In a post on this thread, the term 'active management of labor' was used as
though elective induction were a part of it.
Active management of labor relates ONLY to labor which is spontaneous in
onset, and involves the use of IV Pitocin to ensure progress ONCE LABOR HAS
BEGUN.  The phrase was coined by O'Driscoll and Meagher, both obstetricians
at Dublin's National Maternity Hospital.  They wrote a fascinating book
about it (whatever your opinion of their policy, 'Active Management of
Labour' is great reading) and they say again and again and again that active
management rests on three pillars, the most important of which is NOT the IV
which 40% of mothers have, NOT the breaking of waters which is done on all
women found to be in labour with intact membranes on admission, but the
continuous (and they do mean continuous) companionship of an individual
midwife with each and every woman-- one-to-one care to 100% of women.
This hospital has an extremely low rate of induction of labor and
approximately 40% augmentation of first labours, as well as an impressively
low rate of operative delivery.  Pitocin augmentation of other than first
labours is very rare there.  The National Maternity Hospital has also
achieved Baby-Friendly status by the WHO/UNICEF criteria.
I am not saying they have all the answers, nor am I defending their very
active policy.  But whatever their faults, excessive use of induction is not
among them.
Rachel Myr
who believes that if you are going to give birth in a baby factory, it might
as well be one that acknowledges it's a factory and takes production and
quality control seriously

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