speaking of inductions... question

SmilingBluEyes · Nov 14, 2003

no they do not routinely induce EVERY patient; but many are "social" and attributed to PATIENT desires and convenience, as much as for that of the care provides. We nurses are stuck in the middle of the frustration with these, obviously.

relatively FEW are due to MEDICAL necessity, if that is what you are asking.

L&D_RN_OH · Nov 14, 2003

I'm lucky enough to work in a facility where inductions are done for medical indication or >41 weeks gestation. No one is indueced early w/o a medical reason. However, there are a couple other facilities in this area that, quite frequently, induce early for "maternal fatigue".

mitchsmom · Nov 14, 2003

'relatively FEW are due to MEDICAL necessity, if that is what you are asking.'

I know there are a lot of women who actually want to be induced, and some docs with a relatively high rate for whatever reasons. But I did mean do you guys work with some who literally induce ALL pts. (who don't go into labor before 39 wks or whenever their 'cutoff' date is). I used to go to this doc and I know he's pretty interventionist (there is lots more I could write but I'll stick to the induction thing) - he didn't used to do this as far as I know but I have a friend who just gave birth with him catching and she said that when she went for the 37 wk checkup he said 'ok we need to schedule your induction'... she was like "huh??" and he said "yes, didn't they tell you when you were first pregnant? We induce everyone at 39 wks - what's good for you is good for my other patients (so he can get sleep and provide better care for other pts)... if you don't want this you can go somewhere else." etc etc. I know that things can get lost in translation but this person is very down to earth and trustworthy as far as I have ever known her, plus along with other things I've heard I believe her. So, I was wondering if this is common because it seems over the top to me. Does the ACOG have guidelines concerning inductions? A sort of recommended reasonable rate like C/S rate? This guy has lost a couple of partners and he just seems to be getting worse & worse from what I gather. I wonder what his C/S rate is? I know I'm still a student but I don't know how inducing *everyone* can be ethical, what do you think? I mean, it's pretty obvious that if you want to become an OB you are not going to always get your beauty sleep. Go into dermatology.

trogdor · Nov 15, 2003

We only induce pts based on medical need, not mom is tired of being pregnant or Doc is feeling like sleeping at night. Sometimes we aren't even able to get in our inductions on the day they are scheduled because we are too busy, and don't have enough staff. There are some cases where the Drs schedule an induction for PIH and then the pt comes in and all labs are normal, and their pressures are fine. It makes you wonder if it was just a made up diagnosis that was really to get a social induction in.

SmilingBluEyes · Nov 15, 2003

you need to ask OBSTETRICIANS these questions, darlin....

we are NURSES and I for one, am NOT up on ACOG's (I am a member of AWHONN myself).......recommendations as to what is "reasonable" or acceptable. These things change and NO ONE ASKS US what WE think is REASONABLE...we just schedule and handle what we can. I guess I better speak for myself; I am a nurse,not an MD.....I think ALL inductions for NONmedical need are UNREASONABLE, that's all I can say.

best wishes.

BETSRN · Nov 16, 2003

No, we do not routinely induce all patients. I'd tell anyone to RUN from a doc who does that. As someone else said, sometimes you have trouble even getting the medically necessary ones in and yes, I do think that sometimes docs make up something to try and sneak their patients in. We nipped that in the bud by requiring all our docs to personally have to contact each other if they had an induction that they felt needed to bump another doc who already had the slot. We nurses do NOT act as go betweens for the docs. That helped a lot and now it is rarely an issue.

L&D_RN_OH · Nov 17, 2003

Originally posted by mitchsmom
But I did mean do you guys work with some who literally induce ALL pts.
So, I was wondering if this is common because it seems over the top to me. Does the ACOG have guidelines concerning inductions?

No docs I know. It does seem pretty over thr top, and I would assume that ACOG requires a medical indication for all inductions. Of course, docs can come up with any diagnosis they want for a medical indication.