In this episode of The Pulling Curls Podcast: Pregnancy & Parenting Untangled, host Hilary Erickson is joined by guest Dr. Elizabeth Schmeid, an OBGYN, to discuss the topic of making the choice to be induced. They emphasize that doctors cannot force someone to be induced against their will and that patients always have the option to decide what to do in their situation.
The episode delves into the risks associated with not inducing versus inducing and the importance of informed consent. Listeners are encouraged to ask questions, seek information, and make decisions that align with their body and preferences. Tune in to learn more about navigating the third trimester and making decisions about labor and delivery.
Big thanks to our sponsor my Free Beginning Prenatal Class
Today’s guest is Dr. Elizabeth Schmied
Elizabeth is an obgyn serving the Scottsdale and surrounding area with her partners at Paradise Valley OBGYN. In addition to a passion for women’s health she is a mom of 2 awesome kids. She enjoys hiking, reading, and spending time outdoors in her spare time.
Links for you:
00:00:00 “Inducing labor: discussion with OBGYN Elizabeth Schmied”
00:03:38 Car consent, scary things in pregnancy, doctor’s advice.
00:06:52 Lower expectations, have a flexible plan. Asking for informed consent from doctors.
00:12:00 “Talk with your provider about induction.”
- The podcast focuses on addressing concerns about being induced in pregnancy but not wanting to be.
- Doctors cannot force someone to be induced or come to their home to do so.
- Many doctors give their opinion, and patients often go along with it, so it’s important for listeners to hear different perspectives.
- The motivation behind the podcast is to provide education and support for listeners in making their own decisions.
- The guest on the episode is Elizabeth Schmidt, an OBGYN.
- The discussion revolves around making the choice to be induced and the importance of understanding the reasons behind medical recommendations.
- The speaker mentions that about 10 to 20% of the time, there is flexibility in making decisions about inductions.
- Patients should feel empowered to ask questions, seek information, and engage in informed consent.
- The importance of communication with healthcare providers is emphasized, and effective communication strategies are offered in a prenatal class.
- The speaker advises against not showing up for a scheduled induction and highlights the importance of being monitored and evaluated by the doctor.
Producer: Drew Erickson
[00:00:00.000] – Hilary Erickson
Hey, guys. Welcome back to the Pulling Curls Podcast. Today, in episode 206, we are talking about making the choice to be induced. Let’s untangle it.
[00:00:10.840] – Hilary Erickson
Hi, I’m Hilary, a serial overcomplicator. I’m also a nurse, mom to three, and the curly head behind Pulling Curls and the Pregnancy Nurse. This podcast aims to help us stop over complicating things and remember how much easier it is to keep things simple. Let’s smooth out those snarls with pregnancy and Parenting Untangled, the Pulling Curls Podcast.
[00:00:38.280] – Hilary Erickson
Okay, guys, super excited for today’s guest. I actually worked with her here in Scottsdale. She is an OB-GYN with Paradise Valley OB-GYN. And I can’t say enough good things about her. I loved working with her. I want to introduce today’s guest, Elizabeth Schmied.
[00:00:57.680] – Hilary Erickson
This episode of The Pulling Curls Podcast, Pregnancy and Parenting Untangled is sponsored by my free beginning prenatal class. Did you know that I offer a totally free prenatal class? And inside there, we talk about third trimester testing, and I think it is going to go hand in hand with this episode. You can find it either in the show notes or go to the pregnancy nurse and look under Resources, and it’s right there. Hope to see you inside.
[00:01:22.240] – Hilary Erickson
Hey, Elizabeth. Welcome to the Pulling Curls Podcast.
[00:01:25.480] – Elizabeth Schmied
Hi. Great to see you, Hilary.
[00:01:27.330] – Hilary Erickson
We worked together as medical professionals.
[00:01:31.330] – Elizabeth Schmied
I know. It’s been a long time, but I’m glad to see you’re smiling face.
[00:01:36.130] – Hilary Erickson
I think you’re the first doctor I’ve ever had on. I’ve had a lot of my nurse friends on that I’ve worked with, but I don’t think I’ve ever had a doctor on that I’ve worked with before. So it’s exciting to be here with you because we have been at the nurses station together trying to decide if we should induce a patient.
[00:01:50.380] – Elizabeth Schmied
That’s right. For sure. I know.
[00:01:52.900] – Hilary Erickson
So the reason I wanted to do this podcast is I get a lot of people messaging me on social media or whatever saying my doctor has said I have to be induced and I don’t want to. What can I do? I’m like, well, I mean, they can’t make you be induced. And somehow people are like, Well, he’s going to make me get induced. The one thing I can guarantee to every listener out there is your doctor will not come to your home and pick you up to make sure that you go to the hospital and get induced. That will never happen.
[00:02:21.410] – Elizabeth Schmied
That’s true. No home call.
[00:02:23.400] – Hilary Erickson
No. But I see a lot of doctors. You can tell. It’ll be interesting to hear what you think. I see a lot of doctors who give their opinion like that is going to be what happens because most people just want to know what they recommend and are just going to go with it. And so we’ve gotten attuned to be like, Well, this is what I recommend. And because most people are like, Yep, let’s do that, we just act like that’s our plan. What do you think?
[00:02:44.760] – Elizabeth Schmied
Yeah, I think so. I think sometimes we just want to get to the point and make our recommendations, but we’re never going to force someone to do something against their will. The patient always has the option of what to do in the situation. It’s just their physician’s job to educate them on what they feel the risks of not inducing versus inducing are. Then sometimes, I guess, in those situations, it does feel like you don’t have a choice because there can be some scary risks involved with staying pregnant longer than a doctor advises for certain medical conditions.
[00:03:25.050] – Hilary Erickson
Right. Because a lot of times the risk is either even mom dying or baby dying. Right. Yeah, and it’s their job to tell you that because a lot of people are like, well, you frame that awfully scary.
[00:03:35.680] – Elizabeth Schmied
[00:03:37.920] – Hilary Erickson
But I always tell them, but if our car gave us informed consent when you got in it, like every time you know how it comes up saying you shouldn’t look at the maps while you’re driving. If it gave informed consent, it would say and you could die in this vehicle, right?
[00:03:51.820] – Elizabeth Schmied
Yes, that’s true. And it’s so fun to talk about the scary things, but scary things can happen in pregnancy. And it’s your doctor’s job to try to keep you and your baby safe. That’s our ultimate goal.
[00:04:02.250] – Hilary Erickson
Yeah. And that’s what you’re paying them for ultimately. It’s not just like to measure your belly every week.
[00:04:07.860] – Elizabeth Schmied
[00:04:08.610] – Hilary Erickson
Yeah. It’s to look for the scary things. That’s their job. So let’s pretend like you are a patient and the doctor is like, Well, I think you probably should get induced. Now, you and I both know that there are cases where we’re like, You should get induced, and that ends with a period, right?
[00:04:24.610] – Elizabeth Schmied
[00:04:25.570] – Hilary Erickson
Yeah. And in that case, then you’re going to have to have a stickier conversation with your provider if you really are going against all of their advice. But what percentage of the time do you think it ends in a period, “You should get induced.”?
[00:04:37.990] – Elizabeth Schmied
Oh, maybe 10-20 % of the time.
[00:04:42.930] – Hilary Erickson
Yeah. There is a lot of wiggle room where you’re like, Okay, yeah, sure. That’s also a valid choice, right? Yeah. Yeah. So if you’re Sally and your doctor is like, Well, I think you should get induced. But you also I think a lot of people don’t want to hurt their provider’s feelings.
[00:04:58.590] – Elizabeth Schmied
Yes, that’s true. Maybe.
[00:05:00.730] – Hilary Erickson
Yeah. Which is funny to us in the medical field because people say rude and mean stuff to us very frequently. And so you saying, “Are you sure?” or “Can we talk about some alternatives?” Is definitely not on par with hurting our feelings.
[00:05:18.450] – Elizabeth Schmied
Right. We definitely want you to understand why we’re making these recommendations and what is going on with your body. And so it’s never wrong to ask questions even if your provider seems like their feelings are hurt or they’re annoyed at the time, it’s your body and your choice, and you should ask all the questions that you need in order to feel comfortable with whatever plan you guys decide to make together.
[00:05:42.860] – Hilary Erickson
Yeah. They always say the informed consent is risk, benefits and alternatives, and your doctor is not going to review every single alternative out there with you because they just don’t have the time. I mean, the alternatives are endless, right?
[00:05:56.300] – Elizabeth Schmied
[00:05:57.000] – Hilary Erickson
And often the alternative is waiting.
[00:05:59.420] – Elizabeth Schmied
Yes, that’s true. I think that a lot of times labor is a scary thing to begin with, and we want to have as much control of it as possible, but you’re just not able to fully control what happens, what your body does, and how your baby responds to that. Even if you went into labor, things probably are not going to go exactly how you imagined it would be or how it was planned.
[00:06:27.230] – Elizabeth Schmied
I think a lot of the pushback with induction has to do with not wanting… It being something that wasn’t on your plan or on your radar. But you do have to understand in pregnancy and parenthood and life that a lot of things don’t go as planned. We will work with you to try and get you on board with being as close to your plan as possible, but it just might not work out exactly like that, if that makes sense.
[00:06:51.280] – Hilary Erickson
Yes. I think so much of labor and parenting and life is lowering your expectations and having less of a plan while still having some plan, right?
[00:07:01.000] – Elizabeth Schmied
Yes. That’s the hard thing.
[00:07:02.550] – Hilary Erickson
You wake up and you’re like, Okay, I’m going to take the kids to the park today. But that’s where the plan has to end. You can’t be like it’s going to be a magical day where no one whines, because that’s never going to happen, right?
[00:07:13.250] – Elizabeth Schmied
[00:07:15.370] – Hilary Erickson
Anyway, do you have any advice for words people use to get informed consent out of a doctor who seems to end it with, I think you should be induced. What would you recommend people start a conversation with?
[00:07:31.140] – Elizabeth Schmied
I think that I would just ask my doctor why they recommend that, and then what the alternatives are if I chose not to do that, and what the risk of those alternatives could be or what could happen in that case.
[00:07:45.310] – Hilary Erickson
Yeah, because I think on social media, everyone’s like, well, they should give you informed consent. But as a provider, I mean, essentially, I guess you should be giving informed consent every time I take a blood pressure, right? That is not happening. Every time I take your temperature, every time. So sometimes we get out of the zone of giving a full informed consent because a lot of people don’t want to hear it. It’s not the funnest thing to listen to sometimes.
[00:08:08.750] – Elizabeth Schmied
That’s true. And also you have to remember that your doctor does this all the time. And so it seems cut and dry for them, but you’re experiencing that for the first time. So if you feel like you need to ask questions or you just always stop them and be like, no, I need more information.
[00:08:25.410] – Hilary Erickson
Yeah. And there are the rare providers that literally will just roll their eyes. But I really feel like most young doctors anymore are up to communicate just as much as the patient wants to. They want to inform you. They also don’t want to blast you with the fire hydrant of information about stuff.
[00:08:42.830] – Elizabeth Schmied
Right. Yes, for sure. Sometimes that information can get really scary and we don’t really want to scare you with the worst case scenarios most of the time.
[00:08:52.760] – Hilary Erickson
Yeah. All right. Great advice. Have you ever gone to somebody’s house and made them be induced?
[00:08:57.530] – Elizabeth Schmied
[00:08:59.840] – Hilary Erickson
Have you had patients who… The other thing I saw was somebody was just like, Just don’t show up, which I’m like, Oh, please call and let us know that that’s your plan, because we start to get worried that you got hurt on the way to the hospital or something went wrong or you’re at some other hospital with something really going wrong. Do you have patients? I mean, all the time we have people that just don’t show up for their induction.
[00:09:18.510] – Elizabeth Schmied
Well, it doesn’t happen that often, but I would say absolutely do not do that. You should call your doctor and let them know that you are feeling like you don’t want to have the induction, because if they felt strongly enough to schedule you for an induction, they probably are worried about something about you or your baby or both, and you need to come in to be monitored maybe, or you need extra evaluation. You can’t just ghost them and not show up until your next appointment. They definitely want to talk to you and they definitely want to make sure that you and your baby are safe.
[00:09:55.260] – Hilary Erickson
Yes, because there are… Sometimes the alternative, like she was saying, is to just come into labor and delivery and be monitored for half an hour. We make sure baby looks good, you look good, all those different kinds of things, and then you can go home. Yeah.
[00:10:06.060] – Elizabeth Schmied
And also I want to say that induction isn’t always as bad as everyone talks about it either. A lot of people have nice, easy inductions and. And so take what you read with a grain of salt too.
[00:10:17.350] – Hilary Erickson
Yeah. Were you induced?
[00:10:18.870] – Elizabeth Schmied
I was not induced. I had to have C-sections.
[00:10:21.770] – Hilary Erickson
Oh, there you go. I would say that most of the OBs I’ve talked to either got induced or had C-sections because… Well, I mean, it’s just because most of them were either in residency or new doctor. So they really needed to plan their induction. Yeah.
[00:10:38.840] – Elizabeth Schmied
Yes. But for sure, induction sometimes is hard, but a lot of… So with labor, and most of the time it’s not that much harder than labor is, if harder at all.
[00:10:50.600] – Hilary Erickson
Yeah, that is a great point. In fact, that arrive trial, I don’t know how deeply you’ve gone into it, but it shows that people actually didn’t rate their pain any worse with an induction than they did with labor. And when you bring that up in a labor and delivery community, people just start throwing like flaming knives at you.
[00:11:06.550] – Elizabeth Schmied
I know. It also shows that induction between 39 and 40 weeks decreases the risk of C-section compared to an induction at 41 weeks too.
[00:11:15.590] – Hilary Erickson
Yeah, dodge the knives. They’re coming at us right now.
[00:11:20.870] – Hilary Erickson
Yeah. So it’s interesting. It’ll be interesting to get more information. Although I’m hearing studies are starting to come out just on the same lines as the arrive trial. An induction definitely is. I can just say that I got induced at 41 plus 12, and I cried an entire day before my induction, and that was a huge waste of energy where I could have had a nap instead of a headache, because I don’t know why. My cervix was already five centimeters. If they had just looked at my bag of water, it probably would have broken and I would have had a baby. But I wanted to control everything. What a shock.
[00:11:56.050] – Elizabeth Schmied
Well, isn’t it such an emotional time too already?
[00:11:59.690] – Hilary Erickson
Yeah. And everybody understands that. Okay. Great talking with you, Elizabeth. Thank you for coming on. I hope a lot of moms get a lot of good out of this.
[00:12:07.930] – Elizabeth Schmied
Thank you for having me.
[00:12:09.140] – Hilary Erickson
Okay. I love the points that this podcast brought up. First off, you can talk with your provider. Nobody’s making you be induced. And what she said is 100 % correct. But also if you need to be induced, it’s not really that big of a deal. And if you just looked at it as maybe not as big of a deal as you’re making it, it might just end up better, me case in point.
[00:12:27.800] – Hilary Erickson
So I really enjoyed having her on. No, your doctor is never making you be induced, although I hear that a lot on the internet. You’re making the choice. Make sure that you’re making the choice and that you’re an active participant in it.
[00:12:39.440] – Hilary Erickson
Come join me in the online prenatal class for couples where we have a communication bonus video where we talk about how to best communicate with your provider so that you’re not feeling like the bad guy, but you’re also getting the information that you need.
[00:12:51.290] – Hilary Erickson
Thanks for joining us on the Pulling Curls Podcast today. If you like today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.
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