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Friday, January 7, 2011

Some helpful advice for expectant moms:


Let's start with the basics:
EDD and inducing before 42 weeks
Unless your cycle is an exact 28 day cycle with ovulation on day 14 each and everytime and you only have sex once per cycle AND you can see the sperm enter the egg and implant, you CANNOT know when you will deliver. And consequently, even if you managed to fit the description above, you still CANNOT tell when you will deliver. Why? Because not all babies develop at the same rate and need to come out at the exact time. The whole 40 weeks is based on some old random scale anyway.

"The expected date of delivery (EDD) is 40 weeks counting from the first day of the last menstrual period (LMP), and birth usually occurs between 37 and 42 weeks.[13] The actual pregnancy duration is typically 38 weeks after conception. Though pregnancy begins at conception, it is more convenient to date from the first day of a woman's last menstrual period, or from the date of conception if known. Starting from one of these dates, the expected date of delivery can be calculated using the Naegele's rule for estimating date of delivery. A more accurate and sophisticated algorithm takes into account other variables, such as whether this is the first or subsequent child (i.e., pregnant woman is a primip or a multip, respectively), ethnicity, parental age, length of menstrual cycle, and menstrual regularity.
Pregnancy is considered "at term" when gestation attains 37 complete weeks but is less than 42 (between 259 and 294 days since LMP). Events before completion of 37 weeks (259 days) are considered preterm; from week 42 (294 days) events are considered postterm.[14]When a pregnancy exceeds 42 weeks (294 days), the risk of complications for both the woman and the fetus increases significantly.[13][15]As such, obstetricians usually prefer to induce labour, in an uncomplicated pregnancy, at some stage between 41 and 42 weeks.[16][17]Recent medical literature prefers the terminology preterm and postterm to premature and postmature. preterm and postterm are unambiguously defined as above, whereas premature and postmature have historical meaning and relate more to the infant's size and state of development rather than to the stage of pregnancy.[18][19]Fewer than 5% of births occur on the due date; 50% of births are within a week of the due date, and almost 90% within 2 weeks.[unreliable medical source?][20] It is much more useful and accurate, therefore, to consider a range of due dates, rather than one specific day, with some online due date calculators providing this information.Accurate dating of pregnancy is important, because it is used in calculating the results of various prenatal tests (for example, in the triple test). A decision may be made to induce labour if a fetus is perceived to be overdue. Furthermore, if LMP and ultrasound dating predict different respective due dates, with the latter being later, this might signify slowed fetal growth and therefore require closer review.The age of viability has been receding because of continued medical progress. Whereas it used to be 28 weeks, it has been brought back to as early as 23, or even 22 weeks in some countries."

Now I ask you...if even the WHO says that 42 weeks is still term and just fine and that only after that should you even consider induction if at all, why are doctors so happy to induce at exactly 40 weeks and sometimes earlier? What if your EDD was off by 2 weeks at least because you ovulated a little later that month? So, EDD off and doc thinks you should be induce because you are 39 weeks and haven't dilated? If your baby is born that day...he is then officially one week early, but, developmentally 4 weeks early. Chances are he will be small and need the NICU. I suggest you research and make an informed decision...ask for a NST(non-stress test) and determine how baby is handling everything and if uterus is working properly. If it is, then, let baby continue to develop as much as he needs.
Inductions

These should be avoided at all cost..however, there are sometimes clear medical need for an induction. If you choose to have one take these things into consideration...
Cytotec is very dangerous and should NEVER be used. It clearly states so on the package insert.

Cytotec®misoprostol tabletsWARNINGSCYTOTEC (MISOPROSTOL) ADMINISTRATION TO WOMEN WHO ARE PREGNANT CAN CAUSE ABORTION, PREMATURE BIRTH, OR BIRTH DEFECTS. UTERINE RUPTURE HAS BEEN REPORTED WHEN CYTOTEC WAS ADMINISTERED IN PREGNANT WOMEN TO INDUCE LABOR OR TO INDUCE ABORTION BEYOND THE EIGHTH WEEK OF PREGNANCY (see also PRECAUTIONS and LABOR AND DELIVERY). CYTOTEC SHOULD NOT BE TAKEN BY PREGNANT WOMEN TO REDUCE THE RISK OF ULCERS INDUCED BY NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) (see CONTRAINDICATIONS, WARNINGS, and PRECAUTIONS).

Cervadil is a better choice if one must do it.

If you are given Pitocin, keep in mind that it creates stronger than normal contractions and may stress out baby. If that happens and doctor mentions heart decelerations, ask him to turn down your Pitocin dosage, it is too strong for baby. Do NOT let him scare you into a c-section by telling you he has to "save" the baby...try turning down the too high Pit first and see what happens. Same goes for if you have an epidural with the Pitocin. The epi causes the Pit to slow down some. The doctor then turns up the Pit to compensate. You feel more pain and therefore need more Epi..it starts a vicious cycle. Baby will get distressed and his heart will decelerate and you will need "saved" by the skilled surgeon. Yeah, just ask him to turn it down some and let baby rest.

Breaking Your Waters Artificially

There is almost never a need for having your waters broken by the doctor. In fact, probably never a good reason. If you go in for an induction, NEVER let them break your water unless you are in active labor and a 10 already. Because once you do, there is no turning back, you are stuck in the hospital and will have baby withing 24 hours even if they have to cut it out. 
Babies can be born in their intact sac(in the caul). It is unheard of in todays water breaking happy doctors though. 
In fact, not breaking the water leads to less intense more manageable contractions and can cushion baby all the way out.

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