Wife enduces labor so husband can watch Bears/Saints game?

Congratulations to Colleen and Mark Pavelka on the birth of their son Mark. But the timing of this joyous event raises interesting and unusual problem for medical ethics...

Mark, Jr. was due to be born today, but according to the AP's sports reporter, Colleen opted to induce labor on Friday so that her husband wouldn't lose out on his Bears/Saints football tickets.

Due to give birth on Monday, Pavelka's doctor told her Friday she could induce labor early. She opted for the Friday delivery.

"I thought, how could [Mark] miss this one opportunity that he might never have again in his life?" said Pavelka, 28, from the southwestern Chicago suburb of Homer Glen.

At 10:45 p.m. Friday, Mark Patrick Pavelka was born at Palos Community Hospital after close to six hours of labor.

While her husband watched the Bears play the New Orleans Saints at Soldier Field Sunday, Colleen planned to watch in the hospital with the baby wrapped in a Bears blanket -- a Christmas gift from his grandmother. [AP]

I hope Mark, Sr. buys his Colleen Bears season tickets for life. He really owes her.

I'm assuming that inducing labor a few days early carries little or no risk to mother and baby. I've heard that obstetricians routinely induce labor just to get off work at a reasonable hour. Obviously, it's not right to induce labor under the guise of medical necessity when you really just want to get off work. On the other hand, if it's true that otherwise ethical doctors induce labor for their own convenience, I don't see why families shouldn't be allowed to access the same technologies.

A lot of people are going to be outraged by Colleen's decision, but if she really wanted to do this, I don't see a problem.

I gather that she's a diehard fan herself who would have wanted to be at the game. No matter which day she delivered she couldn't go, but if she could arrange it so her husband could go, why not? I think it's telling that the AP headline writer put her husband's desires front-and-center, while Colleen's own preferences were relegated to the body of the story. I gather from the story that she was looking forward to at least watching the game on TV, instead of delivering a baby that day.

It would be different if Colleen were indifferent to football and her husband pressured her undergo a medical procedure purely for his convenience and enjoyment. If my partner asked me to induce labor for a sports match, I'd be shocked and appalled. (He's not a diehard fan of any sport and neither am I.) But given that this is a family of sports fans, I can imagine Colleen voluntarily undergoing induced labor.

As Angry Black Bitch points out, a lot of otherwise well-meaning people tend to romanticize labor and childbirth. Obviously, unlike many of the births ABB talks about, the Pavelka's decision was made under relative privilege--getting to choose the timing of your birth is a luxury. On the other hand, given that you're lucky enough to have such an option, I don't see any a priori reason not to exercise it.

Ultimately, women should have the power and the social approval to induce labor at their own convenience, within the bounds of sound medical advice.

Comments

[parse]

I'd be completely incongruous and outraged

What do you mean you'd be completely incongruous?

[Lindsay Beyerstein]

Parse, that's just a hypothetical based on who my partner is. He's definitely not that that much of a fan. Neither am I. So a request for induced labor for game tickets would be extremely alienating for me. But that's just me. If these are a couple of sports fans who see eye to eye on the importance of using tickets for a big game, Matzel Tov.

Heh.

I should probably revise that passage to make my intent clearer.

[Andrew]

Why should it matter whether Colleen is a fan or not? Even if she personally couldn't care less she could still want her husband to make the game if she knew it was really, really important to him.

[Lindsay Beyerstein]

I think that asking someone to go into labor prematurely is beyond a favor, it's almost beyond what you can decently suggest to another person for your benefit. My intuition is that we should be hesitant about imposing upon the good will of others, even those closest to us.

However, if Colleen was fan who believed that it was important to go to the game, and if she got some intrinsic satisfaction out of her husband being able to go, it would be a different situation.

My point is that it's different to do something for mutual gratification versus doing something solely for the benefit of someone else (even if you love them). If Colleen could care less about the football game, induced labor would have been an awfully big favor to accept from her, let alone to ask from her.

[Lindsay Beyerstein]

Furthermore, it sounds as if Colleen, being a big fan, was looking forward to at least watching the game on TV--as opposed to being in labor that day. So, the AP headline chooses to tell it like it's all about the husband's desires when in fact it was about Colleen's preferences as well.

[latts]

Just a few random thoughts:

Last time I checked, induction was associated with a higher rate of c-sections, which of course carry additional risks for mom and baby, not to mention they cost a lot more.

Synthetic oxytocin does not cross the blood/brain barrier, which translates into a more painful labor since the brain doesn't know to trigger endorphin production. And some OBs and/or nurses will really crank the Pitocin up, which is hard on the uterine muscle-- I remember reading a few years back that almost all uterine ruptures in labor not associated with a prior c-section (and presumably, some inductions have that complicating factor, too) are due to aggressive inductions.

There's more to starting labor than contractions-- the cervix needs to be soft & effaced, baby positioned, etc.

A baby that's even a few days early can have digestive problems; even though the lungs are formed, the gut's still getting ready for nourishment, and if it's not the baby is going to be pretty unhappy after meals (I've seen this happen to several women, and it's considered a minor complication, although it doesn't seem minor for those first weeks).

The biggest problem with this is cultural & habitual, really-- it's almost analogous to the pressures to groom oneself a certain way and follow certain fashions, because if you don't you're labeled as weird or troublesome. Hostility from medical staff because I won't get with the program that's good enough for X percentage of their other patients isn't something I'd like to face in labor, personally.

All this isn't to say that people should be denied choices, of course, even if I think they're dumb. But it's the sort of thing that should be considered in context of how it affects the assumptions other women face, at the very least.

[John Lucid]

My wife had her labor induced so I wouldn't miss happy hour at Appleby's. Did I mention that we're no longer married?

[Lindsay Beyerstein]

John, heh.

Latts, those are definitely important empirical points to consider. I never thought about the oxytocin/labor pain angle. Thanks for raising that possibility.

[Andrew]

I just think it's possible to get "intrinsic satisfaction out of [your] husband being able to go" without really giving a whit about football yourself. God knows I've gotten satisfaction out of my girlfriends' getting to do stuff they enjoy, even if I do think (say) knitting is a pretty stupid pastime all things considered. I don't see why that kind of gratification is different from "mutual gratification" in a sense that's relevant here. If I were a woman, I feel like I'd induce labor so my husband could watch a game he really wanted to see long before I'd induce it so my doctors could go home early.

I think it's great that we have the technology to make the timing of childbirth more convenient for women. Obviously, I don't want women to be pressured into taking advantage of that if they don't wish to, but I don't see anything wrong with a deciding to induce labor even if it is for basically altruistic reasons.

[Lindsay Beyerstein]

Andrew, I'm inclined to agree that a woman could have reasonable but purely altruistic reasons for inducing labor. However, I'm also inclined to worry that a woman who share some intrinsic motive to induce labor would be making an awfully large sacrifice to make her husband happy. Remember, she's already carried his baby for 9 months. If anything, he should be making some pretty significant sacrifices for her by this point! (I'm not suggesting that Mr. P. isn't doing his part. I'm just saying...)

My main point is that women should be in charge of their bodies, up to and including induced labor if they want it. Assuming, of course that they've been fully briefed on the kinds of risks that Latts was alluding to in an earlier comment.

It's interesting to me that the AP headline suggested a story of female self-sacrifice, while the actual article suggested something more akin to a mutually beneficial decision for a pair of sports fans.

Would a woman be willing to go to the press and say, "I induced labor so I could watch/go to a game?"

I'm thinking that society's not quite there yet. Telling an AP reporter that you induced labor so your husband could go is still edgy. Whereas saying you did it for your own fandom, or even for mutual fandom is probably still beyond the pale.

[Andrew]

Agreed, Lindsay. And interesting angle with the thing about the how the story was framed.

On an unrelated note: they were going to name the kid after Grossman? Surely they could have picked, like, a good player.

[Brian]

In the spirit of casuistry: If your partner, a musician, wanted you to induce labor so he wouldn't miss a once-in-a-lifetime concert, what would you do? What if you wanted to be sure you could watch a unique political event (inauguration, speech, etc.)?

[Bruce from Missouri]

People induce labor all the time for one reason or another. I'm not sure what the big deal is.

At least one of my bosses grandchildren was induced a couple of days early for the convenience of the mother. I know someone else who had a Christmas due date, and induced a few days early so the kid wouldn't be stuck with a Christmas birthday.

[Dr. Free-Ride]

As someone who agreed to have my own slowly-progressing labor induced in the interests of trying to avoid antibiotics, let me state for the record that it was intensely more painful, putting me in a place where an epidural (not in the original plan) seemed better than chewing my own uterus off; the epidural crashed my blood pressure, thus requiring additional medication which spiked my temp -- and, things ended up not going fast enough to avoid the antibiotics anyway.

Short version: to say inducing is not a big deal is to imagine outcomes that are not guaranteed.

[herbert browne]

Inducing labor sounds a little like fixing the video game so that you have unlimited "lives"... and one result is bound to be that some of the majik goes "bye-bye"... See, at this point it's about to become a "3 people" story- and everyone should have their "say" (IMO) about the blessed (&/or infernally painfilled) moments. Hell- with the opportunity for Real Drama, this woman should have gone to the game, too. Being born in the bleachers (and starting out as a catalyst provoking "the kindness of strangers") sounds like a great way to begin Life on the Outside...
^..^

[B-Money]

This has been a total non-issue here in Chicago. It's like it was expected! I thought it was funny that she was so willing. But knowing the diehard fans in this town, men and women, this was not surprising. I am sure if there were health risks, the doctor would have advised against it. In the end, it makes for a fun story.

Side note: interesting that there would be any upset or outrage over this from the pro-choice set. So let me see if I understand this, a woman can choose to abort a baby, but choosing to induce so her husband doesn't have to miss a HUGE game that is important to them both is outrageous? Seems a little...strange to me. Afte all, wasn;t it her choice??? (For the record, I am pro-choice, so spare me any flack.)

-"Ultimately, women should have the power and the social approval to induce labor at their own convenience, within the bounds of sound medical advice."

Couldn't agree more Lindsay!

[The J Train]

I don't know if induction carries significantly increased risks. (Not my field.)

But it's more than an issue of convenience. In most hospitals, nearly every quality indicator that can be measured by the hour goes down at night and on weekends. It's no surprise; that's when you have less staff and less experienced staff (since the newer folks pick their shifts last). If you have to have something done in a hospital, you're always better off having it done during banker's hours.

I don't know if that benefit outweighs any increased risk from induction, but it's something to consider.

[latts]

If you have to have something done in a hospital, you're always better off having it done during banker's hours.

Funny, I was always taught exactly the opposite by the nursing side of the family-- when a hospital's busier and more full, the patient/staff ratio suffers and the potential for errors and delays is higher. Although they did seem to agree that Sundays were a bit iffier because getting on-call docs there in a timely fashion was harder.

[Hawise]

Both my older brother and sister were induced because my mother lived in a rural area with only one OB/Gyn and they were due during his only vacation of the year. This was fifty years ago but I am sure that, in rural areas, this is still a factor.
Except for the whole more painful thing, I was seriously considering it when my son was taking his own good time about getting born.

[Clancy]

"the Pavelka's decision was made under relative privilege--getting to choose the timing of your birth is a luxury."

Good point, and I'll add that some people induce labor early for tax breaks, apparently.

[iain]

Latts and Dr Free-ride have it right. Induction doesn't just mean you get a normal labour sooner than you otherwise would. 'Induction' can just mean a 'sweep' across the cervix to get things going, but that often doesn't have much effect. The next stage of intervention is 'artificial rupture of membranes' (breaking the waters). This often starts contractions, but if it doesn't, other measures have to be taken pretty soon, becuase the risk of infection goes way up once the ARM has been performed. So most often 'induction' means an IV of hormones that provoke contractions. You get stronger, sharper contractions, the progression to second stage can come too fast, so that the labouring woman feels an overwhelming urge to push before her cervix is fully effaced and dilated. This leads to much higher incidence of epidurals, which in turn leads to higher incidence of ventouse or forceps deliveries, and indeed emergency caesarians. At the very least, medical staff would have to make sure that their client was fully informed of the risks associated with induction. I'm not sure that it should even be offered for non-medical reasons. Increasing risks to mother and baby for no gain other than convenience, (to say nothing of whether it's the mother's convenience or her husband's) - dodgy.

[Beth Kiley]

I think if you are going to consider inducing labor for a non medical reason you should try some of the natural ways rather than endure a medically induced labor which can have much more painful contractions. I used labor acupressure and the process was actually quite relaxing and it did get things moving.

[Beth Kiley]

I think if you are going to consider inducing labor for a non medical reason you should try some of the natural ways rather than endure a medically induced labor which can have much more painful contractions. I used labor acupressure and the process was actually quite relaxing and it did get things moving.

[Beth Kiley]

I think if you are going to consider inducing labor for a non medical reason you should try some of the natural ways rather than endure a medically induced labor which can have much more painful contractions. I used labor acupressure and the process was actually quite relaxing and it did get things moving.

[Beth Kiley]

I think if you are going to consider inducing labor for a non medical reason you should try some of the natural ways rather than endure a medically induced labor which can have much more painful contractions. I used labor acupressure and the process was actually quite relaxing and it did get things moving.