We rarely need to help the body start & stay in labor. That’s the first problem. The second problem is that most medical professionals are not typically patient and do not typically trust the body. They believe the body needs their help to do what it was made to do. As a ten year doula & childbirth educator, the majority of inductions being suggested by doctors are based on NON MEDICAL reasons that are portrayed as being substantial medical reasons. Women, please do your research. The ARRIVE study had many issues which are easily learned about online. Inductions can be very long and painful. Many fail. Not all babies born via induction do well, because they simply weren’t ready to be born. Being induced requires constant monitoring and management of your labor. Explore the cascade of interventions. You may not feel those stronger, longer pitocin contractions, but your baby will.
My Dr recommended I be induced at 39 weeks. I am 35 weeks and will not because my baby is not showing any health risks and I have never had any complications with my 3 previous children. I trust my body to do what it’s supposed to
I just skirted by a 41 week 6 day induction. Went into labor a couple days before and got my intervention free hospital birth I was hoping for. Hes 9 days old now 🥰
Contrary to the Arrive Trial, I don't believe induction at 39 weeks decreases csection risk at all. Inductions definitely INCREASE csection risk. I am firmly convinced that when doctors know they're being observed (as was the case in the Arrive Trial), they will manage inductions differently. In my case, I had an induction at 40 weeks that was managed horribly. They broke my water way too soon and gave me an epidural way too soon as well, despite the fact that I clearly stated that I didn't feel I needed it yet. They also cranked up the pitocin. Needless to say, baby went into distress and I ended up "needing" an emergency csection. If those very same doctors had been being observed, especially for csection outcome, I bet my left kidney they would manage my induction MUCH better and make different decisions. They'd likely be way more patient with me and my body. So yeah, unfortunately, despite being a randomized controlled trial, I don't believe the Arrive Trial is reliable at all. The medical system is about resource management first and foremost, and women's personal experiences going through this system are an afterthought. The Arrive Trial is what happens when inductions are managed meticulously in a perfectly world, but unfortunately that's not the world we live in.
This is SO HELPFUL. I am 40+1 and may have to decide if we want an induction in a few days. I was so anxious about the possibility of induction but now, I feel so calm and informed. Thank you, thank you!
Thank you for this video, I was scared to confirm my induction at 40 weeks 1 day because I'd heard that c-sections were more common with induction. This eased my mind so much. Knowing this is safer than the alternative (possibly having a 10 lb baby if I wait for things to happen naturally) makes me feel so much better about going in.
The ARRIVE study sounds great. I would like to know more stats about it. For example, the age group of the women as well as nationality/race. From my understanding these stats do make a difference and childbearing has a lot to do with genetics as well.
Thank you for this info! I’ve discussed induction with my doctor and weighing my options, I love to hear good data backing up medical suggestions. Made me feel way more optimistic about my scheduled induction!
Thank you SO VERY MUCH for this video. Planned induction as a medical procedure applicable to our pregnancy was rather abruptly introduced at a visit during the early third trimester. None of the videos we watched prior to then even seriously touched on it at all. There were only occasional verbal warnings, mired in melancholy subtext to allow the body to go into labor “naturally”. This is one of a paltry few videos that apply to our medical reality. Thank you SO VERY MUCH for addressing our flex-and-flow pregnancy 🤰.
I feel compelled to add that even though an 18% primary c-section rate is great in comparison with the national average.... BUT, I come from an institution where our primary c-section rate grew from 6% to 12% from 1994 to 2019. Believe it or not, 12% seems high to us. By utilizing the midwifery model of care & practicing evidence based medicine, it is possible to obtain even more positive outcomes. I would love to see you discuss collaborative practice & the midwifery model of care! You are amazing & I appreciate your work so much. Excited to hear your own birth story!!! ♥️
Thank you so much for this video and mentioning the study! I go in tomorrow for my induction and this has made me feel much more calm and educated about what to expect.
I honestly wish I would have been induced at 40 weeks vs. 41, I didn't have any further cervical change. I was so worn out just from the act of being pregnant another week that the process was thoroughly exhausting. I had a foley bulb placed the evening before, it came out in the morning went back the next AM to start pitocin. Pitocin all day no cervical change. Stopped the IV. A couple hours later the night doc and midwife came in and said they wanted to try prostaglandins every 4 hours through the night. I had terrible cramping after each dose, but I started having regular contractions about 3 hours after my second dose. Elected not to go back on pitocin, had them break my water. My daughter was born about 7 hours after they broke my water. Long story longer I think my body was going to need some help regardless! And the extra week of waiting was exhausting
I’m 39 weeks right now and had my appointment with my OB yesterday. She recommended an induction of labor since I am not showing any signs of labor but of course told me it’s my choice if I want to wait for it to be natural or plan a date. I definitely want to wait and try to go into labor naturally but also taking her recommendation into consideration I do want to plan for an induction of labor if baby isn’t here soon after his due date. My OB said she would recommend not to go past 41 weeks. This video was so informative and helpful. Thank you so much!
THANK YOU for providing this insightful information and being a constant amazing resource! I didn’t know inductions were controversial until I planned one just this week. Perfect timing on this video for me! Appreciate you providing evidence and experience to help me feel more confident in my decision.
I’ve read that, for women over 35, there’s a risk that the placental health could deteriorate after 39 weeks, which could be an advantage of an elective induction. I’m 37 and currently 28 weeks pregnant, and I’m very seriously considering elective induction between 39 and 40 weeks.
There are some increasing risks of stillbirth in older pregnant women compared to younger, most notably after age 40. Your age may be a factor in deciding what's best for you for sure!
Thank you so much for HOW you explain all of this! Context and tone matter so much, and there's such a skill in presenting the information this way that removes guilt from everyone making decisions! I am so grateful I found this video! 🙌
Scheduled deliveries is not only a convenience for the parents, it’s a convenience for the doctors. Doctors induce in the morning while they are seeing patients in the office, deliver babies in the evening and are home by bedtime. It would be interesting to know how many inductions are performed on Fridays as compared to the other weekdays.
What about the higher risk of hemorrhage with induction (at least inductions that use Pitocin)? I knew about this beforehand, from researching it on my own, but my OB assured me it's totally fine, I did it, & hemorrhaged badly (& almost needed a C-section because of the induction, AND had a severe uterine infection, which passed to my baby, because of them breaking my water at the beginning of the induction, etc.). And the overall experience of the induction was an absolute nightmare. So, I don't know, I don't think anyone could convince me that an elective induction is better.
This video explained all of the questions I have about inductions❤I was recommended induction at 39 weeks yesterday at my OB appt because she is measuring 3-4 weeks behind and low birth weight. I wanted to wait and see what happens but now I am definitely leaning towards the induction to reduce risk of still birth and keep baby safe. Thank you!
Wow…thank you for this very informative. I had a induce labor on Nov. 12,2021. A day from now…. My body is ready amd totally excited for the big day since Iam 42 in few months and I am 39 weeks and 3 days.
Something I see in pregnancy forums a lot that drives me crazy is "I had to induce my first and it was so much worse than starting labor naturally in my second". Or similarly, comparing recoveries with first epidural birth with a med-free second birth and concluding it must have been the epidural and not just first deliveries being harder. They are going to be different experiences regardless! I had an epidural for all 3, but induced the last two and there was almost no difference between any of the three experiences except getting faster and faster and recovery getting easier and easier, which you would expect. Nothing to do with being induced or not. ARRIVE is important because you can statistically compare the differences instead of the anecdotal stories of people comparing their own experiences that are not comparable because they first labors vs subsequent labors.
Have an induction scheduled for tonight and your information was very helpful ease my mind a bit as I was questioning my decision, from everything I read online even though I am passed the due date.
Super helpful and informative! I was just going to comment somewhere that I would love a video on induction and then there was one!! My husband enjoyed watching it with me and we plan to watch the other videos together!
Is it true if the body doesn't respond well to being induced, baby can have fetal stress & heart rate can drop leading to a c-section ? Will my breastmilk be delayed coming in after delivery? How does doctor go aboit breaking the water?
I am currently at 41 weeks and was induced this morning. I would say I will NOT be doing this again for my next child. I wish I had not been pushed to be induced. Technically I’m not over due until 42 weeks. Why go through this supper long and painful induction process that is as far from natural as possible? I wish I had let my body do its thing instead of forcing open the cervix to force my baby out. I did not have any problems besides the date.
Thank you so much for this. I have always been very skeptical of inducing labor and had not heard a detailed explanation of the most current research as to why it’s OK. I was just told by my OBGYN NP, “actually it doesn’t increase c-sections” and that was it. I still don’t think I necessarily want an induction because of the the increase in pain/intensity of labor. But it’s something to think about and fortunately I have a long way to go until my due date.
This was very informative. I’m at 38 weeks and when my OB told me that we will discuss induction, I got scared because I needed my details that what she provided.
So some of the stories I heard about induction, whether elective or medically necessary, what happens is that the hospital or the birthing practice wants you to deliver within a certain time so at some point they will up your pitocin at a rapid rate if you are not progressing as fast as they would like which might cause the baby to be in distress, and that resulted in an emergency c-section... I feel like that would be why so many people feel like induction will have a higher c-section rate because we don't live in a world where every practice is perfectly ethical. I am still hesitant about my own birthing plan and I will have that conversation with my ob. And what do you think about the documentary the Business of Being Born?
Thank you for this information! Such a helpful breakdown of the ARRIVE study. It seems like the study focused on first-time birthing people--is there any discussion of how this data translates over to second, third, etc.-time?
Thanks for all the information! Question about the ARRIVE study: did the providers know their patients were in a study looking at c-section rates and elective induction at 39 weeks? I’m curious if that could impact decisions and this c-section rate.
Can you discuss or share some articles/studies on assisted second stage, both vacuum or forceps. There is very little information out there about this, especially fetal outcomes. I know it is rare to need this but some maternal indicators mean this is the route that is taken. All of the information about inductions is super helpful for me in trying to make a decision for my birth! Thank you for everything you do.
Im on my 36 weeks now my first baby by ivf my doctor recommend induction labor on march 1 my due is march 3 so its fine now i watch this video gives me clarity about induction procedure thanks
Thank you so much for this information! I wish I found this when I was around 34 weeks! My OB told me at 36 weeks and I was a bit scared and held off. I would have been induced on 8/31/21. Luckily she got me in for 9/2/21 and this video eased my nerves! Thank you so much. Cannot wait to meet my little guy in less than a week! ❤️❤️❤️
How did it go? I’m 38 weeks today and I was told by my obgyn if I wanted to schedule my induction next week. I said I’d wait it out till next week and let her know. I had an induction with my first and it wasn’t bad but it’s still intimidating
Thank you for the informative video! I am due 15 December, with gestational diabetes (well-controlled by diet), my doctor suggested having an induced labor on 14 December (39 weeks 6 days) by then to reduce any risks later. I’m planning on taking the epidural as well to make it a positive experience since it’s my first baby!
If an unmedicated birth is a strong personal preference for someone, is that a reason to consider avoiding a “risk-reducing” induction given what you said about length of labor etc? I know that in the ARRIVE trial pregnant people in the induction group reported lower levels of pain but were there also higher rates of epidurals? I couldn’t tell from my read on the study.
im not a doctor but I had a kid both ways so im speaking from experience. induction by combination oxytocin and the ballon feels like many bones breaking with no epidural. the doctors have to stop because contractions come on too fast. they suggested a c section because of our heart rates going because of the pain I refused. the pregnancy without feels less painful and more natural. but again everyone is different and if your going to get a epidural anyway then pain doesn't matter
Thank so much for the video! This is really such important information to share. When I was pregnant with my first I was super stressed about the possibility of having to be induced because I thought it would increase my c section rate (and I am a nurse). I wish I’d had more education then, but I’m sure this will help lots of pregnant people out now!
I’m 39 weeks tomorrow and my doctor hasn’t brought up induction at all. I don’t know what to do. My 1st was born on due date and my 2nd was 10 days early and I went into labor naturally with both, hopefully she makes her way on her own this week!
Thank you for this information! What are your thoughts on an induction at 39 weeks after a very fast previous labor (ie. 4cm-baby in less than 2 hours and baby born within 5-10 min of water breaking)? Is there a high risk of another quick delivery that would make an induction recommended?
I wonder if the results of the ARRIVE RCT are perfectly applicable outside of the experimental setting. Are the actual outcomes the same outside of the trial since the variables were very controlled? Participating providers had to follow a very specific study protocol. Since there is so much variation in induction methods depending on where a person is giving birth and with who, could it be that the findings of the trial won't translate? And I think it's also important to give some weight to a person's birth "experience" not as a frivolous whim, but based on the idea that often, people who have positive birth experiences where they are able to give birth without intervention might go on to have higher levels of confidence in their bodies and selves, better mental health, relationships, parenting, etc. Just from a broader and more holistic standpoint. Not to say that people who choose the the induction birth plan that is successful can't also have great "experiences" of course! I just talk to a lot of people who are torn. It can be hard to hear that our bodies may not work just right on their own and that we need medical help. Some people develop insecurities when this happens. I think having a positive birth experience can actually have lot of value to our whole health picture. Maybe that means feeling we have a higher sense of control using induction, or maybe not.
The ARRIVE trial was not "tightly controlled" and absolutely generalizable to a setting of national US sample. It was performed at 41 different hospitals, including management from hundreds of obstetric providers, many different L&D differences. So absolutely a STRENGTH of this study is its generalizability to the whole US population. This study is not about individual patient preferences, but it is about data upon which individuals can decide their preferences, which they should absolutely do with the help of quality. medical data like the ARRIVE trial. I caution you to avoid language implying that medical intervention in pregnancy is "bodies not working well on their own" because of course that statement is true, if our bodies worked well on their own there would be immortality and we would not see the drastic improvements in surviving birth and infancy that our interventions have allowed for those who need them, and also available for those who choose them.
@@dr.martaperez @Dr. Marta Perez With all due respect I think you are doing a great thing by educating. There is a lot in this video that people never get to hear, even when they are faced with the decision to have an induction. By controlled I mean that the inductions were done a certain way at all sites by all clinicians, yes? That's what I understood from my reading. The actual induction procedures themselves were well-controlled. They'd have to be or this wouldn't have been the good study that it was. In reality, there is much variation in induction procedures, meaning that not all care providers do inductions the same way. I understand that the populations and locations were diverse and large, but the participating clinicians were asked to provide care in the same way. It's for that reason that I question the generalizability. I love data and I love to really dig in! I'm not against induction, I just worry that a holistic picture of health including mental health and a person's future is not always entered into the decision making process and that the study results are doing a bit to possibly skew a little inaccurately towards non medically necessary inductions which often makes people feel they are being irresponsible if they don't choose it. Medical intervention doesn't always mean that a body is not working well on its own, but should it? Often intervention happens before a body has had a chance to try. I'm grateful that we have medical intervention for when that is the case. Of course bodies sometimes and eventually all fail, that's part of the life of the mortal, but it can still be a hard thing to process when we get faced with that reality.
@@AW-pf8jw No, inductions were not done a certain way, there was nothing in the protocol specifying anything about the induction, the obstetric provider used their judgment and evidenced based care. There were *not* protocols on labor induction meds/timing/etc and "provide care in the same way" is only that they were asked to provide evidenced based care, which all providers in the country should be doing the way the hundreds in this study (hopefully) did. Not sure where you got your reading from, but if you'd like to read the full study it's open access. www.nejm.org/doi/full/10.1056/NEJMoa1800566 Study results are meant to give people information about making their decision, they do not comment on what each individual values, and each participant volunteers to be part of a trial and those who come after choose how the information gains fits in their priorities. The people I see making the baseless argument that scientific data and understanding is bad for patients are usually just upset that the results of the science challenge their own narrative of what they *want* to believe about medicine/science, especially in obstetrics.
Hi Dr. Perez, Thanks for the informative video! Expecting Mono-Di twin girls and am 32 weeks :) How did you come up with the 36% decrease in c -sections of induction vs 'see what happens group'? I cant wrap my head around the math and confused if your arrow is backwards? Thanks :)
Is it possible there could be some sort of physician bias that contributes to the reduction of csections in the induction group? In a course provided by a local hospital, the nurses discussed the cascade of intervention.
No, this is a very unlikely because it is a very high quality study with many participants which is able to account for small biases like individual provider preferences. This study took place at 41 hospitals! The "cascade of interventions" is an unfounded myth that is talked about by people who have personal preferences towards a "natural" labor being better than one that uses medicines. As we can see by this study, intervening in labor by inducing at 39 weeks actually decreases the C-section rate.
If you choose an elective induction, is there a risk your body doesn't respond, you don't progress, and require a c section? That could lead to feelings of regret. If your elective induction ends in c section due to no progress, is it likely that you would have had a c section anyways if you waited to go into labor naturally? I hope that makes sense!
That's exactly what the ARRIVE trial wanted to find out! As you saw in the video, there is a LOWER C-section rate from choosing a 39 week induction than from just waiting to see what happens. I suppose it could suggest that if a C-section is needed for someone with a 39 week induction, the chances of it would go up even higher if that same person waited, but obviously we can't know for sure since we can't study 2 different events on the same person! An randomized controlled trial uses chance and large numbers of people to try to simulate that though.
Hi! Thanks for this info. I had an induction at 40+2, and it ended up being precipitous (almost exactly 3 hours active). I've always wondered if this meant my body was already almost ready and the pitocin sped it up. Would an earlier induction @39 potentially mean a slower labour?
As an "old" L & D educator and having the privilege of being in the room for the most important event in life - I like that better than other names we call ourselves 20-35 years ago - we hoped baby's fell out in the elevator before they had so many interventions because of known side effects. I will have to say, I was shocked to see the stats. So...what happened? Before you were born (just guessing!) years ago...induction meant a higher c-rate, and higher ...er...lower (can you tell it's been a long time?) of the baby's oxygen rate, (which meant higher c-rate), and other issues that I don't need to start "fear mongering". I have looked at all of the gold standards and have discovered the rates have changed and you are correct. So, could you explain how this happened? I am curious as I certainly don't want someone remembering my past life and asking me a question and I give a great wrong answer! LOL. I'm guessing the rate of the drip is not as high? Can you tell me what is the rate of the average drip? (If appropriate) It sounds like the contractions are not like the ones of long ago with an induction. I'm so confused... Thank you for putting this on a level that is easy to listen too and getting us old women into the new world. I just can't figure out the switch. I'd love to know how they figured out how to make it better and safer for women. Of course, you will get women who love the idea of feeling and allowing birth to just happen. NO ONE should feel LESS THAN for what they prefer for their birth. If it is safe, then they should be allowed. AND, may I add, if one is a grandmother, the birth process is under the parents decisions. You will be loved if you say nothing and allow and encourage the transition to parenthood. Yes, babies eat a lot when breastfeeding. Funny, we tried doing a grandparents class at the request of new parents. They didn't work. It was to give a tour, to allow for Q & A, etc... But as one said "no one is going to tell me how to be a grandmother. Whoops...hope that's working good! Now...instead of wondering about epidurals and baby's, I had a hysterectomy with an epidural. Yep, awake, but only because I'm more scared of going under than of being awake! ha
I'm going to be induced at 38 weeks due to hypertension, my concern is when can I have the epidural anesthesia? can I have it right after induction? or is there any specific cervical cm before I can have the epidural? I'm worried that my bp will fluctuate when I feel pain... please enlighten me doctor. thank you!
I am 32 weeks pregnant and my baby is above 90 centile in the UK. My hospital consultant is pushing me to have an induction at 37 weeks but I am really worried about the health of the baby being born at 37 weeks. Equally, I am concerned that if the baby goes overweight I will not be able to give birth naturally. Is induction of labour okay for the baby at 38 weeks? I am so stressed and scared about it all now. 😢
This was such a great video! Thank you. I was wondering if there’s any data about elective inductions in order to get a VBAC. Do you think that would be effective?
I think often you aren’t allowed to be induced after a c section because the scar puts you at higher risk for uterine rupture because the contractions are more intense when it is not natural oxytocin. She didn’t say why they can’t do intermittent monitoring but babies don’t always love being induced and can have heart rate decelerations
Thank you for this video. 41 weeks and 4 days .I'm at the hospital got my 3 doses left with 2 doses. Problem is I feel like it's slow each dose is 2 hours apart and I'm only having "period pains "
I thought the ARRIVE trial was flawed since it was not done on general population. Yes 6000 women says yes to induction at 39 weeks but a lot more said no. So the trial was done on women who accept interventions, NOT general population women.
Thank you for your video.. So, i live in Fukuoka Japan, and here maternity hospitals and clinics do not have the option for woman to get epidural like in US or Europe, at least not in my city anyway.. So i was wondering about the pain with induced labor past 6 cm.. because i had my son with an induced normal labor with no medication for pain.. and it was quicker but horrible... im not pregnant again and really wanted to know if you know something about the people who ddnt get the epidural with an induced labor thank you :D
I was induced and my labour was 16hours, kust have a lot to do with the fact that I was overdue and on my 41st week. I have also heard some say being induced is more painful than natural but i doubt that's a proven fact lol
My daughter -in-law was scheduled to be induced on 9/7/22 her due date was 8/25/22 but she is saying that the Dr. sent her home because she was open 2 centimeters. She still has not gone into labor. I'm wondering why they would have sent her home ? Isn't it dangerous for the baby since she has gone so far past her due date?
This was really interesting to me I had always heard that inductions increase csections so thank you for sharing this data. I’m curious if the arrive study found any correlations in the “wait and see group” as to why they ended up with a higher induction rate.
You mean higher C-section rate? Well we know that for people who go into labor on their own, the C-section rate rises each week after 39 weeks also. There are a lot of factors but it could have to do with inadequate placental function, increasing size of the baby, etc.
Hi Dr. Martha Cruz! Thanks for your videos so informative. Could you make a video about second time pregnant with previous preeclampsia if kidneys are still recovering can a pregnancy be successful or what is the care one should have? Thanks!
Do you see an increase in the need for manual removal of the placenta from inductions vs. patients going into labor on their own? What about postpartum hemorrhage?
They did not look at manual removal of the placenta (though theoretically I don't think this would matter). They did look at postpartum hemorrhage and there was do difference between the groups. There was also no difference for: chorioamnionitis, 3rd or 4th degree tears, operative vaginal delivery, or postpartum infections.
My first child was born via induction, as my water was leaking and I had already spent 2 days in hospital without having labor pains. I was 40 +4 weeks. After getting Pitocin I had the baby in under 4! hours without epidural. The drawback was that I lost a lot of blood and almost passed out in the recovery room. Had to stay in bed for three full days and had to take iron pills for months, besides being tired and exhausted for weeks. My lovely son was fine. Looking back, I think I should have been more informed and declined the induction. My other two children were born at 40+7 and 41+3, both perfect with perfect labors and without the blood loss.
Hi! Thank you so much for the great video. What about medical inductions in polyhydramnios at 38 vs 39 weeks? Does it all just depend on your AFI. My AFI has been fluctuating between 28-32 and they’re recommending delivery at 38 weeks if AFI is greater than 30. But if it’s not, then should an elective induction be done at 39 weeks given risk of macrosomia? Thank you!!
Hi Dr Perez Thank you for the valuable info I have a question : can my OB GYN refused to do elective induction at 39 weeks ? Because at my last OB GYN appointment the doctor I saw told me the office where I go they don’t do elective inductions before 40 weeks But I went and reviewed what ACOG says about elective induction and what you are saying now and I wonder if my doctor has the right to refuse to induce me at 39 weeks if I elect to ???! I will really appreciate your response Thank you !!!!
i really want my wife to experience the sensations of the natural hormones and whatnot, but she wants to induce because she's super uncomfortable. i don't feel like its my place to decide how things go but i'll be sad if she misses that opportunity
you are right to think it isn't your place to make decisions about your wife's pregnancy. totally understand you having your own opinions, but please remember that you are not the pregnant one, she is. it's all fine and dandy to want something for someone when you have no idea what it actually feels like to go through it. it is ultimately her experience to have however she feels best. it won't impact you as long as baby is healthy and happy.
You can experience anything you want to experience when you are the one carrying the baby. You’re correct that you are not the one to decide this for your wife
This May all be true, but I don’t believe for one second that the drugs used for induction are risk/side-effect free. The longer-term effects of those drugs on newborns should probably be included in weighing the pros and cons.
Hello Dr.my wife who is 8 months pregnant, went to the hospital for her regular check up and she was put into induced labor without her concent and she is just 8 months pregnant.
The human body is complex and the female body is on a whole different level . A mother will always know how her body is and always trust your body. Your brain will know what to do when it is the right time. Don't fall for all the odd noise coming from docs, who most of the time in large hospitals they always have an incentive to follow hospital patient management and administrative policy. Keep in mind you can be part of a research they are collecting data for. Its a team effort, your baby, your brain and you! ....we had women and relatives who gave birth to baby's ( 5-18 Children) and all that without epidural or c-section. And this was from the villages of Bangladesh. Modern medicine underestimates the body of a female and wants to intervene too early. If you body is not ready , you will have a hard time in most cases.
Thank you! I’m currently 36wks with my second and hoping to VBAC after a c-section for unknown breech presentation where I got to complete and pushing on my own! I’m a pediatric emergency medicine fellow and for timing purposes would like to not go beyond 39 weeks, so considering induction. I’ve done a lot of reading on my own but have found your channel incredibly insightful and would love your perspective!
I had a medical induction at 38.3 weeks due to gestational Hypertension (no pre eclampsia or eclampsia) and had balloon placed and was the most uncomfortable/painful part of the whole process for sure! my question is are prostaglandins equally efective/safe for induction? oral or vaginal? because if I need to be induced again I want more options because I am not doing that balloon again lol. Thanks for the video!!!
Choosing what method for induction is part of the art of being a doctor that takes years to learn. Often a balloon is done with something else, like a balloon + prostaglandins or balloon + oxytocin. Many times if the cervix is soft already, prostaglandins aren't needed. I hope that's helpful!
We rarely need to help the body start & stay in labor. That’s the first problem. The second problem is that most medical professionals are not typically patient and do not typically trust the body. They believe the body needs their help to do what it was made to do. As a ten year doula & childbirth educator, the majority of inductions being suggested by doctors are based on NON MEDICAL reasons that are portrayed as being substantial medical reasons.
Women, please do your research. The ARRIVE study had many issues which are easily learned about online. Inductions can be very long and painful. Many fail. Not all babies born via induction do well, because they simply weren’t ready to be born. Being induced requires constant monitoring and management of your labor. Explore the cascade of interventions. You may not feel those stronger, longer pitocin contractions, but your baby will.
My Dr recommended I be induced at 39 weeks. I am 35 weeks and will not because my baby is not showing any health risks and I have never had any complications with my 3 previous children. I trust my body to do what it’s supposed to
I just skirted by a 41 week 6 day induction. Went into labor a couple days before and got my intervention free hospital birth I was hoping for.
Hes 9 days old now 🥰
Congratulations! Hope you & baby are both doing well ❤️
How much did he weigh just curious
@@nakiarobinson8805 he weighed 9lbs 6 oz
Contrary to the Arrive Trial, I don't believe induction at 39 weeks decreases csection risk at all. Inductions definitely INCREASE csection risk. I am firmly convinced that when doctors know they're being observed (as was the case in the Arrive Trial), they will manage inductions differently. In my case, I had an induction at 40 weeks that was managed horribly. They broke my water way too soon and gave me an epidural way too soon as well, despite the fact that I clearly stated that I didn't feel I needed it yet. They also cranked up the pitocin. Needless to say, baby went into distress and I ended up "needing" an emergency csection.
If those very same doctors had been being observed, especially for csection outcome, I bet my left kidney they would manage my induction MUCH better and make different decisions. They'd likely be way more patient with me and my body. So yeah, unfortunately, despite being a randomized controlled trial, I don't believe the Arrive Trial is reliable at all. The medical system is about resource management first and foremost, and women's personal experiences going through this system are an afterthought. The Arrive Trial is what happens when inductions are managed meticulously in a perfectly world, but unfortunately that's not the world we live in.
This is SO HELPFUL. I am 40+1 and may have to decide if we want an induction in a few days. I was so anxious about the possibility of induction but now, I feel so calm and informed. Thank you, thank you!
I’m currently 40+1 , did you get the induction? Hope you are healing and healthy!
Thank you for this video, I was scared to confirm my induction at 40 weeks 1 day because I'd heard that c-sections were more common with induction. This eased my mind so much. Knowing this is safer than the alternative (possibly having a 10 lb baby if I wait for things to happen naturally) makes me feel so much better about going in.
My situation exactly! Scheduled for tomorrow morning and still in doubt. How did it go for you?
The ARRIVE study sounds great. I would like to know more stats about it. For example, the age group of the women as well as nationality/race. From my understanding these stats do make a difference and childbearing has a lot to do with genetics as well.
Thank you for this info! I’ve discussed induction with my doctor and weighing my options, I love to hear good data backing up medical suggestions. Made me feel way more optimistic about my scheduled induction!
Thank you SO VERY MUCH for this video. Planned induction as a medical procedure applicable to our pregnancy was rather abruptly introduced at a visit during the early third trimester. None of the videos we watched prior to then even seriously touched on it at all.
There were only occasional verbal warnings, mired in melancholy subtext to allow the body to go into labor “naturally”.
This is one of a paltry few videos that apply to our medical reality.
Thank you SO VERY MUCH for addressing our flex-and-flow pregnancy 🤰.
Thanks for the info. My husband is a pilot and we're doing elective induction so he can be there. Glad this is an option!
I feel compelled to add that even though an 18% primary c-section rate is great in comparison with the national average.... BUT, I come from an institution where our primary c-section rate grew from 6% to 12% from 1994 to 2019. Believe it or not, 12% seems high to us. By utilizing the midwifery model of care & practicing evidence based medicine, it is possible to obtain even more positive outcomes. I would love to see you discuss collaborative practice & the midwifery model of care! You are amazing & I appreciate your work so much. Excited to hear your own birth story!!! ♥️
That's a great C-section rate! I love collaborative practice!
Thank you so much for this video and mentioning the study! I go in tomorrow for my induction and this has made me feel much more calm and educated about what to expect.
I honestly wish I would have been induced at 40 weeks vs. 41, I didn't have any further cervical change. I was so worn out just from the act of being pregnant another week that the process was thoroughly exhausting. I had a foley bulb placed the evening before, it came out in the morning went back the next AM to start pitocin. Pitocin all day no cervical change. Stopped the IV. A couple hours later the night doc and midwife came in and said they wanted to try prostaglandins every 4 hours through the night. I had terrible cramping after each dose, but I started having regular contractions about 3 hours after my second dose. Elected not to go back on pitocin, had them break my water. My daughter was born about 7 hours after they broke my water. Long story longer I think my body was going to need some help regardless! And the extra week of waiting was exhausting
I’m 39 weeks right now and had my appointment with my OB yesterday. She recommended an induction of labor since I am not showing any signs of labor but of course told me it’s my choice if I want to wait for it to be natural or plan a date. I definitely want to wait and try to go into labor naturally but also taking her recommendation into consideration I do want to plan for an induction of labor if baby isn’t here soon after his due date. My OB said she would recommend not to go past 41 weeks. This video was so informative and helpful. Thank you so much!
how did everything go < 3
Hey momma how did your labor process go? Did little one come on their own or with assistance?
THANK YOU for providing this insightful information and being a constant amazing resource! I didn’t know inductions were controversial until I planned one just this week. Perfect timing on this video for me! Appreciate you providing evidence and experience to help me feel more confident in my decision.
So glad it's helpful timing!
I have an induction scheduled for 40+1 and the data you explained from the ARRIVE trial has made me much more calm. Thank you!
How was your experience with induction?
I’ve read that, for women over 35, there’s a risk that the placental health could deteriorate after 39 weeks, which could be an advantage of an elective induction. I’m 37 and currently 28 weeks pregnant, and I’m very seriously considering elective induction between 39 and 40 weeks.
There are some increasing risks of stillbirth in older pregnant women compared to younger, most notably after age 40. Your age may be a factor in deciding what's best for you for sure!
I wish they would have done a study like the ARRIVE study, but with high risk pregnancy
Thank you so much for HOW you explain all of this! Context and tone matter so much, and there's such a skill in presenting the information this way that removes guilt from everyone making decisions! I am so grateful I found this video! 🙌
Scheduled deliveries is not only a convenience for the parents, it’s a convenience for the doctors. Doctors induce in the morning while they are seeing patients in the office, deliver babies in the evening and are home by bedtime. It would be interesting to know how many inductions are performed on Fridays as compared to the other weekdays.
I’m 40+1 day today with an induction scheduled in 3 days. This video gave me a lot more peace about being induced. Thank you!
Hi Dr Perez! Could you speak about complications with inductions? And their likelihood? Thank you!
I ended up getting induced at 39 w due to pre eclampsia. The induction went really well. I honestly think I will asked to b induced the next baby.
What about the higher risk of hemorrhage with induction (at least inductions that use Pitocin)? I knew about this beforehand, from researching it on my own, but my OB assured me it's totally fine, I did it, & hemorrhaged badly (& almost needed a C-section because of the induction, AND had a severe uterine infection, which passed to my baby, because of them breaking my water at the beginning of the induction, etc.). And the overall experience of the induction was an absolute nightmare. So, I don't know, I don't think anyone could convince me that an elective induction is better.
This video explained all of the questions I have about inductions❤I was recommended induction at 39 weeks yesterday at my OB appt because she is measuring 3-4 weeks behind and low birth weight. I wanted to wait and see what happens but now I am definitely leaning towards the induction to reduce risk of still birth and keep baby safe.
Thank you!
Thank you for this info, just what i needed to hear. At 40+1 booked in for induction at 40+5. Feel so much more relaxed, whatever way it goes.
Wow…thank you for this very informative. I had a induce labor on Nov. 12,2021. A day from now…. My body is ready amd totally excited for the big day since Iam 42 in few months and I am 39 weeks and 3 days.
Hi there, how long was your labor before delivery
Something I see in pregnancy forums a lot that drives me crazy is "I had to induce my first and it was so much worse than starting labor naturally in my second". Or similarly, comparing recoveries with first epidural birth with a med-free second birth and concluding it must have been the epidural and not just first deliveries being harder. They are going to be different experiences regardless! I had an epidural for all 3, but induced the last two and there was almost no difference between any of the three experiences except getting faster and faster and recovery getting easier and easier, which you would expect. Nothing to do with being induced or not. ARRIVE is important because you can statistically compare the differences instead of the anecdotal stories of people comparing their own experiences that are not comparable because they first labors vs subsequent labors.
Have an induction scheduled for tonight and your information was very helpful ease my mind a bit as I was questioning my decision, from everything I read online even though I am passed the due date.
How did your induction go??
It went amazing the doctor and nurses at Dignity Health, were absolute gems and I was very grateful for there knowledge.
Super helpful and informative! I was just going to comment somewhere that I would love a video on induction and then there was one!! My husband enjoyed watching it with me and we plan to watch the other videos together!
Wow love this! Thank you so much for.. I'm so thankful I found you during my first pregnancy! I hope we get more vlogs with your newborn 🥰
You are so welcome!
I was definitely torn on what to do but I am definitely going through with my induction!! For my baby’s sake
Is it true if the body doesn't respond well to being induced, baby can have fetal stress & heart rate can drop leading to a c-section ? Will my breastmilk be delayed coming in after delivery? How does doctor go aboit breaking the water?
I am currently at 41 weeks and was induced this morning. I would say I will NOT be doing this again for my next child. I wish I had not been pushed to be induced. Technically I’m not over due until 42 weeks. Why go through this supper long and painful induction process that is as far from natural as possible? I wish I had let my body do its thing instead of forcing open the cervix to force my baby out. I did not have any problems besides the date.
You didn’t get epidural when induced?
Thank you so much for this. I have always been very skeptical of inducing labor and had not heard a detailed explanation of the most current research as to why it’s OK. I was just told by my OBGYN NP, “actually it doesn’t increase c-sections” and that was it.
I still don’t think I necessarily want an induction because of the the increase in pain/intensity of labor. But it’s something to think about and fortunately I have a long way to go until my due date.
This was very informative. I’m at 38 weeks and when my OB told me that we will discuss induction, I got scared because I needed my details that what she provided.
How was your experience with induction?
So some of the stories I heard about induction, whether elective or medically necessary, what happens is that the hospital or the birthing practice wants you to deliver within a certain time so at some point they will up your pitocin at a rapid rate if you are not progressing as fast as they would like which might cause the baby to be in distress, and that resulted in an emergency c-section... I feel like that would be why so many people feel like induction will have a higher c-section rate because we don't live in a world where every practice is perfectly ethical. I am still hesitant about my own birthing plan and I will have that conversation with my ob. And what do you think about the documentary the Business of Being Born?
Thank you for this information! Such a helpful breakdown of the ARRIVE study. It seems like the study focused on first-time birthing people--is there any discussion of how this data translates over to second, third, etc.-time?
Birthing people?
Mothers *
Good questions because I'm pregnant with my 7th and I'm 40 weeks a 5 days.
Thanks for all the information! Question about the ARRIVE study: did the providers know their patients were in a study looking at c-section rates and elective induction at 39 weeks? I’m curious if that could impact decisions and this c-section rate.
They did. I was just reading an article about this the other day on the evidence based birth site and it called out this issue.
Oh my God now I feel relief thank you so much for the valuable information 🙏
Can you discuss or share some articles/studies on assisted second stage, both vacuum or forceps. There is very little information out there about this, especially fetal outcomes. I know it is rare to need this but some maternal indicators mean this is the route that is taken. All of the information about inductions is super helpful for me in trying to make a decision for my birth! Thank you for everything you do.
Im on my 36 weeks now my first baby by ivf my doctor recommend induction labor on march 1 my due is march 3 so its fine now i watch this video gives me clarity about induction procedure thanks
Would you ever be willing to do a video on preeclampsia and cholestasis? Especially in regards to induction? I was diagnosed with both
I second this. I had severe cholestasis for the majority of my pregnancy.
Thank you so much for this information! I wish I found this when I was around 34 weeks! My OB told me at 36 weeks and I was a bit scared and held off. I would have been induced on 8/31/21. Luckily she got me in for 9/2/21 and this video eased my nerves! Thank you so much. Cannot wait to meet my little guy in less than a week! ❤️❤️❤️
How did it go? I’m 38 weeks today and I was told by my obgyn if I wanted to schedule my induction next week. I said I’d wait it out till next week and let her know. I had an induction with my first and it wasn’t bad but it’s still intimidating
Thank you for the informative video!
I am due 15 December, with gestational diabetes (well-controlled by diet), my doctor suggested having an induced labor on 14 December (39 weeks 6 days) by then to reduce any risks later. I’m planning on taking the epidural as well to make it a positive experience since it’s my first baby!
I’m 39 weeks and I already have an induction date due to the down fall of my mental health
If an unmedicated birth is a strong personal preference for someone, is that a reason to consider avoiding a “risk-reducing” induction given what you said about length of labor etc? I know that in the ARRIVE trial pregnant people in the induction group reported lower levels of pain but were there also higher rates of epidurals? I couldn’t tell from my read on the study.
im not a doctor but I had a kid both ways so im speaking from experience. induction by combination oxytocin and the ballon feels like many bones breaking with no epidural. the doctors have to stop because contractions come on too fast. they suggested a c section because of our heart rates going because of the pain I refused. the pregnancy without feels less painful and more natural. but again everyone is different and if your going to get a epidural anyway then pain doesn't matter
This is so interesting! Is there any info yet on the success of 39 week induction with TOLAC?
Wow great information, heave really learned alot. Thank you 👍
Thank so much for the video! This is really such important information to share. When I was pregnant with my first I was super stressed about the possibility of having to be induced because I thought it would increase my c section rate (and I am a nurse). I wish I’d had more education then, but I’m sure this will help lots of pregnant people out now!
Thank you my daughter is in hospital right now having induction and you have answered many of my questions
I’m 39 weeks tomorrow and my doctor hasn’t brought up induction at all. I don’t know what to do. My 1st was born on due date and my 2nd was 10 days early and I went into labor naturally with both, hopefully she makes her way on her own this week!
I’m being induced tomorrow at 36+5 and I’m terrified 😭
How did it go?
Thank you for this information! What are your thoughts on an induction at 39 weeks after a very fast previous labor (ie. 4cm-baby in less than 2 hours and baby born within 5-10 min of water breaking)? Is there a high risk of another quick delivery that would make an induction recommended?
I wonder if the results of the ARRIVE RCT are perfectly applicable outside of the experimental setting. Are the actual outcomes the same outside of the trial since the variables were very controlled? Participating providers had to follow a very specific study protocol. Since there is so much variation in induction methods depending on where a person is giving birth and with who, could it be that the findings of the trial won't translate? And I think it's also important to give some weight to a person's birth "experience" not as a frivolous whim, but based on the idea that often, people who have positive birth experiences where they are able to give birth without intervention might go on to have higher levels of confidence in their bodies and selves, better mental health, relationships, parenting, etc. Just from a broader and more holistic standpoint. Not to say that people who choose the the induction birth plan that is successful can't also have great "experiences" of course! I just talk to a lot of people who are torn. It can be hard to hear that our bodies may not work just right on their own and that we need medical help. Some people develop insecurities when this happens. I think having a positive birth experience can actually have lot of value to our whole health picture. Maybe that means feeling we have a higher sense of control using induction, or maybe not.
The ARRIVE trial was not "tightly controlled" and absolutely generalizable to a setting of national US sample. It was performed at 41 different hospitals, including management from hundreds of obstetric providers, many different L&D differences. So absolutely a STRENGTH of this study is its generalizability to the whole US population. This study is not about individual patient preferences, but it is about data upon which individuals can decide their preferences, which they should absolutely do with the help of quality. medical data like the ARRIVE trial. I caution you to avoid language implying that medical intervention in pregnancy is "bodies not working well on their own" because of course that statement is true, if our bodies worked well on their own there would be immortality and we would not see the drastic improvements in surviving birth and infancy that our interventions have allowed for those who need them, and also available for those who choose them.
@@dr.martaperez @Dr. Marta Perez With all due respect I think you are doing a great thing by educating. There is a lot in this video that people never get to hear, even when they are faced with the decision to have an induction. By controlled I mean that the inductions were done a certain way at all sites by all clinicians, yes? That's what I understood from my reading. The actual induction procedures themselves were well-controlled. They'd have to be or this wouldn't have been the good study that it was. In reality, there is much variation in induction procedures, meaning that not all care providers do inductions the same way. I understand that the populations and locations were diverse and large, but the participating clinicians were asked to provide care in the same way. It's for that reason that I question the generalizability. I love data and I love to really dig in! I'm not against induction, I just worry that a holistic picture of health including mental health and a person's future is not always entered into the decision making process and that the study results are doing a bit to possibly skew a little inaccurately towards non medically necessary inductions which often makes people feel they are being irresponsible if they don't choose it. Medical intervention doesn't always mean that a body is not working well on its own, but should it? Often intervention happens before a body has had a chance to try. I'm grateful that we have medical intervention for when that is the case. Of course bodies sometimes and eventually all fail, that's part of the life of the mortal, but it can still be a hard thing to process when we get faced with that reality.
@@AW-pf8jw No, inductions were not done a certain way, there was nothing in the protocol specifying anything about the induction, the obstetric provider used their judgment and evidenced based care. There were *not* protocols on labor induction meds/timing/etc and "provide care in the same way" is only that they were asked to provide evidenced based care, which all providers in the country should be doing the way the hundreds in this study (hopefully) did. Not sure where you got your reading from, but if you'd like to read the full study it's open access. www.nejm.org/doi/full/10.1056/NEJMoa1800566 Study results are meant to give people information about making their decision, they do not comment on what each individual values, and each participant volunteers to be part of a trial and those who come after choose how the information gains fits in their priorities. The people I see making the baseless argument that scientific data and understanding is bad for patients are usually just upset that the results of the science challenge their own narrative of what they *want* to believe about medicine/science, especially in obstetrics.
Thanks very much.just on time for me.well explicit.
Hi Dr. Perez,
Thanks for the informative video! Expecting Mono-Di twin girls and am 32 weeks :)
How did you come up with the 36% decrease in c -sections of induction vs 'see what happens group'? I cant wrap my head around the math and confused if your arrow is backwards? Thanks :)
Very educative you are the best
Is it possible there could be some sort of physician bias that contributes to the reduction of csections in the induction group? In a course provided by a local hospital, the nurses discussed the cascade of intervention.
No, this is a very unlikely because it is a very high quality study with many participants which is able to account for small biases like individual provider preferences. This study took place at 41 hospitals! The "cascade of interventions" is an unfounded myth that is talked about by people who have personal preferences towards a "natural" labor being better than one that uses medicines. As we can see by this study, intervening in labor by inducing at 39 weeks actually decreases the C-section rate.
If you choose an elective induction, is there a risk your body doesn't respond, you don't progress, and require a c section? That could lead to feelings of regret. If your elective induction ends in c section due to no progress, is it likely that you would have had a c section anyways if you waited to go into labor naturally? I hope that makes sense!
That's exactly what the ARRIVE trial wanted to find out! As you saw in the video, there is a LOWER C-section rate from choosing a 39 week induction than from just waiting to see what happens. I suppose it could suggest that if a C-section is needed for someone with a 39 week induction, the chances of it would go up even higher if that same person waited, but obviously we can't know for sure since we can't study 2 different events on the same person! An randomized controlled trial uses chance and large numbers of people to try to simulate that though.
@@dr.martaperez thanks so much for the awesome video and time taken to respond. Always great info. !
Wow. Thank you. I have my confidence back 💖
Hi! Thanks for this info. I had an induction at 40+2, and it ended up being precipitous (almost exactly 3 hours active). I've always wondered if this meant my body was already almost ready and the pitocin sped it up. Would an earlier induction @39 potentially mean a slower labour?
As an "old" L & D educator and having the privilege of being in the room for the most important event in life - I like that better than other names we call ourselves 20-35 years ago - we hoped baby's fell out in the elevator before they had so many interventions because of known side effects. I will have to say, I was shocked to see the stats. So...what happened? Before you were born (just guessing!) years ago...induction meant a higher c-rate, and higher ...er...lower (can you tell it's been a long time?) of the baby's oxygen rate, (which meant higher c-rate), and other issues that I don't need to start "fear mongering". I have looked at all of the gold standards and have discovered the rates have changed and you are correct.
So, could you explain how this happened? I am curious as I certainly don't want someone remembering my past life and asking me a question and I give a great wrong answer! LOL.
I'm guessing the rate of the drip is not as high? Can you tell me what is the rate of the average drip? (If appropriate) It sounds like the contractions are not like the ones of long ago with an induction. I'm so confused...
Thank you for putting this on a level that is easy to listen too and getting us old women into the new world. I just can't figure out the switch. I'd love to know how they figured out how to make it better and safer for women.
Of course, you will get women who love the idea of feeling and allowing birth to just happen. NO ONE should feel LESS THAN for what they prefer for their birth. If it is safe, then they should be allowed. AND, may I add, if one is a grandmother, the birth process is under the parents decisions. You will be loved if you say nothing and allow and encourage the transition to parenthood. Yes, babies eat a lot when breastfeeding. Funny, we tried doing a grandparents class at the request of new parents. They didn't work. It was to give a tour, to allow for Q & A, etc... But as one said "no one is going to tell me how to be a grandmother. Whoops...hope that's working good!
Now...instead of wondering about epidurals and baby's, I had a hysterectomy with an epidural. Yep, awake, but only because I'm more scared of going under than of being awake! ha
Do you consider advanced maternal age a medical reason for 39 week induction?
I'm wondering about this too
Yes
Can you talk more about ACOG's study and decision to allow induction of labor for a pregnancy after loss or stillbirth.
I'm going to be induced at 38 weeks due to hypertension, my concern is when can I have the epidural anesthesia? can I have it right after induction? or is there any specific cervical cm before I can have the epidural? I'm worried that my bp will fluctuate when I feel pain... please enlighten me doctor. thank you!
When did the give you the epidural? I have the same question.
I am 32 weeks pregnant and my baby is above 90 centile in the UK. My hospital consultant is pushing me to have an induction at 37 weeks but I am really worried about the health of the baby being born at 37 weeks. Equally, I am concerned that if the baby goes overweight I will not be able to give birth naturally. Is induction of labour okay for the baby at 38 weeks? I am so stressed and scared about it all now. 😢
This was such a great video! Thank you. I was wondering if there’s any data about elective inductions in order to get a VBAC. Do you think that would be effective?
I think often you aren’t allowed to be induced after a c section because the scar puts you at higher risk for uterine rupture because the contractions are more intense when it is not natural oxytocin. She didn’t say why they can’t do intermittent monitoring but babies don’t always love being induced and can have heart rate decelerations
when we will say failed induction ??
is inducing by breaking the amniotic sac dangerous at 41 weeks?
Thank you for this video. 41 weeks and 4 days .I'm at the hospital got my 3 doses left with 2 doses. Problem is I feel like it's slow each dose is 2 hours apart and I'm only having "period pains "
I thought the ARRIVE trial was flawed since it was not done on general population. Yes 6000 women says yes to induction at 39 weeks but a lot more said no. So the trial was done on women who accept interventions, NOT general population women.
I was also offered induction at 39 weeks. Definite no for me.
This is so interesting! Thanks for this information !!
Thank you for your video.. So, i live in Fukuoka Japan, and here maternity hospitals and clinics do not have the option for woman to get epidural like in US or Europe, at least not in my city anyway.. So i was wondering about the pain with induced labor past 6 cm.. because i had my son with an induced normal labor with no medication for pain.. and it was quicker but horrible... im not pregnant again and really wanted to know if you know something about the people who ddnt get the epidural with an induced labor
thank you :D
I was induced and my labour was 16hours, kust have a lot to do with the fact that I was overdue and on my 41st week. I have also heard some say being induced is more painful than natural but i doubt that's a proven fact lol
Would love to know about similar studies in other countries and if they e reached the same conclusion. Thanks!
Would being on a blood thinner, such as heparin, be a medical necessity for an induction? If so, why would it be necessary?
Getting an induction at 40 weeks and 3 days on the 28th 😳
My daughter -in-law was scheduled to be induced on 9/7/22 her due date was 8/25/22 but she is saying that the Dr. sent her home because she was open 2 centimeters. She still has not gone into labor. I'm wondering why they would have sent her home ? Isn't it dangerous for the baby since she has gone so far past her due date?
This was really interesting to me I had always heard that inductions increase csections so thank you for sharing this data. I’m curious if the arrive study found any correlations in the “wait and see group” as to why they ended up with a higher induction rate.
You mean higher C-section rate? Well we know that for people who go into labor on their own, the C-section rate rises each week after 39 weeks also. There are a lot of factors but it could have to do with inadequate placental function, increasing size of the baby, etc.
Hi Dr. Martha Cruz! Thanks for your videos so informative. Could you make a video about second time pregnant with previous preeclampsia if kidneys are still recovering can a pregnancy be successful or what is the care one should have? Thanks!
What is your general POV on inducing early when someone is on heparin?
Meds used
And stages of labor with induction?
Epidural when does it happen?
Thank you for a good vid
Do you see an increase in the need for manual removal of the placenta from inductions vs. patients going into labor on their own? What about postpartum hemorrhage?
They did not look at manual removal of the placenta (though theoretically I don't think this would matter). They did look at postpartum hemorrhage and there was do difference between the groups. There was also no difference for: chorioamnionitis, 3rd or 4th degree tears, operative vaginal delivery, or postpartum infections.
My first child was born via induction, as my water was leaking and I had already spent 2 days in hospital without having labor pains. I was 40 +4 weeks. After getting Pitocin I had the baby in under 4! hours without epidural. The drawback was that I lost a lot of blood and almost passed out in the recovery room. Had to stay in bed for three full days and had to take iron pills for months, besides being tired and exhausted for weeks. My lovely son was fine. Looking back, I think I should have been more informed and declined the induction. My other two children were born at 40+7 and 41+3, both perfect with perfect labors and without the blood loss.
Hi! Thank you so much for the great video. What about medical inductions in polyhydramnios at 38 vs 39 weeks? Does it all just depend on your AFI. My AFI has been fluctuating between 28-32 and they’re recommending delivery at 38 weeks if AFI is greater than 30. But if it’s not, then should an elective induction be done at 39 weeks given risk of macrosomia? Thank you!!
Hi Dr Perez
Thank you for the valuable info
I have a question : can my OB GYN refused to do elective induction at 39 weeks ?
Because at my last OB GYN appointment the doctor I saw told me the office where I go they don’t do elective inductions before 40 weeks
But I went and reviewed what ACOG says about elective induction and what you are saying now and I wonder if my doctor has the right to refuse to induce me at 39 weeks if I elect to ???!
I will really appreciate your response
Thank you !!!!
i really want my wife to experience the sensations of the natural hormones and whatnot, but she wants to induce because she's super uncomfortable. i don't feel like its my place to decide how things go but i'll be sad if she misses that opportunity
you are right to think it isn't your place to make decisions about your wife's pregnancy. totally understand you having your own opinions, but please remember that you are not the pregnant one, she is. it's all fine and dandy to want something for someone when you have no idea what it actually feels like to go through it. it is ultimately her experience to have however she feels best. it won't impact you as long as baby is healthy and happy.
You can experience anything you want to experience when you are the one carrying the baby. You’re correct that you are not the one to decide this for your wife
i now understand better why it's not so obvious for some folks to stick around
Hey I am 40 weeks and getting induced soon, baby's head is not engaged, is normal delivery possible?
This May all be true, but I don’t believe for one second that the drugs used for induction are risk/side-effect free. The longer-term effects of those drugs on newborns should probably be included in weighing the pros and cons.
Hi I am currently 40 weeks 2 days didn’t dilate yet so doctor suggested will induce by sept 1st .. before 41 weeks .. no medical condition
Hello Dr.my wife who is 8 months pregnant, went to the hospital for her regular check up and she was put into induced labor without her concent and she is just 8 months pregnant.
That sounds illegal. What country was this?
Getting induced in 3 weeks at 39 weeks
Hi ,Iam in 39 week and 5 day but I don’t have a construction I don’t know why
Hi am 39 weeks pregnant and getting braxton hit me 🙏 😊🙏
How is 22 to 18% a decrease by 36%
Hello Doc. Its true that its ok at 37 weeks to induce labor.for said it was more water in water bag . ? From philippines😇🥰
The human body is complex and the female body is on a whole different level . A mother will always know how her body is and always trust your body. Your brain will know what to do when it is the right time. Don't fall for all the odd noise coming from docs, who most of the time in large hospitals they always have an incentive to follow hospital patient management and administrative policy. Keep in mind you can be part of a research they are collecting data for. Its a team effort, your baby, your brain and you! ....we had women and relatives who gave birth to baby's ( 5-18 Children) and all that without epidural or c-section. And this was from the villages of Bangladesh. Modern medicine underestimates the body of a female and wants to intervene too early. If you body is not ready , you will have a hard time in most cases.
I'm 37 weeks I'm getting induced Friday because baby stop growing
Can you comment on IOL after prior c-section?
That would be a VBAC IOL - there are slightly different considerations there, I'll discuss it more when I do my VBAC episodes!
Thank you! I’m currently 36wks with my second and hoping to VBAC after a c-section for unknown breech presentation where I got to complete and pushing on my own! I’m a pediatric emergency medicine fellow and for timing purposes would like to not go beyond 39 weeks, so considering induction. I’ve done a lot of reading on my own but have found your channel incredibly insightful and would love your perspective!
I had a medical induction at 38.3 weeks due to gestational Hypertension (no pre eclampsia or eclampsia) and had balloon placed and was the most uncomfortable/painful part of the whole process for sure! my question is are prostaglandins equally efective/safe for induction? oral or vaginal? because if I need to be induced again I want more options because I am not doing that balloon again lol. Thanks for the video!!!
Choosing what method for induction is part of the art of being a doctor that takes years to learn. Often a balloon is done with something else, like a balloon + prostaglandins or balloon + oxytocin. Many times if the cervix is soft already, prostaglandins aren't needed. I hope that's helpful!
@@dr.martaperez thanks! I guess I meant if u can do without balloon at all! Thanks!