Born in the USA by Marsden Wagner Page A

the woman and the baby. In investigating litigated cases of a baby or a woman dying as a result of an induction, it is common to find “postdate” on the woman’s chart as the indication for induction. When we look more closely at the chart, however, it is common to discover that the pregnancy was not postdate at all but was only at 41 1/2 weeks or even 4 1/2 weeks. Claiming that the pregnancy was postdate allowed the doctor to do the induction he almost certainly wanted to do anyway for his own convenience.
    When an obstetrician sets out to convince a pregnant woman to consent to an induction, he is almost always successful. All he has to do is communicate his own fears by conveying directly and indirectly all that might go wrong with a natural birth. The baby might suddenly die in the uterus. The baby’s heart might suddenly stop. All these tests we’re doing are to make sure that the baby is okay. When the woman is finally asked to sign an informed consent form, the form is likely to list every disaster that mighthappen if the induction is
not
done, but it does not list every disaster that could result from doing the induction.
    So when the doctor suggests induction, the idea is appealing to the woman because it appears to end a dangerous situation for the baby—remaining in the womb. Women are rarely told that every day the baby remains in the uterus, it grows bigger and stronger and becomes less likely to develop complications during the birth. They are rarely told that a woman’s body knows when the baby is ready. 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.
    Yet in the United States we are inducing labor in more than 40 percent of all pregnancies. It’s like taking a baseball bat to a mosquito. The obstetrician’s fear that a pregnancy will have trouble if it goes “too long” dovetails nicely with the great convenience of being able to schedule an induction.
    As mentioned earlier, a Maternity Center Association survey found that in 2004 we were inducing labor in 44 percent of births. If we add to this the 16 percent of cases in which drugs are used to stimulate or speed up a labor that has already started (augmentation), the total number of pregnancies in which powerful and dangerous drugs are used is 60 percent, or nearly two-thirds of all births. 34 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.
    The widespread use of Cytotec for labor induction without adequate evaluation appears to be impervious to the usual methods of quality control in health care. The FDA, the pharmaceutical industry, scientific opinion, and peer review have all failed to significantly slow down, much less stop the Cytotec epidemic. That leaves two last methods of quality control—educating the public and litigation.
    At this stage, it is very important to discuss Cytotec induction in the media. Women and families need to know the truth about this drug, so they can “just say no” when an obstetrician offers it. 35 But there has been little or no information made available to the public, in large part owing to “tribal loyalties” among doctors. Many obstetricians are aware of the problems with Cytotec, but they will not speak out in public. Most give journalists the “party line” about how good the drug is. Investigative reporting has become essential in protecting women and babies from dangerous obstetric practices. Already one national television network in the United States has done a program on induction with Cytotec, as has a nationalCanadian network, and several regional affiliates have reported on the issue. Highly critical newspaper, magazine, and