post term pregnancy info

August 18, 2007 § 1 Comment

Subject: [independentchildbi rth] Post-term pregnancy
info.

Here are some facts on post-term pregnancy and
induction.

As you know, this is a BIG issue for most pregnant
women these days. In the book Born in the USA by
Marsden Wagner, M.D., M.S. (which I recommend everyone
read – along with Henci Goer’s book The Thinking
Woman’s Guide to a Better Birth), he makes sense of
the induction epidemic as well as the state of U.S.
maternity care.

A normal pregnancy lasts 38 to 42 weeks and only 3
percent go beyond 42 weeks. No one thinks to stop a
labor at 37 to 38 weeks but many want to induce at
40.5 to 41.5 weeks. What are the facts? What can we
tell our clients?

Dr. Wagner has researched this and many other
disturbing issues in his book. Citing a valid study
done in 1996 looking at 1,800 postdate pregnancies
that found no increase in baby deaths as well as no
increase in complications compared with births of
babies born between 38 and 42 weeks. He states:

“The truth is that only about 10 percent of babies at
more than forty-three weeks’ gestation get into
trouble”.
“Women are not told that only 3 percent of
pregnancies, if left alone, will go beyond forty-two
weeks and that only 10 percent of those babies past
forty-three weeks get into trouble —- 10 percent of
3 percent = 0.3 percent of babies will get into
trouble”.
“It is ridiculous to think that two-thirds of American
women have such lousy uteruses that they must be
whipped into shape with drugs in order to have
babies”.

It has been determined that an induction rate of <10
percent is medically necessary. The rate of induction
in the USA is over 40 percent. Our local (Santa Clara
County) rates range from a [self reported] rate of 40
to 5 percent [three of our hospitals refused to give
this information] .

This becomes a much bigger issue when Misoprostol
(Cytotec) is used. Most (if not all) of our hospitals
are using this drug that is not approved for this use
by both the manufacturer or the FDA. Dr. Wagner said
that the use of this drug goes beyond “off label” use
(which is common in U.S. obstetrics) but is being used
“against label”.

Dr. Wagner suggests that the only two “last” methods
of quality control are —— “educating the public
and litigation”. I vote for educating the public first
and litigation as a last resort.

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