Like most L&D nurses, I hate to induce a primip with a long thick and closed cervix. Especially when she is not 42 weeks. Some babies go 42 weeks. We hate to see the 3 day induction. Which goes like this: 1st evening you get cervadil. Next morning we start pitocin even if you are still not ripe. Repeat cervadil in evening or maybe put in misoprostal next morning repeat pitocin. We might turn the pitocin off a few times if the floor gets busy during the day so you get set back a few times. By the 3rd day the woman and her partner are begging for a C-section. We hate to do this. Sometimes she pops into labor and delivers a baby no problem. But that is usually if she has a ripe cervix in the 1st place or by the end of 12 hours of cervadil. ...
Funny thing is no matter how much you tell folks about how the 3 day induction will suck, most will sign up for it. They must think, "Oh I won't be the 3 day induction and if I am I will get a c-section." I think most people down play the risk of c-section. Either they down play it or the catastrophize it. In my book a c-section is to be avoided if possible. It really is a big surgery but not a catastrophe. Most abdominal surgeries can be done by laproscopy. We have not figured out the laproscopic c-section.
It got me thinking about a blog I was following recently. Sometimes my google alerts kick up blogs of expecting moms and I end up scanning through them. This woman decided on an induction at 41+2 and wrote "I know I know, there are a lot of people out there that are against inducing, but [husband] and I are not." There are many ways the story could unspool, but the way it ended up was an induction beginning Sunday night, lasting through Monday night, and ending with a c-section on Tuesday morning due to exhaustion and slow progress. So, pretty consistent with Pinky's description.
This woman seemed OK with having ended up with a c-section, and I think it's great that she felt happy about her experience. But to me, it was illustrative of how choices with real consequences can start being treated as philosophic differences. I'm sure I would be placed into the class of one of the "lot of people out there" against inducing, but I am not "for" or "against" induction. Rather, I think that induction, particularly used electively and/or when the body is not ready (as measured by a Bishop's score), carries risks and that individuals should be aware of these risks.
Making the choice to use or not use an intervention involves a set of risks and benefits that every individual has to weigh for themselves. And one of the risks of induction is that it will be long, exhausting, slow, and result in a c-section which, as Pinky points out, carries real risk of its own. That's easy to ignore, though, when the discourse becomes whether people are "for" or "against" epidurals, inductions, c-sections, etc. That obscures the reality that these are not "chocolate or vanilla" choices of personal preference. It makes it easy to ignore the 3-day inductions and c-section complications, or at least to perceive them as common outcomes of labor (and so not consequences of the induction) vs. common outcomes of induced labor. It's hard because I think many people are trying to spread the word about the risks of induction. But if it's coming across as another "pick your flavor" choice, it's obviously not coming across correctly.