how to become a labor and delivery nurse

The Inside Guide to a Scheduled Labor & Delivery

Would you want to pick out your baby's birth date?

They say there's only one thing that's for certain about labor and delivery: Nothing is ever certain. But what if you could change that? What if you could choose, at least to some extent, exactly how and when your baby could be born? For some women, choosing a scheduled labor and delivery to usher their babies into the world just makes sense.

Shannon Tyrell was induced for delivery with her first child, a son named Lucas, and had no hesitations with allowing her doctor to induce her again the second time around with her daughter.

"I liked that we finally knew the date so we could plan it with [my husband's] work and were able to figure out who could take Lucas," Shannon told me. "And at the time I was soo over being pregnant; I was relieved to know I was going to be done and meet her!"

And while experts generally agree that letting babies choose their own birthdays is best, in a world of schedules and convenience, some doctors are working with patients to arrange scheduled labor and deliveries.

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"I feel an elective induction after 39 weeks is certainly acceptable," states Dr. Ronald de la Pana, OB/GYN at Los Robles Hospital in Thousand Oaks, CA. Although he stresses that he follows the American College of Obstetricians and Gynecologists' recommended timeframe of only inducing women at 39 weeks or later, Dr. De la Pana feels comfortable inducing women for a variety of reasons, a primary one simply being convenience. "With inductions, there is definitely a convenience factor--for me as the OB, for the mother to coordinate with the rest of the family. There are plenty of social reasons [that aren't medically necessary] that are also good reasons for an induction," he explains.

As a labor and delivery nurse, I definitely see a high number of scheduled inductions for non-medical reasons, but the truth is, inductions can be risky, especially for first-time mothers whose labors may be more intensive and time-consuming. Mothers who choose inductions also face a much higher risk of a c-section--in some cases, a 50 percent higher risk than if they had gone into labor naturally.

So what should you do if you are considering asking your provider for a scheduled induction?

Dr. De la Pana advises women to speak with their doctors fairly early on during their pregnancies if they are considering an elective induction. "I think it's important to have the understanding to have the discussion about birth early," he says. For example, although he warns that if a woman's care provider turns down her request for a non-medically necessary induction, "it's usually in the best interest of the woman or baby," he concedes that a woman is always open to seeking a second opinion. "However, can be difficult to transfer prenatal care after 28 weeks," he states.

Dr. De la Pana believes that the conversation concerning a woman's induction of labor should be "doctor-led," but he also states the decision needs to be one that "the patient is comfortable with."

What about elective c-sections?

So if mothers have the right to choose an induction for their deliveries, should they also be able to choose to go under the knife?

Dr. Jeff Livingston says that although elective c-sections seem to get a lot of publicity, primarily because they are considered somewhat controversial, he says "it's not something that I see very often at all, maybe 1 or 2 patients a year will request that."

The ACOG's official opinion on elective c-sections at the mother's request is a bit confusing to read. Although it states that vaginal delivery is recommended in cases where no medical indication is necessary, it goes on to describe that elective c-sections are not recommended for women wanting more than one child or that elective surgeries should not be "given before 39 weeks."

Dr. Livingston echoes the somewhat murky stance of the ACOG, saying, "As a doctor, it's really important to go through the risks and make sure that they are fully informed of the decision, but in the end, I feel like they have the choice for route of delivery; my preference would not be a c-section without a reason; but in our world where we allow other elective surgeries and plastic surgeries, it makes sense."

As with anything regarding the healthy and safe delivery of your baby, be sure to carefully consider the risks and benefits involved with a scheduled birth and talk to your care provider about what's best for you and your family.

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