why, oh why?

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Test may help pick time to induce labor

This test has been available for years, and was originally marketed as being a way to determine who was most at risk of preterm birth. I guess that they weren't making enough money off it...........

I get a lot of mamas who are STOP (sick and tired of pregnancy) and want to be induced. I won't induce a mom unless there is a legitimate indication. If a mom has a medical indication, you do what you have to in order to get the baby out. A test like this will let you know how easy or hard that will be, and maybe suggest whether or not cervical ripening would be a good idea. But the test costs more $$ and time than simply starting the ripening process.

I think that I have done maybe 2 'social' inductions in the last 5 years - and even those were of moms who were ripe and ready and would probably have done it on their own.


Sounds like a money maker to me.

On the other hand, I wish my doctor had done something like that before he induced my second baby. (He was leaving the country on vacation and didn't want to leave me to be attended by his associates. Because he considered me "high risk. Whatever.) I was not ready. He had tried stripping the membranes twice before he finally checked me into the hospital. I was not ready. Talk about unpleasant.... I won't complain anymore because it was 25 years ago, and the outcome was good and the baby has grown into a wonderful woman. But still, when I here the word 'induction' I tend to grab my abdomen and want to groan.

This test is routinely used in Nunavut, in the high Arctic.

You see, moms have to be flown to a community with a hospital or a midwife birthing centre -- and then sit around at a medical boarding home, away from family and other childern, for weeks. (Please don't suggest they drive there -- there are no highways in Nunavut. None!)

With fFN tests, the moms get to stay in their home commuities longer -- and it saves the government money (shorter stay at the boarding home.)

Cin, you bring up a very good point. The problem is, my first medical practice would have urged the same thing to me about an excessive drive to the hospital, and I live five minutes from the hospital. ;-)

We've seen "necessity creep" in many areas of medicine. Your case is a clear-cut yes. Mine is a clear-cut no. But I do know a woman who was induced because she lived 20 minutes from the hospital on a heavily-traveled route during rush-hour (hence likelihood for backup) and the doctor "didn't feel comfortable" with letting her go past 37 weeks. Go figure.

I do find it ironic that they're touting the medicinal value of allowing the body to get ready naturally for labor. God also invented something that allows the body to get ready for labor naturally. It's called "time".

Cin-Why isn't there anyone in their home community who can help them give birth to their babies in their own homes? Like, how did the Inuit (that is the right word for "Eskimoes", right?) manage to give birth before the invention of airplanes?

What do they do there if someone has a life threatening accident? They air lift them to a hospital, right? Or they have some local center which can handle some emergencies, stabilize worse cases there and airlift them to a hospital. Right? So, some sort of emergency airlift has to be available for the few women who would need to be transported to the hospital because they had difficulty giving birth at home. That way the 95% of women who DONT need to be miles away from home in a hospital could have normal unmedicalized births in their own home. No induction, no airplane ride, just go about your business in your own home until labor comes on, then call your husband, your friends, and your midwife, and have a baby.
Susan Peterson


Sounds so easy -- but you have to understand a few things.

First, the Inuit (yes, Eskimoes is the old name) prefer to give birth in a place where there's a doctor nearby in case of emergencies. Before airplanes, everyone did give birth at home -- and some women died. Inuit elders prefer to spare their granddaughters that risk, so they tend to demand obstetrical care in a location with an MD --and what the elders say, goes.

Second, you need to understand the geography of the place. If something goes wrong, you may have to wait three hours just for the very fast medical Lear jet (medevac) to arrive, then three hours in the plane (with nurses and often a doc) until you reach the hospital in Iqaluit. This makes women understandably nervous about home birth.

Third, you must understand there are only 30-thousand people in Nunavut -- and the place is about as big as the U.S., or bigger. So not all communities even have a nursing station, let alone a doctor.

The Nunavut government has come up with a brilliant compromise -- it built a birthing centre, then trained traditional midwives, or their daughters and granddaughters, to be certified midwives. They set them up in Rankin Inlet, and placed a doctor in the community who can do an emergency section at the centre if required.

It's a start.

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