Monday, September 16, 2013

Trusting Birth: 43 Weeks of Faith

By Dr. Christopher Stroud, MD, FACOG
Home page: StroudObGyn.com


This handsome young man is Luis Alan and at birth he weighed 10 pounds, 1 ounce. I had the pleasure of attending his birth recently and I just had to share a few things about it with you.

Luis is the first-born to his mother and, despite his impressive size, was born vaginally. That alone is certainly interesting, but the real story here is of his mother’s perseverance and faith in herself. You see, on the day of Luis’ birth, his mother was 43 weeks pregnant, something rarely seen any more. We are often a community of convenient inductions of labor. That is to say, many in our community elect to have labor induced at a convenient time; at a time that works best for them, for their physician, perhaps for their family members, for a variety of reasons. Elective induction of labor is somewhat of a community norm.

Luis’ mom knew from the beginning of her pregnancy that something was wrong with trying to take charge of an otherwise natural process; that there had to be risks with attempting to take charge of labor. She made it clear to me at our first meeting that she preferred to avoid induction of labor unless there was a clear indication otherwise. Her pregnancy progressed uneventfully; even remarkably unremarkable some would say. As she approached her due date she didn’t show frustration or concern. When she was one week past her due date many of the women around her began to ask why she wasn’t being induced and she explained that there was nothing magic about the due date and that we had a plan to, “watch and wait.”

Then when she was two weeks past her due date the number of those around her feeling compelled to share their opinion that she should be induced grew, but she elected to, “Watch and wait.” She would always ask me, “Is there any sign that something is wrong with my baby? Is there any reason we should induce labor other than the fact that we’ve passed my due date?” My answer was, “No.” So we watched and we waited. When we found ourselves headed towards the forty-third week of her pregnancy she remained unshaken in her desire to avoid induction of labor if possible. She had several false alarms and trips to labor and delivery thinking (hoping) she was in labor. On one such trip she encountered another physician who tried hard to convince her to be induced because of her advanced gestational age, even suggesting it was, “Unsafe to let the pregnancy continue.” She said, “No thanks,” and went home.

We monitored her every-other-day during the last week so to make certain everything was fine with Luis and just when it looked like the pregnancy would never end she came to the hospital in actual labor one evening. But that’s not the end of the amazing story of her perseverance…

Luis’ labor was not your average labor, just as the pregnancy wasn’t an average pregnancy. This labor was slow, by any definition of slow. Hours upon hours went by with little, if any change. We talked about using medications to augment her dysfunctional labor pattern and she said, “Let’s just wait,” so we waited. We waited all through the night and eventually used a very small dose of an oral medication just to help the process along over the final phase of labor. She finally became fully dilated and after several hours of very hard work, delivered this beautiful baby, Luis.

This birth is a story of perseverance, confidence, and faith. She had such unshakable faith in her ability to do what she was so masterfully created to do: to give birth. Despite a barrage of advice to the contrary from those around her, she held fast to what she knew was right. She consulted with me to confirm that Luis was safe and that she was healthy, and then she and her husband made an informed decision to do what they believed was right: to watch and wait. That decision saved them, in my opinion, from what could have easily resulted in a certain cesarean section.

I spend a lot of time and energy talking about vaginal birth after cesarean section (VBAC) and how to improve one’s chances of a successful VBAC. But this birth should remind us that the best way to approach VBAC is not to approach it - by never having the first cesarean section. In the vast majority of cases that means avoiding induction of labor if at all possible. Patience, faith in your body and its ability to do what it’s perfectly designed to do, and a partnership with a healthcare provider that will help you achieve the birth experience you desire are your most effective tools in the fight to avoid unnecessary cesarean sections. There are numerous times when labor should be induced; induction of labor is not evil in and of itself. The problem lies with the unnecessary induction of labor.

I am blessed to participate in some truly wonderful pregnancy and birth experiences. I will not soon forget the time I spent with Luis and his parents...



Dr. Christopher Stroud is a Board Certified Obstetrician-Gynecologist with practices in Fort Wayne and Auburn, Indiana. Part of his mission, he states, is to "care for women throughout the continuum of their lives in a way that is scientifically and morally sound." He can be contacted via his website, StroudOBGYN.com, via email at christopher.stroud@parkview.com or on the Facebook page for his practice. 

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20 comments:

  1. He is perfect!! You are truly a blessing to this field! God gave you a great passion!! Glad you follow it!!

    Great work mom! :)

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  2. My first of nine was 43 weeks and weighed in at 10lb 6oz and was delivered vaginally. There was no talk of inducing me just because I was one or two weeks overdue.

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  3. All 3 of my pregnancies were well over 42 weeks - with doctors talking induction - and my refusal - trusting in my body. All 3 were delivered vaginally. I avoided coming to the hospital until well into labor because of desire to avoid medical intervention. It very difficult to go against the recommendations of doctors.

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  4. What an amazing story! Big props to the mother for sticking to her guns. I know how hard it is when it seems like everyone is pressuring you to do something different. Congrats to her, and thank you for being such a caring provider!

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  5. This makes me feel confident to go against my Dr's wishes for the induction scheduled for Wed. I hope that he will listen to me. He was VERY adamant that I shouldn't go past 41 weeks. It's so unnerving to me, especially when you read stories like this one! Makes me wish we were still in Fort Wayne to see Dr. Stroud!

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    1. Jenni, Did you know that 42 weeks is the actual amount of time for a natural labor? If you and baby are healthy, just be firm and keep saying "no thank you" to pressure to induce.

      Congrats and be well!

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    2. The date I gave everyone as my due date was 42 weeks gestation, since that is the actual full gestation for human pregnancy. I was hoping my baby would be even later than that because there was a concert I wanted to go to! :-)

      When my baby was born 40 and 1/2 weeks, folks said he was "early". I realized there IS no "early" or "late"...that I have known folks to give birth at 39 weeks and at 47 weeks and all in between, and all were healthy babies. It's best to let nature take its course, and not a doctor's opinion or schedule. Then birth is at its most beautiful and healthiest.

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    3. Babies don't all grow at the same rate -- some take less time, some take more time to be ready. The 'so called' 40 weeks is just an average. They trigger labour at the right time to be born. When they have enough lung surfactant to be able to breathe properly, the signally hormonally to the mother that the time is right. We should respect that.

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  6. I am 40 weeks pregnant today. This is just the story I need to hear. It is harder mainly when everyone around you is getting impatient. My baby will be here when he or she will be here. Thank you for sharing this beautiful story.

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  7. This is exactly the word that needs to hit the streets! Thank you Dr. Stroud...this is why I ALWAYS recommend you...you're the next best thing to Ina May Gaskin. :)

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  8. All I can say is 'Thank you.' Thank you for standing out in a crowd that so easily caves to unnecessary interventions!! What an amazing Mama!!!

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  9. I wish you were my doctor. I wish you were every woman's doctor. What a wonderful story of informed Mama and supportive doctor working together for optimal health and best outcomes. We need more stories like this one!!!

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  10. Thank you! My third came at 43 weeks. Not all births or babies fit into the box of 37 to 42 weeks.

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  11. My son was born 1 day shy of 43 weeks, and labor was 55 hours long. I am grateful for the experience and happy that he was delivered vaginally without interventions. He is still teaching me about patience and to trust the process!!

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  12. Awesome Mama! Amazing Doctor! I wish there were more physicians with the mindset that nature and mamas knows best.

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  13. Thank you so, so much for this. ❤ As a mom who birthed at 44 weeks (with people harassing me constantly from 36 weeks on - including a doctor who told me I should be induced and/or sectioned by 39 weeks) I feel very alone most of the time. Merely reading this and knowing there might be a couple other people out there in today's world who DO believe in their baby's ability to trigger birth when s/he is ready is encouraging. I am not the only one in the world... Thank you. ((hug))

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  14. I have 5 kids and had a c-section with my twins. I had my last baby 2 yrs after c-section and was always being bullied into having another section which I clearly did not want! I went 5 days past my due date and had slow labour and the doctor on call was forcing me to sign paperwork for a section and I refused and she left! I was left alone with midwives who supported me and admired me for standing up to the bully of a doctor who said she was not wasting anymore of her time and I would have to have section, even though my baby was fine. Outraged by me saying no, she stormed out. I delivered my baby girl naturally without drugs 30 mins after she left! She weighed 10 and a half pounds! I went home in 6 hours. It was best of all 5 deliveries as I trusted my own body and midwives were so happy I stood up to the doctor.

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  15. Interventions at such an early stage seem to be so common in the States. I do not understand the misconception that birth has a set formula. Every woman and baby is different, therefore every labour is diferent. In Britan it is common to leave the mother and baby with no intervention (other than monitoring once or twice a week) until week 42 regardless of the weight of the baby.

    Allow the female body to do what it has done on its own without medical intervention for millions of years!

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  16. I wish you were my doctor too! And I also wish I had been aware of all this before the birth of my son seven years ago. I am currently looking towards my 5th C-section in February. I can't find any doctors that are even remotely interested in a VBA4C!

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  17. Amazing story. Thanks for sharing your experiences.

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