Talking Turkey: Due Dates, Induction & the Holidays

In the United States, this week kicks off the madness fun of the holiday season. Friends and family visits, favorite dishes and desserts, time-honored traditions, along with a little chaos in between -- it's all part of the season. But if you're pregnant and due near the end of November or December, there may be added stress and concern this holiday season.

Around the holidays, many pregnant women experience pressure from family or healthcare providers to schedule baby's birthday around festivities and travel plans, otherwise known as "elective induction." It's important to understand, however, that scheduling a baby's birth day without a compelling medical reason can cause increased and unnecessary risks for you and your baby.

"Thanksgiving isn't a complication of pregnancy," says Lamaze President Robin Elise Weiss, MPH, PhDc, CD(DONA), CLC, LCCE, FACCE. "And yet, it's fairly typical for labor and delivery wards to be extra busy in the days and weeks leading up to a major holiday like Thanksgiving and Christmas. Inductions make it easier for care providers to manage their own holiday schedule, so it's important for women to know why induction is being recommended."

Families also can be enticed to schedule induction, as it's easy to get caught up in the stress of the holidays, the uncertainty of baby's arrival, and how that will play into the celebration of holidays. Some women also fear that their preferred provider won't be on call and agree to schedule birth in order to guarantee their availability.

"I really understand that pressure," said Sue Galyen, RN, MSN, HCHI, LCCE, FACCE, a Lamaze childbirth educator from Brownsburg, IN. "You build a relationship with your care provider over the course of a pregnancy. Plus, you build up expectations about your holiday celebration. So it seems like 'no big deal' just to get the birth over with. But it's so hard to think that a scheduled birth, whether through induction or cesarean, was worth it when either mom or baby experience a complication as a result."

One of the most common complication from scheduling your baby's birthday is that baby is born too early. A growing body of research shows that giving a baby those last few weeks and days inside the uterus can be crucial to the baby's health. Babies born even a little early face risks including breastfeeding difficulties, learning and behavioral problems, breathing problems, increased chance of time in the neonatal intensive care unit (NICU), and risk of death.

The process of induction, including the use of interventions like pitocin, continuous electronic fetal monitoring (EFM), and artificially breaking your water, carries individual added risks to mom and baby, as well as increasing the chance of ending in cesarean.

You can play a key part in avoiding prematurity. Signs that you're being pressured into an unnecessary early delivery include:

• Care provider suggests that the baby is too big and will be easier to deliver a little early
• Suggestion is made that specific care provider won't be available for a holiday birth or will be booked up
• Timing of the birth is centered around travel and celebration schedules
• Holiday stress is driving feelings of wanting to get the pregnancy over with

Here are some things you can do if you feel you are being pressured into an early birth:

• Ask your provider if you need to make a decision right now. Few decisions need to be made on the spot unless the mother or baby are clearly doing poorly.
• Research your options. Use credible sources of information, like Lamaze, Childbirth Connection, or your doula to see what the research says and talk to other moms about their experiences.
• Make a pro/con list. Label your pros and cons with medical vs. personal and weigh the medical pros and cons more heavily. If you are talking about a major medical intervention like cesarean or induction and you don't have a good list of cons, it's a good sign that you need to do more research.
• Trust your gut. Your instincts are geared to protect you and your baby from risk. Listen to what your gut is saying in the context of the research.
• Find support. It's hard to disagree with your health care provider, so be sure that you go into your appointments with solid information or someone who can help you have an informed, evidence-based conversation about your best options.

Elective induction -- inducing labor without a compelling medical reason -- is one of many routine interventions that has not proven a medical benefit to mothers and babies and can impose harm. You can learn more about having the healthiest birth possible, including how to avoid induction, by reading the Lamaze Healthy Birth Practices and enrolling in a Lamaze childbirth education class.