled early birth to guarantee their availability. The pressure is understandable -- you build a relationship with your care provider over the course of a pregnancy on top of building up expectations about your holiday celebration.

"So it seems like no big deal just to get the birth over with," said Sue Galyen, RN, MSN, HCHI, LCCE, FACCE, a Lamaze childbirth educator from Brownsburg, IN. "But it's so hard to think that a scheduled delivery, whether through induction or cesarean, was worth it when either the mother or baby experiences a complication as a result." One complication of scheduling your baby's birthday is that often, baby is delivered just a little too early. A considerable body of research confirms that giving a baby those last few weeks or days inside the uterus can be crucial to the baby's health. Babies born even a little early face risks including breastfeeding difficulties, learning and behavioral problems, breathing problems, increased chance of time in the neonatal intensive care unit (NICU), and risk of death.You can play a key part in driving down avoidable prematurity.

Red flags that might signal being pressured into an unnecessarily early birth include:

• The care provider suggests that the baby is too big and will be easier to deliver a little early
• The suggestion is made that the care provider won't be available for a holiday delivery or will be booked up
• The timing of the delivery is centered on travel and celebration schedules
• Holiday stress is driving feelings of wanting to get the pregnancy over with

Here are some things you can do if you feel you are being pressured to schedule your birth:

• Ask your provider if you need to make a decision right now. If not, ask why not? Few decisions need to be made on the spot unless mother or baby are clearly doing poorly.
• Research your options. Use credible sources of information, like Lamaze, Childbirth Connection, March of Dimes, and ACOG (see more info on these resources below) and your childbirth educator and doula to see what the research says and learn from other parents' experiences.
• Make a pro/con list. Label your pros and cons with medical vs. personal and weigh the medical pros and cons more heavily. If you are talking about a major medical intervention like cesarean or induction and you don't have a good list of cons, it's a good sign that you need to do more research.
• Trust your gut. Your instincts are geared to protect you and your baby from risk. Listen to what your gut is saying in the context of the research.
• Find support. It's hard to disagree with your health care provider, so be sure that you go into your appointments with someone who can help you have an informed, evidence-based conversation about your best options.

Resources for Information on Labor Induction

Childbirth Connection - Childbirth Connection is a not-for-profit resource center dedicated to helping women and health care professionals make informed maternity care decisions. Among the many topics on their site, they have an in-depth section called "Induction of Labor." Questions addressed include medically necessary reasons for induction, tips for avoiding induction, and the safest point in pregnancy for babies to be born.

March of Dimes - March of Dimes is a not-for-profit group that helps moms have full-term pregnancies and researches the problems that threaten the health of babies. March of Dimes has a resource on their site that explains why at least 39 weeks is best for your baby, including detailed information on the important development that babies undergo in the final weeks and days before they are born.

ACOG - The American Congress of Obstetricians and Gynecologists is the organization responsible for developing guidelines by which most OB/Gyn offices are expected to follow. Their site offers a basic FAQ section on labor induction that, most notably, states, "Unless a problem occurs, labor induction is not done before 39 weeks of pregnancy."

Lamaze - If you're looking for more information on induction, check out the Lamaze resource page that's all about induction, including more links to resources, an infographic, and video.