INDUCED into Induction – are we growing babies or rhubarb?

induce: verb
– To succeed in persuading or leading (someone) to do something. “the pickets induced many workers to stay away”.

Of course, the definition we usually use in maternity care is:
bring about or give rise to.
“none of these measures induced a change of policy”
We typically use it in the context of artificially bringing about the beginning of labour.
Thing is, it seems to me the first definition is as valid as the second right now.
I think many, many doulas and midwives would agree that every day, in every way,
women are being induced to be induced.

The persuasion comes in many forms:
Much better to pop it out before it gets too big, eh?
So much nicer to know the day your baby will be born. We can make a plan and know where we stand
If you’re anxious, we can start the process for you if you like
I’ll just pop your name on the induction list and get that all booked in for you
Just to be on the safe side, eh? We have to err on the side of caution
We need to get your baby out now (often followed by a 5 day wait due to short staffing and huge parental anxiety)

During other conversations, the shadows start creeping in:
You are high risk
You wouldn’t want anything to happen
We don’t do that here
It’s hospital policy
Your placenta will fail
We have to
We need to
I’m just going to
Relax, just relax

We are told we are too old and too young, too fat and too thin, too diabetic. Our mental health is blamed, or told that its because it’s our first baby or our 4th. The baby is too small and too big, we have too much water and not enough. We will never give birth on our own. We will bleed to death. We can’t have babies vaginally. There’s no choice here you are going to have to be induced.

And if we say we would prefer not to be induced?
“I’m afraid that is not possible
I’m not authorized to allow that
Did the consultant give you permission?
Does your husband think this is a good idea?
Tell your wife to be sensible
Do you want your baby to die?
I’m afraid I will have to refer you to Social Services
We have a legal obligation to….
Listen, this is not a prison. Of course you can go home anytime. But are you going to come back in two days with a dead fetus inside you and say I didn’t warn you?”*
And when a mother has been induced to be induced, she is booked in with a smile and not told…
Not told about the wards, bursting at the seams
Not told about the noise and lack of sleep
Not told about the hospital being closed so their induction is paused
Not told about the lack of staff so their induction is paused
Not told about Delivery Suite being full, so their induction is paused
Paused
Paused
Paused…

Not told that despite the ’emergency’ that requires their baby to be immediately evicted, the process could take a long time, or not work at all.
Not told that they may be left to labour alone on a ward without their partner.
Not told about the lack of space, the heat, the terrible food, the shared toilet and showering facilities.
Not told what happens, in what order and why.
Not told that sometimes it happens too quickly; the womb overstimulated in a white heat of pain.
Not told that often it doesn’t happen at all.
Not told about the 4-hourly vaginal exams, the drips, the monitoring belts, the coming and going, the changing of shifts.

Induction is a choice. An item on the menu.
Choose according to your circumstances, preferences and instincts.
Choose based on information that is as factual as possible.
Choose based on the pros and cons.
Choose knowing the actual chances of various things happening (absolute not relative risk).
Choose knowing your care is being individualised to you.
Choose knowing that you are not being processed on a one-side-fits-all conveyor belt.
Choose knowing no one has a crystal ball.
Choose after conversations with people who are not crippled with fear.
Choose trusting yourself and your caregivers.
Choose having been given time and physical space and privacy.
Choose in the knowledge that you are the expert in your own baby.

Most of all, choose freely, without manipulation, coercion, blackmail, cul de sacs, fait accomplis, fearmongering, dead baby cards, well meaning platitudes, patronising exchanges, mansplaining, blinding with science, a sense of obligation to your caregiver, fear of being punished, or fear of having your children removed.
Because babies are not rhubarb. Most of the time, they do not require forcing in the dark.

*all real quotes from our clients