Listening to Mothers... About Induction of Labor
Childbirth Connection's landmark national Listening to Mothers surveys were the first to focus on those who care most about maternity issues: mothers themselves. The most recent survey addressing labor and birth experiences polled 1,573 women who gave birth in U.S. hospitals in 2005. Among the results are important data about induction of labor, a major intervention with significant health consequences for mothers and infants. The full reports can be found at childbirthconnection.org/ListeningToMothers.
What was the frequency of labor induction for Listening to Mothers survey participants?More than 1 in 3 women (34%) reported having labor induced by artificial means. This rate is significantly higher than the rate reported in national statistics for the same year (23%), most likely due to underreporting of induction on the birth certificate, the official source of the national rate of induced labor.
More than one in five women (22%) tried to self induce labor using non-medical techniques such as exercise, sexual intercourse, and nipple stimulation and of these, 21% (4% of the total sample) were successful. One-third of the women who attempted self-induction did so to avoid a medical induction. Three-quarters of those who were unsuccessful in inducing their own labor eventually underwent medical induction of labor.
What reasons did mothers report for medical induction?The mothers reported that their caregivers had tried to induce labor for both medical and non-medical reasons. Mothers could select more than one response, and the leading reason mothers cited was a caregiver concern that they were "overdue" (25%), followed by a maternal health problem that required the induction (19%), the mother's desire to get the pregnancy over with (19%), and caregiver concern about the size of the baby (17%).
What did mothers share about knowledge, choice, and decision making?When asked about information on side effects needed before agreeing to have labor induction, most (78%) mothers said that it is necessary to know every complication, and nearly all others (19%) said that it is necessary to know most complications. However, most women were unable to correctly answer basic questions about the adverse effects of labor induction, and women who had experienced labor induction were more likely to answer the questions incorrectly than those who had not.
Overall, 11% of mothers reported experiencing pressure from a health professional to have labor induction, however, among mothers who had an induction, 17% cited pressure compared to 7% who did not have an induction.
What else did mothers say about induction of labor?Listening to Mothers survey participants also had the opportunity to talk about their experiences in their own words. With just a few exceptions, women described induction of labor in negative terms, often describing a cascade of interventions beginning with the decision to induce.
I wanted to have a more natural birth, but the induction took longer than we planned. I was tired and we started the epidural along with the pitocin.
I had little control over the course of labor since my water broke before it began. The worst thing is that I feel that the induction and subsequent drugs and cesarean were a greater risk to the health of my baby than the risk of infection from a broken amniotic sac.
I feel that I was railroaded into labor, pain medication and subsequently a cesarean section. The baby then had to be protected by my husband from a spinal tap immediately after birth. I did not get to hold my baby for hours after birth. It was not enjoyable only interfered with by health care workers.
My doctor tried to 'scare' me into being induced prior to my due date because, as it turns out, he was going on vacation the week I was due.
The best thing I can say that has come from me giving birth would have to be the knowledge I've gained from all of this. I know what questions to ask now, and I also know what risks MY body and MY next baby could possibly go through.
The worst thing was when they had to give me Pitocin. It gave me really strong contractions and they didn't let up until I pushed the baby out.
I think women should be allowed to eat during labor. I ate at 6 PM. They induced my labor at 4 AM and I gave birth at 7:31 PM. I didn't get to eat or have anything but ice chips for over 24 hours.
My goal, this time, was to not get pressure about doing anything against my wishes because my first birth was a genuine nightmare with unnecessary induction, tons of drugs and medical students watching me push! I stayed home most of the labor to make sure I wouldn't get any of that. And I didn't, everything was perfect. It's all in choosing the right doctor first.
I persisted for no drugs to induce labor and got my way, but had to be very persistent.
I had a lot of pressure from the nursing staff to take Pitocin and to have an epidural. I felt like the birth experience was severely impacted by this pressure, as if the most important thing to the nurses was for me to have the baby quickly. My doctor is a big fan of induction, which is not my cup of tea. I had an induction with my first child and wanted desperately to avoid one this last time. Luckily I was able to."
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