But what DOES the research say?
It’s something a doctor said to me when I was pregnant with my second child... “I strongly recommend we induce you”. I’d been induced with my first and was adamant not to be induced this time round unless absolutely necessary. But my waters has released and my contractions hadn’t started, and I’d agreed to go in to hospital to get assessed. The midwife had checked me out and recommended I stay for an induction, which I had declined, so she’d gone to get a doctor to convince me (don’t even get me started on the laundry list of issues I now have with this whole series of events looking back now!). It hadn’t even been 12 hours since my waters had released, so when I went in, doula at my side, armed with the NICE guidelines to back up my choices, I hadn’t expected to be faced with so much coercion. Antibiotics and an induction was repeatedly recommended, along with “your chances of infection doubles if you don’t have an induction”, and “do you want to harm your baby?”. I refused the antibiotics (I’m not against antibiotic use, but I had no fever, no sign of infection, and didn’t want prophylactic use unnecessarily), and the induction, and decided to go home and do everything I could to bring on labour naturally. I went on to have a wonderful positive water birth in the midwife led unit.
The thing that I find worrying, is that if I had not done my research, and had not had a strong and well informed advocate by my side reminding me of my preferences and options, I would probably have given in and agreed to the induction, robbing myself of the positive healing birth I so desperately needed. That statement “your chance of infection doubles if you’re not induced” isn’t a lie. It does. But the devil is in the details, and what was neglected to be mentioned, is that it doubles from 1% to 2%. A fact that was obviously left out. This small fact is hugely important in the decision making process. Had it been doubled from 25% to 50% it would have potentially been a totally different decision to make. Had I done more in-depth research at the time, I’d have also known that vaginal exams increase that risk of infection once waters have released. In fact, internal exams triple the chances of a
PROM in the first place. There are so many factors to consider when making decisions about birth. How many weeks pregnant are you? Are you pre or post 37 weeks? Do you have any other medical factors influencing the recommendations being given to you? Gestational diabetes? Pre-eclampsia? Blood pressure? What about your own personal preferences? Mental health impact? Previous trauma? All of these factors may or may NOT have been considered. Every person, every pregnancy is unique.
The point of this post isn’t to persuade you to decline all interventions, far from it. Medical interventions certainly have their time and place. Neither is it to paint all midwifes ad doctors as medicalised birth bullies. What I AM saying, is that in pregnancy it is so important to do your research. Even MORE helpful is to have someone knowledgeable about birth to help you both FIND that research and INTERPRET it. Just as with anything, how research is presented can be coercive or factual and unbiased, so knowing WHERE to look up the facts and basing your decisions on reliable sources can be tricky without help. This is where people like me can help. Paying for a hypnobirthing and antenatal class, particularly a live 121 course, can seem like a large amount of money to justify.... until you’re faced with a change in your path to birth and need support, knowledge and signposting from an expert. The book you read or prerecorded course you downloaded isn’t going to be able to help you. But do ac course with an instructor and we will go above and beyond to look up the info you need, there and then, in order for you to make that informed decision from good quality info. And looking at my story above, it’s easy to see how quickly your journey can change without fully understanding your options. You probably won’t regret buying that slightly cheaper model pram in 20 years time. Can you honestly say the same if you end up with birth trauma, full of what ifs?
If you’d like more info on PROM, you can read the latest research at https://evidencebasedbirth.com/evidence-inducing-labor-water-breaks-term/