Is a 37% Induction rate for healthy women normal?

Induction of Labour Audit, Power Point Presentation 2011  
Airedale Maternity Services did an audit on various aspects of their Induction of Labour practice and presented it to the local MSLC.  Key statistics included:

Parity 24% nul par, 19% 1 par ( the majority of women induced are first time mums, or with one previous pregnancy that was 'viable' whether or not the baby lived beyond 20 weeks gestation).

45% of those induced are 41 weeks gestation and 37% of the women induced are for postdates only.  This means that nearly half the women are being induced within the recognised normal range for gestation, and

37% of those induced are entirely healthy and normal, the arbitary line of induction policy is the only reason for this intervention.

The other shocking thing is that in this Trust 73% of women induced are put on Electronic Foetal Monitoring, not intermittent auscultation. The reasons we were told are 'historical' ie not evidence based.

Comment: As women and midwves we need to ask whether we have got our sums right on length of pregnancy if 37% of healthy women need to be induced for postdates alone. A Stats textbook called Supercrunchers by Ian Ayres demonstrates how our clinicians have got their sums WRONG in calculating the length of preganncy.  Also check out Ann Frye' fantastic textbook of Holistic Midwifery.  She quotes Professor Carol Woods method of calculating length of pregnancy - based on research into the actual lengths of pregnancy groups of women have.  We should not accept high induction rates of health women for postdates as normal and acceptable maternity care.

I sparkle like a diamond

Once upon a time a long time ago yesterday, there was a young woman who sat on her bed looking very sad :

She was so sad her hair was lank and grey, her face was grey, her clothes were grey.  She was sad and grey.

She was so sad and grey that her bed was grey, her bedroom walls were grey, and as she looked at the people around her they were drab and grey.

In the morning she went into her workplace and it was grey and sad and unappealing.

So she went out into the garden.  And there she found a rose, beautiful and crimson.  She said to the rose, "Why have you so much beauty and colour when I am so sad and grey?  The rose replied, "I am being just who I am."

She came to some phlox standing tall and white and full of scent. "Why are are you so white and beautiful, when I am so grey?"  the girl asked the flowers.  "Because we are being just who we are."  Came the reply.

Then she came across a cluster of sweet peas.  They were lilac, and blue and purple, swaying in the breeze. "Why have you so much colour when I am so grey?"  she asked the Sweet Peas.  "We are just being who we are."  The Sweet Peas responded.

The girl walked on and came to a Hawthorn tree where she sat down and began to think.  And she reached down inside herself and brought out a beautiful sapphire, sparkling and glittering in the sunlight and in its prisms she saw pinks and blues, purples and greens, yellows and golds.  The world was filled with colour and so was she, the girl was no longer grey but sparkled with colour and life.

The girl held the prism for a while and laughter sparkled on her lips: she was being just who she was.  She placed the sapphire carefully back in her soul and continued on her way sparkling like a diamond, full of colour and life.

Radical mother, cake maker, born stroppy I was tired and worn out, discouraged and depressed. Today I told myself this story and remembered who I was.

Carrying the Courage of Conviction

"We do not have to take our troubles lying down – the most effective way of birthing new life as we all know is standing up!"

This begins as a report on the opening of ABL’s Carlisle Business Centre Conference Suite on Wednesday 30th June 2011- but Oh there is always more to it than that . . .

Steve Wyler OBE was the ketnote speaker.  He is a Big cheese in the new organisation Locality which is an amalgamation of the Development Trust Association with Settlements and Social Action Centres. 

Steve commended the courage of ABL to take risks to invest in the local community in the middle of a recession and talked about the commitment of ABL and other development trusts to enABLing their communities.

He then went on to talk about the bigger strategy which he and his colleagues at national level are working on, to support the courage and commitment of local communites like Manningham seeking to invest in their people.  This is what we are asking for, he said – and sometimes getting: 

1. Asking for a pause in the ‘slash and burn’ cuts which fall most heavily on the poorest communities.  Giving time for communities to  co-design local alternatives, taking the chance to do things a different way.  They have got 3 months moratorium to do this.

2. Community Right to Buy – this is now in the Localism bill but there is opposition from the Lords and from landowners who see that they may lose out.  In Scotland there is a stronger law which has enabled the inhabitants of many of the Western Isles to own the land they live on.

3. Community Allowance – to enable people on benefits to do short terms sessional paid work for community organisations without effecting their benefits.

4. Community Rights Act.  This puts a requirement on banks to be transparent about lending activities in poor communities;  where they are found to be wanting it puts a requirement on them to put remedial measures in place ( eg supporting local business, partnership/support for credit unions etc).  This law is effective in the US and communties are using it.  Steve said: “We think it is a scandal not to have this here.”

5. To have a large team of Communtiy Organisers working within communities.  They will listen to people, find out what they want and see if they can come together to effect change – often this is about taking down the barriers those in  power have put up preventing people helping themselves – positive solutions run on our terms not yours.  The Government is up for this.

Steve said that: We are about working to do thing differently, working with local people’s hopes and dreams and helping to make them happen.

Here clearly was a can do man in a can do organisation where poor local communties are able to build and invest in their own future.  This takes courage and conviction.

Mothers and Midwives let us carry that courage and conviction to build birth care and communities on our human terms, let us start challenging the barriers to us claiming our birthrites -  and those who put them there.  Let us invest in our children and in our futures together.

In the evening it was my local church’s Church Meeting: a difficult one as the financial situation is bad – but it comes down to the same issues of courage and conviction: who we are, why we are here, what are we going to do with the resources we have to fulfil our aims and why we are here?  And in partnership with fantastic organisations like Locality we can turn around whole communities not just individual churches.

Who has the courage and the conviction? We do not have to take our troubles lying down – the most effective way of birthing new life as we all know is standing up!

The Mother magazine: Around the campfire

The Mother magazine: Around the campfire