And I would add homeopathy can help too.......
More articles at
http://pregnancytoday.com/experts/cpm-naturalinduction.htm
http://www.drfeder.com/pregnancy/doula-pitocin-labor.htm
http://www.moondragon.org/obgyn/pregnancy/vbac2.html
http://homeopathyworld.com/childbirth_guide.htm  (best used with homeopaths
help)
http://www.gentlebirth.org/archives/  Midwife Archives

BOOKS
http://www.nccn.net/~wwithin/bookstor.htm#homeopathy
Homeopathy for Pregnancy, Birth & Your Baby's First Year by Miranda Castro,
Homeopath
Homeopathic Medicines for Pregnancy & Chidlbirth by Richard Moskowitz, MD,
Homeopath

***********
Mothering Magazine
http://www.mothering.com/11-0-0/html/11-2-0/11-2-babydecide105.shtml

Pregnancy and Birth: Birth Preparation
 
Let the Baby Decide: The Case against Inducing Labor
Issue 105, March/April 2001
By Nancy Griffin

It was a sunny Friday afternoon, and Tracy was three days past the due date
for her first baby. After finishing up the tenth call of the day from
well-meaning but anxious friends and relatives, she headed out the door for
her weekly checkup with her obstetrician. "If you don't go into labor by
your next appointment, we may have to induce you," her doctor had advised.
Tracy wondered if the slight menstrual-like cramps she'd had the past few
days meant that something was happening at last.

At the doctor's office, a vaginal examination revealed that Tracy was 2
centimeters dilated, her cervix 80 percent effaced, with the baby at minus
one station. According to an ultrasound scan, her amniotic fluid levels
seemed borderline low, and because she was having mild contractions, the
doctor suggested that she "go on over to the hospital and have a baby today!"

Excited, Tracy called her husband at work. He rushed to meet her at the
hospital, where she was admitted and hooked up to an IV. Eight hours later,
with no further progress, Tracy received an epidural, and labor was induced
by the intravenous administration of the commonly used drug Pitocin. A few
hours later, her bag of waters was broken artificially; 36 hours later,
Tracy was recovering from a C-section after delivering a healthy, 7-pound
baby girl. Why did Tracy have to undergo a C-section? What, if anything,
had gone wrong?

Nearly two decades ago, Roberto Caldreyo-Barcia, MD, former president of
the International Federation of Obstetricians and Gynecologists and an
eminent researcher into the effects of obstetrical interventions, made the
stunning statement that "Pitocin is the most abused drug in the world
today."1 According to the Journal of the American Medical Association, 16
percent of expectant mothers are induced in the US; another 16 percent go
into labor spontaneously but are helped along ("augmented") by Pitocin or a
variety of other labor-stimulating interventions.2 Other estimates range
from 12 to 60 percent of mothers, depending on whether the numbers refer to
type of induction or augmentation, the population sample, or the mother's
socioeconomic background.3-18

Pitocin is a synthetic oxytocin (the natural hormone that induces labor)
made from pituitary extracts from various mammals, combined with acetic
acid for pH adjustment and .5 percent chloretone, which acts as a
preservative. The World Health Organization deplores routinely using
Pitocin. The Physicians' Desk Reference says that Pitocin should be used
only when medically necessary, beginning with a minimal dosage, as there's
no way of predicting a pregnant woman's response. The induced mother should
receive oxygen, be continuously monitored by EFM, and have competent,
consistent medical supervision. At the first sign of overdosage, such as
tetanic contractions or fetal distress, Pitocin should be discontinued, and
the patient treated with symptomatic and support therapy. After being
induced, the laboring mother can still help her labor progress through
natural techniques such as walking (if she's not had an epidural), changing
positions, emptying her bladder once an hour, and nipple stimulation.
Pitocin can cause increased pain, fetal distress, neonatal jaundice, and
retained placenta; and recent research suggests that exposure to Pitocin
may be a factor in causing autism.19-20

A survey by Robbie Davis-Floyd, a cultural anthropologist at the University
of Texas, found that 81 percent of women in US hospitals receive Pitocin
either to induce or augment their labors.21 Regardless of exactly how many
labors are induced in the US today, the majority aren't medically
necessary, and between 40 and 50 percent resulted in failed induction.22 A
review of the medical literature on routine induction of labor reveals that
disagreement among medical researchers in different countries is rampant,
and no conclusive evidence exists that routine induction of labor at any
gestational age improves the outcome for either mother or baby.23
Caldreyo-Barcia concluded that induction is medically required in only 3
percent of pregnancies24 and that therefore approximately 75 percent of all
inductions put both the mother and baby at risk.25

The "Cultural Warping of Childbirth"
Induction of labor is defined by the American College of Obstetricians and
Gynecologists (ACOG) as "the stimulation of uterine contractions before the
spontaneous onset of labor for the purpose of accomplishing delivery"--that
is, artificially starting a labor that has not begun naturally on its own.
Augmenting labor, often confused with induction, is a slightly different
process, used to help or speed up a labor that began on its own. Midwives,
physicians, and other healthcare providers have been inducing labor for as
long as the human race has attempted to gain control over the processes of
nature. A basic fear of the natural process of childbirth has led, over
many centuries, to what President of the American Foundation for
Maternal-Child Health Doris Haire describes as "the cultural warping of
childbirth." Justifiable fear about the possible death of a baby or mother
in childbirth, combined with beliefs in magic, rituals, drugs, herbal
remedies, and much later, technology, has led to the use of a whole host of
"cures" for labors that didn't seem to start "on time."

In his classic book Husband-Coached Childbirth, Robert Bradley, MD,
compares the arrival of human babies by nature's schedule to fruit ripening
on a tree. Some apples ripen early, some late, but most show up right in
season. Along with Grantley Dick-Read, the father of what we now call
"natural childbirth," Bradley advocated relaxation, trusting nature, and
allowing babies to show up when nature intended.

Artificial oxytocin, or Pitocin, was successfully synthesized in 1953, and
two years later it was available to physicians for the inducing and
augmenting of labor. By 1974 it was well known that Pitocin had a 40 to 50
percent induction failure rate;26, 27, 28 and in 1978, largely due to the
work of Doris Haire, Pitocin was investigated by the US Senate and the
General Accounting Office. Between 1978 and 1981, Haire testified at three
congressional hearings on obstetric care, which included reports on the
dangers to mothers and babies of the routine and elective induction of
labor. (Elective induction is defined as the induction of labor without a
clear medical indication.)

One compelling theory, presented at the 1996 annual meeting of the American
Psychiatric Association by Eric Hollander of Mount Sinai Medical Center in
New York, links autistic children with Pitocin-induced labors. Hollander
suspects that Pitocin interferes with the newborn's oxytocin system,
producing the social phobias of autism. When he administered oxytocin to
autistic patients, it made them four times more talkative, and according to
the patients themselves, twice as happy, although not all patients
responded.29

In 1978, the FDA advisory committee removed its approval of Pitocin for the
elective induction of labor. (The drug has never been approved by the FDA
for the use of augmenting labor.) The current Physicians' Desk Reference
clearly states that "Pitocin is not indicated for elective induction of
labor." An innovative New York Public Health Law, section 2503, passed in
1978, requires physicians and midwives to provide full, informed consent to
laboring mothers regarding the use of drugs during labor and delivery.

Today, despite the problematic nature of inducing labor and the lack of
hard data supporting these protocols from carefully designed controlled
trials, the routine elective induction of labor in both normal and
gray-area pregnancies (ones not yet showing clear medical indication, just
possibilities) is still common.

Why Induce Labor?
According to ACOG, "Induction of labor is indicated when the benefits to
either the mother or fetus outweigh those of continuing the pregnancy."30 A
very small number of babies (a typical estimate would be less than
Caldeyo-Barcia's 3 percent, mentioned above) actually need to be induced
for medical reasons. Another 3 to 12 percent seem to want to drive their
mothers crazy and hang out inside that wonderful, warm, loving womb. No one
knows why these suspected "postmature" babies choose not to make an
appearance exactly when those of us on the outside want them to.31

Actually, the percentage of babies born exactly on their predicted due date
is so small it's a wonder we bother with due dates at all. It's perfectly
normal for 80 percent of healthy babies to have anywhere from a 38- to
42-week gestation.32 Several generations ago, a physician might tell an
expectant mother that she was due "sometime in late October or early
November"; today, women are given a "precise" due date, often determined by
ultrasound testing. Many instances of so-called postmaturity result from
nothing more than an inaccurate due date.

Robert Mittendord of the University of Chicago Medical Center has isolated
16 factors that can influence the accuracy of a predicted due date.
Ethnicity may play a role; African-American women, for instance, often have
pregnancies that are, on average, three to eight days shorter than those of
other women. First-time mothers can almost be counted on to deliver ten
days or more after their due date. The length of gestation seems to peak
for babies of mothers who are around 29 years of age, so maternal age may
be a factor. Caffeine consumption makes pregnancies shorter. Taking The
Pill up to two months before conception can cause havoc with due dates.
Finally, because biologic variation in fetal size increases throughout
gestation, ultrasound dating can be deemed somewhat reliable only in the
first trimester.33

The gestational age of an unborn baby is best determined by looking at a
number of different factors. If you combine an accurate date of the last
menstrual period with a first-trimester pelvic exam, fundal measurement
(from the pubic bone to the top of the uterus), date of "quickening," and a
fetal heart tone, then confirm these findings with a first-trimester
ultrasound, you'll end up with a due date that is still only 85 percent
accurate, plus or minus 14 days. Second-trimester ultrasounds tend to be
inaccurate by plus or minus 8 days, and third-trimester ultrasounds by a
whopping 22 days.

It's probably best to stick with the "late November, early December" method
unless you are fortunate enough to know the exact date of conception,
another way to attempt to pinpoint a due date. Medical science recognizes
in vitro or artificial insemination as the only accurate means of
determining conceptual age. However, if a woman was using an ovulation
predictor test correctly, or her husband was home between business trips
only once after her period ended (and she actually wrote this date down on
a calendar), she could nail down her due date by counting forward ten lunar
months from conception. Even so, she might end up with a baby who
stubbornly decides to belong to that 10 percent who go beyond 40 weeks.
Despite all of these calculations, an induced baby may turn out to be
premature rather than postmature.

What Exactly Is Postmaturity?
ACOG defines a post-term pregnancy as one that lasts beyond 42 weeks of
confirmed gestational age. The need to diagnose postmaturity accurately is
important because perinatal mortality, the risk of fetal distress, and the
need for C-sections double by 42 weeks.34-38 Risks of true postmaturity
include stillbirth, meconium aspiration, and "dysmaturity syndrome," found
in some babies adversely affected by being in a declining uterine
environment. Robert Hamilton, assistant clinical professor of pediatrics at
UCLA, says that in all his years as a pediatrician, he has seen actual
postdate babies less than 5 percent of the time. Moreover, the vast
majority of post-date babies overcome problems after birth and are
ultimately healthy.39, 40 AGOC estimates that 95 percent of post-term
babies are born safely between 42 and 44 weeks.41-45 (Perhaps these babies
were meant to "ripen" a bit later than their "average" counterparts.)

The most accurate current criterion for diagnosing postmaturity is the
mother's amniotic fluid volume. As placental function decreases in a true
postmature pregnancy, blood flow and blood pressure in fetal organs
decreases. The result is lower levels of amniotic fluid, as measured by an
amniotic fluid index. Fluid levels of less than 5 centimeters are
considered low and greatly increase the risk of cord prolapse. A normal
level is 8 centimeters or more; 5 to 8 centimeters is borderline.
(Borderline fluid levels can be caused by something as simple as
dehydration, so a woman should be sure to drink plenty of water throughout
her pregnancy.)

It is not known whether the increased risk to the baby is caused by the
postmature pregnancy itself, or if some babies who are inherently at
greater risk are more likely to be overdue. Therefore, it is difficult to
determine via research if the timely induction of labor decreases the risk
in post-term pregnancies. The American Academy of Family Physicians' 1996
Assessment of Post-Term Pregnancies concludes that whether there is any
"fetal testing modality that will provide the most accurate prediction of a
healthy fetus is debatable."46

How Does Labor Begin Naturally?
Up until recently very little was known about how natural labors actually
begin. Scientists knew that the release of oxytocin resulted in both
uterine contractions and milk production. Pioneering research by scientists
at Cornell University, the University of Pittsburgh School of Medicine, and
the University of Auckland, New Zealand, suggests that it's the baby's
brain that initiates birth.47

These researchers discovered a pea-sized region of the fetal sheep brain
called the paraventricular nucleus, which actually serves as a biosensor
designed to trigger the events leading to a birth. Two hormones, corticol
and adrenocorticotropic hormone (ACTH), reach peak levels in the fetal
bloodstream just before birth. Peter W. Nathaniels of Cornell University
suggests that the "fetal brain may act as a tiny monitor, tracking its own
development."48 When the baby is ready for birth, the paraventricular
nucleus signals the fetal pituitary gland to increase ACTH secretion. The
pituitary, in turn, tells the fetal adrenal gland to secrete more cortisol.
These hormonal increases cause changes in the mother's hormones, including
the release of oxytocin, which lead to uterine contractions. Because
scientists speculate that a malfunction of the fetal biosensor may account
for early or late births, this research may prove helpful in the future,
both to stop premature labor or to effectively induce a truly postmature
pregnancy.

All of the currently available methods of inducing labor bypass this
important first step of fetal paraventricular nucleus biosensor interaction
between the hormonal systems of both mother and baby.

Protecting Our Unborn Babies
Labor should be induced only when medically necessary, never simply for
convenience or because a woman is sick of being pregnant. The risks in
these situations far outweigh the perceived benefits. Determining
postmaturity or a woman's readiness to give birth are complex processes. We
are just beginning to understand the long-term effects on the fetal brain
of drugs such as Pitocin, and the exact long-term effects of inducing or
augmenting labor are unknown. Pregnant woman wanting information on the
safety of a drug can consult the Physicians' Desk Reference or call the
product safety officer at the pharmaceutical company where it is
manufactured.

Not all babies appear to be harmed by the inducing or augmenting of labor,
but these procedures do carry risks. According to Doris Haire, "The fact
that Pitocin can shorten the normal oxygenating intervals that occur
between contractions is a threat to the integrity of the fetal brain and
can have lifelong consequences for the affected baby."49

Pregnant women owe it to themselves and their unborn babies to do
everything they can to stay healthy and thereby minimize or prevent the
need for medical induction. Babies born from natural, spontaneous labors
have the best overall outcomes, and their mothers experience easier labors
and quicker postpartum recoveries.

Natural Methods for Inducing Labor
Suggestions for the natural induction of labor have ranged from taking
castor oil to having sex. Before turning to a few techniques that might
actually work, let's take a look at some of the "old wives' tales" that
have made the rounds.

Castor oil simply causes the person taking it to empty her bowels quickly
and efficiently. Because the uterus is so tightly wedged against the
intestines, movement in the bowel can sometimes trigger uterine activity.
Castor oil looks like a pretty silly remedy when one realizes the complex
interaction between the brain chemistry of the mother and the baby leading
to labor. Take castor oil only under the supervision of a midwife or a
doctor. Balsamic vinegar and senna tea have similar but much weaker effects
on the intestines.

Uterine-stimulating herbs, such as black cohosh (Caulophyllum), blue cohosh
(Cimificugua), achyranthes root, goldenseal, motherwort, wild ginger, and
red raspberry leaf, have been used to induce labor. No long-term follow-up
study has ever been carried out to show that the use of herbal remedies is
safe for inducing labor. All drugs, including medicinal herbs, reach the
baby, and any dosage that has an effect on the mother is going to have an
overdosing effect on the baby simply because the mother's body weight is
about 20 times greater. A pregnant woman, therefore, should never
self-prescribe any medicinal herb. Anyone who must be induced for a medical
reason, and who wishes to use alternative induction methods, should be
guided by a knowledgeable herbalist, acupuncturist, or aromatherapist.

Essential fats and oils such as pennyroyal and safflower have historically
been used to treat all manner of female complaints and are considered to be
alternatives to cervical gel (artificial prostaglandins applied directly to
the cervix to "ripen" it). Safflower is simply a safe cooking oil, but
pennyroyal is known to have potential abortive effects.

Acupressure is considered by some American practitioners as potentially
effective in jogging a late labor, but traditional Oriental practitioners
almost never use acupuncture on women at any time during pregnancy.
Traditionalists believe in trusting Mother Nature.

Aromatherapists advocate the use of the oils of lemon, clarysage, and
fennel, which are massaged into the abdomen and inhaled by the expectant
mother. Anything inhaled by a pregnant woman, however, is also inhaled by
her baby, and cannot therefore be deemed safe.

Sex is an age-old method of induction that seems to be effective. Prolonged
and continuous nipple stimulation results in the natural release of
oxytocin and is a proven nonmedical method for inducing labor.50, 51, 52
The release of semen onto the cervix during intercourse can promote
cervical ripening because semen contains prostaglandin, a hormone partially
responsible for cervical softening.

Finally, relaxation--mental, physical, and emotional--prevents the pregnant
woman from releasing adrenaline, a hormone that stops labor so that the
expectant mother can find safety first before her baby is born.

All of these things, together with a healthy lifestyle, good nutrition, and
a healthy pregnancy, combine to produce healthy babies who show up on
time--the exact moment when nature intended.


Medical indications for inducing labor may include, but are not limited to,
the following conditions in either mother or baby:

High blood pressure
Premature rupture of the membranes
Maternal infection or medical problems, such as diabetes mellitus, kidney
disease, or chronic pulmonary disease
Suspected fetal jeopardy
Fetal death
Severe blood incompatibility
Severe pre-eclampsia or toxemia
Postdate pregnancy, where there is a proven danger to the baby
Source: American College of Obstetricians and Gynecologists 

Notes


1. Diana Korte and Roberta Scaer, A Good Birth, A Safe Birth (New York:
Bantam, 1984).

2. JAMA Statistical Bulletin (January 21, 1998).

3. "Induction of Labor," American College of Obstetricians and
Gynecologists Technical Bulletin 217 (December 1995).

4. "Induction of Labor in Postterm Pregnancy," ICEA Review 12, no. 1
(February 1988).

5. See Note 2.

6. "Expectant Management While Waiting for Spontaneous Labor Compared to
Immediate Induction Following PROM," New England Journal of Medicine (1996).

7. Assessment of the Postterm Pregnancy, American Academy of Family
Physicians, 1996.

8. "A Critical Review of the Recent Literature on Postterm Pregnancy and a
Look at Women's Experiences," Birth (1985).

9. "Elective Induction v. Spontaneous Labor: A Retrospective Study of
Complications and Outcomes," American Journal of Obstetrics and Gynecology
(1992).

10. "Postdate Pregnancy, Part 1 and 2," Journal of Nurse-Midwifery (1985).

11. "Postmaturity: Much Ado about Nothing?," British Journal of Obstetrics
and Gynecology (1986).

12. "Prolonged Pregnancy: The Management Debate," British Medical Journal
(1986).

13. "Elective Induction of Labor," The Lancet (May 1975).

14. Henci Goer, Obstetrical Myths v. Research Realities (Westport, CT:
Bergin and Garvey, 1995).

15. See Note 1.

16. Sally Inch, Birth Rights (New York: Pantheon, 1984).

17. "Care in Normal Birth," The World Health Organization.

18. Robbie Davis-Floyd, Birth as an American Rite of Passage (Berkeley:
University of California Press, 1992).

19. See Note 17.

20. "Life in a Parallel World: A Bold New Approach to the Mystery of
Autism," Newsweek, May 13, 1996.

21. See Note 18.

22. See Note 16.

23. See Note 14.

24. Ibid.

25. See Note 1.

26. The Physicians' Desk Reference, 52nd ed. (Montrale, NJ: Medical
Economics Co., 1998).

27. See Note 10.

28. "Neonatal Morbidity and Mortality and Long-Term Outcome of Postdate
Infants," Clinical OB-Gyn (1989).

29. See Note 20.

30. See Note 3.

31. See Note 7.

32. Ibid.

33. Ibid.

34. See Note 4.

35. See Note 7.

36. See Note 8.

37. See Note 10.

38. See Note 11.

39. See Note 4.

40. See Note 7.

41. See Note 4.

42. See Note 7.

43. See Note 8.

44. See Note 10.

45. See Note 11.

46. See Note 7.

47. "Fetus Tells Mother It's Time for Labor," Science News.

48. Ibid.

49. Personal interview, Doris Haire, September 23, 1998.

50. Jacques Gelis, History of Childbirth (Boston: Northeastern University
Press, 1991).

51. Richard Wertz, Lying-In: A History of Childbirth in America (New Haven,
CT: Yale University Press, 1989).

52. See Note 18.

Resources

The Bradley Method. The American Academy of Husband-Coached Childbirth.
91413-5224 PO Box 5224, Sherman Oaks, CA 91413. 800-4-A-BIRTH
(800-423-2397) www.bradleybirth.com

The American Foundation for Maternal and Child Health. 439 E. 51st Street,
New York, NY 10022. 212-759-5510

International Childbirth Educators Association. PO Box 20048, Minneapolis,
MN 55420. 612-854-8660. www.icea.org

American College of Obstetricians and Gynecologists (ACOG). 409 12th
Street, SW, Washington, DC 20024-2188. 202-863-2518 (Resource center).
www.ACOG.org

National Association of Parents and Professionals for Safe Alternatives in
Childbirth (NAPSAC). Rt. 4, Box 646, Marble Hill, MI 63764. 573-238-2010.

Internet Resources (available by subscription or at libraries)

Infotrac, Medical Lexus, Medline, Elsevier

Science Books

Brackbill, Yvonne. The Birth Trap. C. V. Mosby, 1984.

Bradley, Robert. Husband-Coached Childbirth. Bantam Books, 1996.

David-Floyd, Robbie. Birth as an American Rite of Passage. University of
California Press, 1992.

Dick-Read, Grantley. Childbirth without Fear. 5th ed. Harper & Row, 1984.

Edwards, Margot, and Mary Waldorf. Reclaiming Birth. The Crossing Press,
1984.

Elkins, Valmai Howe. The Rights of the Pregnant Parent. Shocken Books, 1980.

Goer, Henci. Obstetric Myths versus Research Realities. Bergin and Garvey,
1995.

Inch, Sally. Birth Rights. Pantheon Books, 1984.

Korte, Diana, and Robert Scaer. A Good Birth, A Safe Birth. Bantam, 1984.

McCutcheon, Susan. Natural Childbirth the Bradley Way. E. P. Dutton, 1984.

Mitford, Jessica. The American Way of Birth. Penguin Books, 1992.

Romalis, Shelly. Childbirth: Alternatives to Medical Control. University of
Texas Press, 1981.

Rothman, Barbara. In Labor: Women and Power in the Birthplace. W. W.
Norton, 1982.

Nancy Griffin, MA, AAHCC, is the mother of a 16-year-old daughter and owner
of the Mommy Care Mothering Center in Los Angeles. She is a Bradley Method
childbirth teacher at St. John's Hospital, a lactation educator, and an
expert in pregnancy and postpartum exercise. Nancy would like to thank
Haire for her invaluable assistance with this article.