Why Won't They Just Induce Labor?

QUESTION

Dear Midwife,
I am 37 weeks. My doctor said I was totally effaced and dilated to 3. The plug came out a week ago. The baby's head is engaged. I have been experiencing diarrhea. I am 41 and this my 5th baby. I have never continued labor without Pitocin. Every time I go to hospital they send me home.

My contractions have gone on for months. Lately I have had contractions down to 3 minutes but they send me home. What should I do .They tell me don't come back until you are in severe pain. I can barely walk with this baby's head engaged and am in pain.

Why wont they just induce me. I am afraid I will get to the hospital too late since I am already through the 1st stage of labor. Am I getting bad care from the hospital?

Thanks,
Diane

ANSWER

Sorry, you asked the wrong person -- I think you are getting absolutely appropriate care. You can be dilated to 3 cm for literally weeks if this is your fifth baby without going into labor on your own. A responsible practitioner will not induce you so close to the prematurity cut-off, as some babies mature more slowly than others and they would not want your baby to have to go to the nursery (I have had babies as late as 39 weeks by good dates whose lungs weren't done).I know it is hard to be patient, especially at this time of the year, but waiting until the baby is ready can make a huge difference in the baby's life -- well worth the discomfort to have a truly healthy baby.

That said, have you considered a "day off?" I often suggest to women in your predicament to send the kids to wherever they will be for the labor (or wherever else works) for 24 hours and just spend a day relaxing and doing the fun things for themselves that they never seem to get to do. Drink bunches of water, eat good food, have a slow bath, do some gardening, watch a movie, whatever sounds really good. You might even have a little fun with the baby before it is born.

It is easy to focus on all the difficult aspects of the end of pregnancy, but don't miss the miracle. No man and only some women ever has the experience of having another viable human being inside of them -- a truly amazing experience that is over when it's over. Treasure this time, while you are dealing with the discomforts. It is very precious.

-- Cynthia, CNM

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Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.