I’ve had enough of this lot. The Failure To Wait Brigade. I am on holiday, while a client of mine is in hospital. She has been there for days and days. She went in for monitoring because she was 11 days over her estimated due date (this, in itself, is not a medical issue. This is nature, doing things in different rhythms for different people). She decided to decline the advice of induction at 11 days over, choosing to wait until at least 14 days over. She was intending to come home again, but she never got out.
Did you know, that if you are 11 days over your estimated due date, or your waters have released and you haven’t gone into labour yet, you should only ever be offered induction. You shouldn’t be told you have to have one. If, after being offered an induction, you decline, the alternative, as outlined in the National Institute of Clinical Excellence (NICE) guidelines, is Expectant Management. The idea is to monitor how you and your baby are doing, while waiting for nature to take its course. A lot of pro natural birthers talk about the “Failure to Wait” in maternity care. But the NICE guidelines incoporate a clause whereby mothers are offered the choice to wait. Great! I can let parents know about this choice, and I did, in my role as birth doula. Most people don’t know they have this choice, because they are not told.
So, she declined induction at that point in her pregnancy. My lovely client hadn’t planned to birth in a hospital, and she didn’t want to birth in a hospital, so this was her opportunity to let her body and her baby wait, so she could have a natural birth as planned.
This is the second client of mine in a row, who decided to decline an offer of induction, and opt for expectant management. They both planned to birth outside of the hospital, and I fully expected them to go home after the monitoring, and have a lovely, peaceful night in their own bed. The peace would increase their chances of going into labour naturally. But neither of them got out of hospital again. Don’t forget, there was nothing medically indicated with either of these women, so why did they need to be in hospital? They say things happen in threes, so I’m blogging before the third, to get things off my chest and help me make sense of it for next time.
They were both fine. The baby was fine. But their bodies did things in a slightly different rhythm to that of hospital protocol. They were both too slow. One was too slow to go into labour after her waters released, and the other was too slow to go into labour after her estimated due date (only 11 days, not even statistically abnormal). Both these women are spiritual women, women who knew intuitively that they wanted a natural birth. In their pregnancy, they got ready, their mindset changed beautifully until they knew and trusted, and their confidences quietened their mind as they reflected in on what was to come.
They didn’t count on the force of the “failure to wait” brigade. When you hire a doula, she is there for the birth. But not neccessarily there before the birth, while the failure to wait brigade put the pressure on. I can point people towards the information, such as that of the NICE guidelines (along with a small reminder that they can decline anything, and that they haven’t actually got anything wrong with them). I can do this on the phone, or by text. In both these cases the women decided to opt for monitoring, and go home and wait. After all, you’re more likely to start labour in the familiarity of your own home, and start labour is what these women very much wanted, to help them towards their natural birth.
But they never got home. Why not? I don’t know. I wasn’t there. This guts me. Makes my stomach turn, because, apparently, they were bullied. Words were used to scare them into staying. This is not part of the NICE guidelines. They were both played the “dead baby card”. One was even told that if she declined induction, she had a 60 to 80% chance of her baby dying. I’m pretty sure she heard this wrong, as it is obviously clap trap, but the point is how she felt. Pressured, unsafe, worried, and ended up accepting induction, against every grain of her intuition. The other woman was actually labouring when the brigade upset her, and cajoled her into accepting induction. Her husband was apparently told that although she was showing signs of labour, if they don’t induce, it could “take all day”. Erm, yes. Both women spent their last few days of pregnancy in turmoil, stressed, willing their bodies to go into full blown labour, and grieving. Grieving the loss of their beautiful waterbirths. What are the chances of labour happening spontaneously when we are stressed, anxious, upset, feeling threatened and unsafe? Well, I know the answer, but the Failure to Wait brigade evidently don’t. They think they know better, they think they are helping, they think they are keeping babies and mothers safe. I don’t see this as safe. I don’t see it as helping. I don’t see it as compassionate. It has to stop. If they had been able to get themselves home, it needn’t have been like that. I grieve for them too.
For more information about induction and your choices,
http://www.nice.org.uk/nicemedia/pdf/CG070NICEGuideline.pdf
http://www.glorialemay.com/blog/?p=116
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How sad that this sounds too familiar. At 12 days “overdue” and in early labour (with proof from the test they actually referred to as a lie detector) we waited 5 hours for a 5 minute consultation with the doctor who played the dead baby and statistics card. I was incredibly lucky to have my husband with me who I think enjoyed challenging each “statistic” by asking how they actually knew what the current statistics were as medically intervening in natural births skewed the data 🙂 I continued to labour slowly, comfortably and peacefully at home. And I would do it all again exactly the same!!
I can totally relate to these cases and remember how you get indirectly pressured, especially after 2 days of monitoring after declining induction!!!
One of my friends got played the dead baby card too! And that was just a few days after her due-date. Luckily she understands statistics and referred to them, saying that she would wait until 14 days “over”due before discussing it again. Again luckily the baby was born before then (in the statistically correct timeframe) and did not have to discuss it again. How horrible it must be to have your home water hypno birth denied!!! So sad!
Yes, all too familiar 🙁 I hope it all works out well for your client, and with the minimum interference.
Well said, and I totally agree with every word. I was very angry recently as a friend was TOLD she would be induced on her due date as she’d had repeated bleeds from her cervix, although scans showed her baby was fine. During the final consultant meeting they said she no longer needed induction but they would still offer it if she wanted it, there were no medical indications whatsoever. My friend was seriously considering it too as she had this idea in her head her baby would be born on a certain date. Thankfully the baby had other ideas and was born a few days before its expected due date!