I am enjoying our discussion of how induction can have an adverse effect on
breastfeeding.  The number of inductions we were doing at our local hospital
got to be very frustrating for me as it was in direct conflict with my birth
philosophies.  I worked full time as a labor and delivery nurse 5 years ago
in a local civilian hospital.  When I got to work at 6am almost every time I
could be guaranteed I would be inducing someone all day long.  At that time,
we were not using cytotec (misoprostil) for cervical ripening.  We were
using Prepidil.  To make a long story short, I got tired of the Prepidil,
pitocin, amniotomy drill for twelve hours at a time, to then have to leave a
laboring at 6:30pm at night by turning her care over to the night shift who
attended her birth.  It took less than a year to get burned out on this
practice.

The reasons for induction varied and were much as have been described
previously, for social reasons.  I really don't have a problem with the
inductions we do for pre-eclampsia, IUGR, oligohydramnios or non-reassuring
fetal heart rate tracings.  These babies are usually better off being born
because conditions in the womb are not favorable for them.  It is also
interesting to note the huge numbers of posts I read on our Perinatal
Nursing discussion list about induction, sharing of protocols and
procedures.  There is even some squawking there about how we assist with too
many inductions with poor indications today and how the physicians get mad
at nursing when we can't take their inductions.

From a personal perspective, the topic also interests me because I am at
that point of being tired of being pregnant (36 weeks with baby #4) but am
healthier now than I have been at this point with any other pregnancy
because I am not working outside of my home any longer.  I can only imagine
how I would be feeling if I were still working, with swollen feet and an
aching back and a rising BP as I have had in the past three pregnancies.
How many of these women are really getting the rest that they need and are
going full speed ahead until they give birth?  Perhaps they just have more
energy than I ever did!  Anyway, yes I'm tired of being pregnant and would
welcome labor in another week but am perfectly content to let baby grow as
long as it need to.  I can't say that I felt that strongly with my previous
pregnancies.

The elective cesarean birth topic has been another hot topic in our area as
the conference on the subject was in Kansas City this spring.  You can read
more on the topic at:
http://hometown.aol.com/icanofkc/patient_choice_cesarean.htm

http://hometown.aol.com/icanofkc/GMA.htm

As for evening primrose oil, there are some who still recommend it.  We were
just talking about it at my baby shower this weekend.  You can apply it
directly to the cervix (I'd have to have someone help me!) or you can take
it orally starting at 36-37 weeks to ripen the cervix.  I won't be doing
this (I am probably walking around 2-3 cm dilated already!) but it is still
recommended for certain women.  I have not seen any science to back up the
practice or that this practice does any harm.

I will be going no mail soon for a few weeks for obvious reasons and will
let you all know how our birth goes.  I think it is time I go back to bed
(gotta love that pregnancy induced insomnia!)

Maurenne Griese, RNC, BSN, CCE, CBE
Manhattan, KS  USA
[log in to unmask]
http://www.networksplus.net/griese

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