Monday, August 8, 2011

Fully Functional and Anatomically Correct

Kudos to you if you get the title reference.

Blame it on the newborn I'm nursing while I type, how recently I gave birth to her, the fact that I do a lot of work with pregnant women, my habit of reading pregnancy blogs, or simple the reality that, for one reason or another, I always seem to have babies, pregnancy, and birth on the brain, be they mine or the concept in general, but today's entry will be birth related. Since that's a little off the normal stream of thought here, I'm giving anyone reading this some advance warning. If discussion of babies arriving into the outside world or womens' reproductive rights aren't up your alley, come back tomorrow. I'm planning to make deodorant and pick some more figs tonight, so I'm sure I'll have a post regarding one of those things up then.

I had a bit of an epiphany this morning regarding inductions. I won't go into too much detail regarding the process of inductions, but here is some background information if you don't know much about them. Induction of labor is a very common procedure in the US. It also has a pretty high rate of failure, and, even when successful, can be very painful. There are many reasons they are performed, some based in evidence, some with research finding they don't improve outcomes, or even worsen them. The process can vary, but the most common method in US hospitals involves a drug to soften the cervix, another administered through an IV with a gradually increasing dosage to stimulate contractions, then artificial rupture of membranes to drop the baby into the pelvis. This process can take days. If you want to know more about indications for induction, the risks, or the physical process, do a little research. There's a ton of info out there.

My epiphany was regarding failed inductions and the mindset that goes with them. I've had one. They are not fun. Worse is the feeling after. Most often they are followed by a surgical delivery for what is termed "failure to progress". I've long disliked this term. No one likes to be told they've failed, and there is a whole slew of thoughts that follow that, like "Am I broken?" and "Is there something wrong with me?". Not exactly confidence boosters. This is no normal failure though. This is being told that someone had to rescue your baby from your body because it wasn't coming out otherwise. While this can leave some women feeling grateful for that rescuer, it can also leave their confidence in their body's ability to function on its own pretty shaken.

I'd like to pretend like I'm immune to this, like I never thought of it as failure and I unleashed my inner mama bear after my failed induction and told people where they could shove it. I didn't. In fact, I simply directed my loss of confidence in another direction. I got deeply frustrated with the idea of failed inductions being termed as failure to progress because, if the the mother wasn't a good candidate for induction, I had it in my mind that the induction made her fail. While that was going in the right direction, it was still going with the idea that the mother had failed.

An off hand comment from a midwife on another blog made me reassess this when she reminded a woman who mentioned her failure to progress diagnosis that, if her baby wasn't ready, her body had done exactly what it was designed to do by trying to keep her baby in the womb to gestate a little longer. This simple statement has completely overturned how I think of failed inductions. The induction may not have worked, but that doesn't mean the mother's body has failed. Our bodies aren't designed to have an eject button for whenever someone else decides it's time. They are designed to keep our children safe so they can develop until they are ready for birth. When an induction fails with a mother and baby that aren't ready for birth, the mother's body isn't failing, but functioning as it has evolved to protect baby from a premature arrival.

May I always remember this when discussing inductions from now on.

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