Sweet Deception

My doula client called me yesterday to let me know how her prenatal visit went on Wednesday. We are expecting her baby any day now so when she called I thought she was going to tell me that she was in labor. In labor she was not. She told me that her midwifes at the Health Department wanted her to go to the hospital on Sunday for an induction because of "borderline high blood sugar."
"Blood sugar?" I repeated to her over the phone again and again. "You're sure they said blood sugar and not blood pressure." She assured me that they said blood sugar. In all my readings I have never come across anything that would suggest that borderline high blood sugar would be a reason for an induction. The reasoning behind the induction, I suspected, was a fear that the baby was going to be too big, a condition called macrosomia. Interesting, I thought, when several highly respected authors, including Marsden Wagner and Jennifer Block, stated that macrosomia is not a justification for induction.
To make sure I wasn't crazy I called my midwife friend for her opinion. "NOT true!" was her first reaction when I told her about the reasoning for the induction. She assured me that I wasn't crazy and that she would never recommend a mom for an induction because of suspected macrosomia, especially not with a diagnosis of "BORDERLINE" high blood sugar. Ultrasounds can be off by as much as two pounds and even the most trained provider cannot predict a baby's birth weight.
When I talk my clients about induction I always want them to ask why the induction is being recommended. If everything is OK with mom and baby? Then why are we inducing? We all know that inductions more than double the chance of the birth being a surgical delivery, so the risk of surgery should always be considered when discussing induction. Does the risk of surgery outweight the risk of staying pregnant? I do not believe that macrosomia should ever be deemed a justification for induction or elective surgical delivery. If the baby is too big the only way we will know that is if the labor starts on its own and then the baby doesn't fit. Period. There is no guarantee when predicting birth weight and weight alone does not mean the baby cannot be born vaginally. A ten pound and a six pound baby could have the same head circumference and if the ten pounder is in a more favorable position than they may be easier to birth. I feel that most inductions are orchestrated cesareans. An obstetrical Münchausen by proxy used by the doctors and medwives to prove their superior medical knowledge in predicting that the baby "just couldn't be born vaginally, see I told you so."
We need to trust birth, trust our bodies and trust our babies. My client is angry that her midwifes would recommend such an invasive procedure. She wants her baby to be born in her own time, on her own terms. This afternoon I'm going to go visit my client, not to give her advice on natural methods for induction, but to support her in her decision not to be induced on Sunday. My midwife friend wants to come by and meet with her as well to assure her that she can birth her baby vaginally. I'm so happy to have such a wonderful friend devoted to honoring babies, respecting women and trusting birth! The world needs more motherbaby friendly midwifes!!!!!