“How do I know if I’m in labor?” – with Dr. Sadia Mobeen

Dr. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB-GYN and maternal fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy and wellness. All right, Dr. Mobeen, welcome back to the podcast. Happy New Year. How you doing?

Dr. Mobeen: I’m good. How are you? How was your new year?

Dr. Fox: My new year was uneventful, which is typical as you age.

Dr. Mobeen: Exactly. I was in bed before the ball even dropped this year.

Dr. Fox: Definitely. That is a Fox tradition to go to sleep well before the new year is ushered in. But all good. All good. So thanks for coming on the podcast. We’re going to be talking about a really common question that comes up to us in the office. It comes up when you’re on call and you get phone calls, people come in triage and that’s how do I know if I’m in labor or not? Like what’s the deal? And I guess in your experience, is this something you get asked a lot?

Dr. Mobeen: I get asked this at least…I get at least one phone call about this almost every call shift, sometimes more than one. So yes.

Dr. Fox: And I think that it’s fair. It’s a fair question. And I don’t think we’re going to necessarily answer it today because it obviously is individualized. But I think the point is really to help people understand the framework that we use when evaluating someone to determine if you’re in labor so that people have a better understanding sort of what kind of questions we’re going to ask, what kind of things would lead us to believe you might be in labor and bring you into the hospital or the office, or if we’re seeing you in the hospital, when might we keep you versus sending you home? Obviously, this is not a resource where you just listen to the podcast and know for sure one way or another. And so caveats and disclaimers abound. Ask your own doctor or midwife your own clinical questions. This is just a resource. So the MFMA legal team has now thanked me for putting that out there. So we can begin. I guess, as an overview, maybe if you could help our listeners understand how do we even define labor, like what is it that starts labor or that would be the definition of someone going into labor?

Dr. Mobeen: Typically, for you, for most people going into labor, they would need to have regular contractions that are strong enough to cause their cervix to change, so that way that they can progress and they can give birth. So typically they need to be strong and they need to be at regular intervals as well. And usually labor pain starts, it starts, like, lighter and it gets stronger over time and they usually get closer together and more regular. But the only way we would know 100% if you were in labor was if we did an exam. And sometimes we need to do multiple exams to compare if you’re making change or not.

Dr. Fox: Yeah, that’s a really good point, because, you know, the cervix, you know, people can have contractions and their cervix is not changing. And that’s not labor. And people, their cervix can change over the course of pregnancy or towards the end and not have contractions, meaning you can go from being closed one week to 1-centimeter dilated the next week without having regular contractions. And that’s not labor as well. You really need both of them happening together. And you don’t always know, right, if someone comes in and they’re contracting regularly and they’re 1-centimeter dilated, I don’t know if they’re making change. I would need to check them a few hours later to see if they’re now 2-centimeters dilated. And so sometimes we don’t even know unless it’s in retrospect after examining them multiple times, like you said. So even when we evaluate you, we don’t always know and we’re sometimes just taking our best guess. And certainly someone at home wouldn’t know if their cervix is changing. There’s no symptoms to your cervix changing. You just feel the contractions. And that’s really what most people are going by at home.

Dr. Mobeen: Exactly. Well put.

Dr. Fox: And then there is another sort of option, which is like a parallel conversation, which is some people, when they go into labor, actually, it does not start with contractions. It starts with their water breaking. So talk about that a little bit.

Dr. Mobeen: Typically, 10% of people’s water will break before they go into labor. And that’s like pre-labor rupture membranes. Normally it happens because the membranes get…it’s a physiological process where the membranes weaken towards, once you’re past term, closer to your due date. And sometimes you can be having some contractions that may not be as strong, like possibly Braxton Hicks, where that can cause the force of that to cause your water to break. If that happened, then even though you’re not having these symptoms, we would recommend that you come in and be evaluated because most people will eventually go into labor usually within 12 to 24 hours after water being broken.

But if your water breaks before your labor starts, we would recommend that you come in and be evaluated because the longer your water is broken, even if your labor hasn’t started, there are risks associated. And then that’s why we have that conversation about if your water is broken, what to do next in terms of options. We talk about, you know, the recommendation usually is that if your water is broken, you should come in and we should help your labor start. Sometimes we have a conversation where when should we wait a little bit versus to see if your labor will start by itself, versus if we should help you along. But that’s like a parallel conversation, like you said, it just depends on what your initial symptom is when you call.

Dr. Fox: Right. So we’re going to talk about those two scenarios separately. So scenario number one is sort of what most people experience when they go into labor, which is first they get regular, painful contractions that causes their cervix to change. And then eventually in labor, their water breaks or sometimes we break it for them in labor. So that’s scenario number one, which is more common. And then scenario number two, which you mentioned is about 10% of the time, is first the water breaks and then either someone goes into labor on their own or we help them along and they go into labor. So let’s talk about the first scenario, which is contractions starting first. So when do contractions begin in pregnancy for most people?

Dr. Mobeen: They usually begin anytime in the third trimester. They initially will start off as, like, pretty mild and irregular. A lot of times you’ll have those, like, weaker contractions to help your cervix soften over time and then help it thin out to get your body ready for labor. And that’s why we always talk about…we always ask questions when people come and say, “I’m having, you know,” sometimes they can have tightening, sometimes mild cramps. We typically want to know, you know, how often they’re having the contractions, how strong they are, if they can like…usually I’ll ask them if they can walk and talk through it, if they’re able to sleep through it, how many seconds it usually lasts and if it’s getting worse over time.

Dr. Fox: Yeah, I think also some of this evaluation is a little bit different based on when these contractions are happening. You know, because very many people have contractions throughout the third trimester and the questions we ask might be different and our evaluation might be different if someone is preterm versus full term, meaning if someone is, let’s say, a week before their due date, they’re 39 weeks and they tell me they’re having a contraction, you know, every 10 minutes or so. At that point, I don’t think they’re in labor and I usually tell them, you know, not much to worry about and we’ll go through a few things. But basically, we usually tell them to stay home. Whereas if they were 29 weeks, right, and they’re quite premature, we generally would take that a lot more seriously, because even though it doesn’t sound like they’re in labor right now, that is something that’s a little bit unusual. And we often will bring them in to be evaluated, again, depends on the exact circumstances and how painful the contractions, what their history is, this and that. But we certainly will think about it differently.

So in terms of contractions, it’s also important to, when evaluating, is it normal? Is it not normal? How far pregnant you are? Because as you get more pregnant towards the due date, it’s typical that you’re going to get more and more contractions, which is a normal thing. But it’s not that typical to have more and more contractions in the preterm period. They get them from time to time, but not typically regular contractions. That’s an unusual thing, I would say, for most people. Some women get them, but most don’t.

Dr. Mobeen: I agree.

Dr. Fox: For someone who’s, let’s say, full term, right. So let’s only concentrate on someone who’s 37 plus weeks. So we’re not going to focus on the preterm labor evaluation. So someone who’s full term. A lot of people ask me, “Are these real contractions? Are they fake contractions? Are these Braxton Hicks contractions?” How do you differentiate those or explain that to people? Because that’s a very common question that people ask.

Dr. Mobeen: So what I typically say is how you can tell the difference, I usually tell them that, “You know, it’s normal, like, you’re term, your body’s going to start to contract. Typically, sometimes you’ll have back pain. Sometimes you’ll have mild cramps. Your belly will also tighten.” Typically, how you can differentiate between a labor contraction and Braxton Hicks is a labor contraction kind of, like, knocks the wind out of you, stops you in your tracks, usually lasts anywhere from 60 to 90 seconds. You’re not able to, like, talk or walk through it or sleep through it. If you’re having those, then you should start timing them to see how far apart they are. Typically, you need about three to five contractions in a 10-minute window to cause cervical change. But I usually tell them to call if it’s their first baby, when they’re about five minutes, when they’re contracting about five minutes apart or about an hour.

Dr. Fox: Yeah, I don’t know who Braxton and Hicks were, but they got some serious name recognition for contractions. And essentially, you know, people ask, “What are Braxton Hicks contractions?” And what I typically tell them is Braxton Hicks contractions are essentially contractions where you’re not in labor. And so it’s probably a lot of people might use them synonymous with false contractions or false labor. Or, you know, people have a lot of different names for it. But basically, the uterus contracts. It’s normal to contract and at different frequencies. And before you’re in labor, they’re just contractions. And then once you go into labor, we call them, you know, full labor. And that tipping point is usually gray for people because they don’t know, again, when their cervix is going to start to change. So what you were saying is one of the ways people might know is how painful they are and how regular. I mean, Braxton Hicks don’t tend to be very painful and very regular. They could be, but they don’t tend to be. But when someone’s in labor, that typically happens. Now, what about going to the other side of the equation where someone’s water breaks before they go into labor? How would someone know that their water broke?

Dr. Mobeen: Usually, most of the time, they’ll have like a large gush of fluid where they’re either, like, soaked their clothes or wake up with the couch or, like, the bed being soaked. That’s the obvious way to know. Now, other times, patients can have a small gush of fluid where they’re not sure if their water broke because a lot of times it’s common for pregnant women to pee on themselves, have some increased discharge. So it just depends on when they call, what they’re describing. If they describe the first scenario where they have a gush of fluid, it’s highly suspicious. So we recommend coming in and being evaluated. Now, with the second scenario, if they’re unsure, what we usually do is one, we offer them either the option to come in for an evaluation or two, we usually will tell them to put a pad on, walk around for 30 minutes to an hour. If your water is broken, you are going to continue to leak. So if you end up soaking the pad, likely your water is broken and you should come in to be evaluated, is what I usually talk to them about.

Dr. Fox: And then if you’re going to evaluate them, what is the evaluation you do to check if their water is broken?

Dr. Mobeen: So I typically have them come in to the office or the hospital. I start off with a speculum exam where I will place that metal speculum that we use when you go to any gynecologist’s office and we will typically look to see if there’s fluid in the vagina. Sometimes I’ll have them cough if I don’t see any. Then we do other tests such as we have this stick that we place that turns blue. If you have amniotic fluid in the vagina, then sometimes we will do a sonogram to check the fluid to see if the fluid level has dropped significantly from their last visit. We also will sometimes, if we see fluid, place it on a slide and look underneath the microscope to see this tree-like pattern. So just different tests that we have that will help us evaluate. And depending on what we find, we would determine if the water is broken or not.

Dr. Fox: So let’s go through a scenario for our listeners. Let’s say you’re on call and it’s, you know, 11 at night and someone is is not sure if they’re in labor, right? They’re full term. They’re having contractions and they’re not really sure whether this means they’re in labor and they should go to the hospital or whether it means they should stay home and wait. And so they, you know, they call the office, you know, they get you on the phone through the answering service and you pick up. What are the questions that you’re going to ask them? And I’m going to give you, like, some of the answers to help understand what are the things we sort of bring you into the hospital for and what are the things we would tell you to stay at home. So, like, what are the questions you would ask someone who’s saying, “I’m full term. It’s my first pregnancy and I’m not sure if I’m in labor.”

Dr. Mobeen: So I ask them if they’re having contractions. I typically will tell them they’re, like, usually cramps, painful cramps where you’re not able to walk or talk through them. That’s usually my first question.

Dr. Fox: Okay, so let’s say they say, “Yes, I think I’m having those. They’re pretty painful.”

Dr. Mobeen: How often are they having…how often are you having them?

Dr. Fox: So let’s say they said every seven minutes.

Dr. Mobeen: Okay, and I would ask how often they, like, how long do they last?

Dr. Fox: Right. So let’s say they last…I’m not sure how long they last.

Dr. Mobeen: But they’re about every seven minutes. How long have they been going? How long have you been having contractions?

Dr. Fox: I’ve had two of them.

Dr. Mobeen: Okay. So in this situation, I would typically say as long as the baby’s…I would also ask if she had any vaginal bleeding or a gush of fluid like her water broke.

Dr. Fox: Right. And so let’s say, “No, no bleeding. And I don’t think my water is broken.”

Dr. Mobeen: And I would ask to make sure the baby…is the baby moving like normal?

Dr. Fox: Baby’s moving great.

Dr. Mobeen: So what I would say is because it’s your first baby, you’re term, your body’s probably starting to contract, it’s normal for that to happen. What I would recommend is continue to monitor at home. Once you start having these painful contractions about every five minutes for an hour, then give me a call back, because at that point I would bring you into the hospital for an evaluation.

Dr. Fox: So the threshold of contractions about every five minutes for an hour. So just to understand, what is the reason that we would use something like that? Like, why would they have to be going on for an hour and why should they be every five minutes apart? And are those sort of like hard lines or are those just sort of averages?

Dr. Mobeen: They’re just averages. Typically, you need about three to five painful contractions to cause cervical change. Sometimes depending on where the patient lives, they may take them a little while to get to the hospital. So usually by the time they get there, then if they’re like five minutes apart, then they should be getting stronger and closer together. So the theory is, you know, by the time they get there, that they’ll be, like, stronger and closer together. So that way more likely a chance that they’ll be in labor versus…but it’s not, you know, an exact science. It’s just depending on how painful, how much pain the patient’s in. If I hear that she’s physically in a lot of pain and cannot tolerate it, then I may offer an evaluation sooner versus, or if the contractions have been going on every six minutes for the last hour, then I may say, “If you’re really uncomfortable, just come on in.”

Dr. Fox: Yeah, I think that’s a really important point that it’s not that there’s like a rule that you can’t be evaluated unless you’re having a certain threshold of symptoms. It’s sort of, you know, the principle is the only way that you or I are going to know for sure if someone’s in labor is we see them, we examine them, you know, we figure out exactly what’s going on. But that requires someone to, you know, get up, get out of bed, you know, get to the hospital or the office or whatever it is. It might be the middle of the night. If they have other kids at home, they got to, you know, get someone to watch them. You know, there’s effort involved in this. And a lot of people don’t want to do that to find out, hey, I’m not in labor, go back home. And so not everyone feels exactly the same about that. Right. Someone who lives very close to the hospital might be, on the one hand, more comfortable waiting at home knowing, hey, I’m going to make it to the hospital either way. I’ll be fine. Whereas the other, they also might be more they might desire to come in because like, hey, it’s no big deal for me to come in and get checked, so I’d rather just know and find out. So it can go in both directions.

Or flip side, someone lives very far away, they might really hesitate to come in because they don’t want to go in and go back. It’s such a long trip. On the other hand, they might say, “You know, I don’t want to, like, go into full-blown labor and deliver in the car.” And so people’s circumstances will affect this. And obviously, their own concerns, their own anxieties, their own fears will do that. And so there is…and also how they’re experiencing the pain. Someone says, “You know, these contractions aren’t that painful to me. I’d rather stay at home a little bit longer.” Again, assuming everything else sounds fine, we’re going to give them a lot more leeway with that than if they’re in horrible, horrible pain. They’re like, “I want an epidural yesterday.” Then obviously we’re more likely to bring them in. So these rules that people hear and we say and this or that, they’re like you said, they’re not hard rules. They’re just sort of guidelines where if you’re contracting painfully, like you described before, where they sort of take your breath away, they last 30 to 60 seconds, they’re regular, they’re every four to five minutes and then they’re going on for an hour. The odds are you’re in labor if you’re full term, not 100%, but the odds are. So if you come in, the chances are you’re not going to get sent home. Right. No one’s going to say, “Hey, your cervix is closed. You’re not contracting. Go home.”

Whereas if someone’s contracting not so painfully and they’re 10 minutes apart and they’ve only been going on for 30 minutes, there’s a pretty reasonable chance that if you come in, you’re not in labor and you’re either going to be sitting around for a long time or you need to get induced or you’re going to go home. And so that’s sort of the reason these things came about. It’s not like that there’s some rule that we’re not allowed to evaluate someone before a certain time and we have to evaluate someone after a certain time. And I think that sometimes gets lost in the marketing around these rules. I mean, I assume when you’re on call, you have people who come in earlier than you normally would and people come in labor than you normally would based on their circumstances.

Dr. Mobeen: Yes. So I always offer it…we’ll always offer them. If they want to come in…I’ll tell them, like, if I think they need to. But if they want to, I will always offer that to them, if that makes them feel more comfortable to just come in and be evaluated.

Dr. Fox: Yeah. And it’s the same thing like, you know, people ask me, “When should I call?” And again, it’s not like, you know, and I tell people these are the phone calls we take. Like, when you’re on call for an OB practice, many, many, many of the phone calls we get are, “Hey, I’m contracting. Should I come in,” or “Hey, I’m not sure if my water broke.” Like, this is very, very typical and we’re very comfortable walking people through that. And so we give people some basic structure to that, not really a guideline, but just some basic information. So they sort of get a sense of this is the time we’re probably going to tell you to come in and this is the time we’re probably going to tell you to stay home. So you don’t need to call us if you’re contracting every 15 minutes and they’re not very painful, but you’re obviously welcome to if you’d like to. And we’re happy to talk about it and figure out what’s going on. And so, again, all this stuff is really meant to just be helpful, not really, like, rules, so to speak. Let’s go to the other scenario. Someone calls you and says, “Hey, I just woke up and I’m a little bit wet and I’m not sure if my water broke.”

Dr. Mobeen: So I would ask them one, how many weeks they are.

Dr. Fox: Right. So let’s say we’re full term, first baby.

Dr. Mobeen: Okay, so I would ask them, one would be what time did this happen and how much fluid did they they notice?

Dr. Fox: It just, I just woke up. It happened 15 minutes ago and it was enough to, I don’t know. There’s a little tiny puddle under me, maybe the size of a, I don’t know, a few inches.

Dr. Mobeen: Okay, I would ask them, like, what color is it, if there’s any odor or smell to it?

Dr. Fox: Not that I can tell.

Dr. Mobeen: Okay, and any vaginal bleeding?

Dr. Fox: No bleeding.

Dr. Mobeen: Okay, so in this situation, I would talk to them about, you know, there is a chance that your water could be broken. I would also ask them if they’re having any contractions.

Dr. Fox: Not really.

Dr. Mobeen: Okay. And I would also…so I would tell them that the chance their water could be broken. But, you know, since there’s a small amount of fluid and they’re not sure, I would talk to them about one, either coming in to be evaluated or two, putting on a pad and walking around for about 30 minutes to see if, you know, if her water is broken, she’s going to continue to leak fluid to see if she’s leaking fluid.

Dr. Fox: Right. And what is the threshold where you would say, “Oh, that sounds like enough that your water is broken, just come in.” Is there, like, something you have in mind or is it just sort of you get a sense from what they tell you?

Dr. Mobeen: It’s, like, case by case, depends on what they tell me. Sometimes if she tells me she had a gush of fluid, if she was awake or like she was walking and all of a sudden had a gush of fluid, sitting on the couch, had a large gush of fluid, that’s pretty accurate for having your water broken. Sometimes they’ll say they have, like, a small amount of fluid. You know, they’re not sure. Then in those situations, I would recommend them monitoring and putting on a pad. But just depending on what they tell me, there’s no hard or fast rule. It just depends on, like, one, what number baby it is, how far they live, their history. And then if they want, you know, I always offer them to come in and be evaluated. Sometimes they live far away. They naturally don’t want to have to come all the way here for me to tell them they have to go home. So in those situations, I would be more likely to have them monitor. But usually I follow…like we’ll just follow up with them in like 30 minutes to an hour just to see what’s going on. And depending on what is happening, if they tell me there’s like a little bit of fluid on the pad or they soak the pad, then of course, I recommend that they come in and be evaluated.

Dr. Fox: Yeah, I mean, I agree. I mean, I tell people that usually I would say 90% of the time it’s pretty obvious, right, when someone calls, whether their water is broken or not, to say, you know, “I got a big gush, my socks are wet.” You know, they’re like, “Hey, there’s nothing else that could possibly be going on. My water broke.” Say, “Okay, come in.” You know, every now and again, we’re surprised and their water didn’t break. But almost always, that’s a pretty, you know, surefire sign. And on the flip side, if they say, “You know, I have a tiny bit of mucousy discharge and nothing else has been leaking for the past hour,” it’s pretty obvious their water is not broken. You know, maybe 10% of the time, it really is hard to know based on the story. It could be, you know, a slow trickle of fluid. It could not be. And we really have no way of knowing unless we bring them in and check them out. But I’d say usually we can figure it out over the phone and get it right. Usually, not always. So say the scenario is different and you’re not on the phone. You’re actually seeing them in person in the hospital. So you mentioned before what you would do if we’re trying to figure out if their water is broken. What if someone, you know, they come into the hospital, they are contracting, let’s say painfully every four to five minutes. So that’s correct. And you examine them and they’re 1.5 centimeters dilated. How do you figure out if they’re in labor or not at that point?

Dr. Mobeen: So first, I would check and see if they had had an exam earlier in the office, earlier in the week, if I have something to compare it to, depending on what the exam was earlier and how long ago it was. And I also see how painful the contractions are. How, you know, if the patient wants pain management, typically between early labor, there’s options of like IV pain medication versus epidural. And then I would talk about since she’s only 1.5 centimeters, the option to have, you know, another exam in about two to three hours to see if there is change being made. If there is, then she’s likely labor and should be admitted. If there is not, then likely it’s, like, early latent labor/false labor pain. Now, everybody has different pain thresholds. So even if there is no change and the patient is very uncomfortable, depending on how many weeks she is, there’s always, you know, 39 plus weeks, there’s always the option to stay and get pain management. And we can, you know, help you with the labor process by inducing you. But most of the time, it just really depends on what the initial exam is and the comparison to the second exam.

Dr. Fox: Yeah, it underscores that there’s a lot of gray in terms of, number one, when exactly is labor starting? Did it start with the contractions? Did it start when you actually can tell that the cervix is changing? Because it changes very slowly in the early part of labor. So you can check someone, you know, over two hours and have the cervix be the same, but then find out later they probably were in labor. You know, if you check someone at 7 in the morning and they’re 1 centimeter and at 9 in the morning, they’re 1 centimeter and at 11 in the morning, they’re 2 centimeters, well, does that mean they went into labor at 9? Were they in labor at 7 but it took some time? It’s very hard to know this and that’s well known. And so that’s sort of gray area number one.

And gray area number two is, does everybody in early labor need to be in the hospital? And the answer is no. Right. There’s people who labor at home for some time. There’s people who labor and deliver at home. There’s people who, you know, there’s all different forms of things that happen. And so for people who are planning a hospital birth, like in our practice, we do hospital births, whether they need to be in the hospital, a lot of it sort of depends on the circumstances. One of them is obviously, how is the baby doing? How’s the mother doing? How’s her health and all these things? Fine. But also, how much pain is she in? And if she’s like, “I’m not in that much pain. I think I’d be more comfortable at home for the next three, four or five hours,” whatever it is, and the baby looks fine, that’s certainly reasonable in very early stages of labor. Whereas if someone said, “I’m not comfortable at home” or “I don’t want to be at home” or “I’m in enough pain that I want an epidural” or something, then fine. Then we admit them to the hospital. So you could have two patients with the exact same stats, let’s say, for their labor, one of whom goes home and one of whom stays in the hospital. And that’s totally reasonable. And so we try to individualize it. And we don’t have hard and fast rules exactly about who needs to be in the hospital and who doesn’t, again, assuming the baby’s well and the mother’s well, because those are other reasons to stay in the hospital. But just in terms of labor. And that’s a conversation that we have. And in your experience, when people come to the hospital and they think they’re in labor, how many of them are looking to go home for a little bit more, how many of them are looking to stay? Or is that just very, very individualized?

Dr. Mobeen: It’s very individualized. It really just depends on how much pain they’re having and how much they can tolerate and also their desire for a more natural birth versus, like, if they are okay with us augmenting/inducing. It just depends on the person, honestly. Everybody’s different and it’s very variable.

Dr. Fox: Yeah. And that’s also sometimes, like you said earlier, part of the decision we have on the phone, whether to bring someone into the hospital, is sometimes based on that as well. If someone’s like, “Hey, I was planning to labor at home as much as I could because I’m more comfortable here,” and then we would probably bring them in a little bit later, again, assuming there’s no bleeding, assuming their water is not broken, assuming the baby is moving, things like that. We would say, “All right. Wait a little bit longer” and how far they live from the hospital and all those things. Whereas someone is like, “No, no, no, I’m not looking to labor at home. I’m looking to labor in the hospital. I want a nurse with me. I want an epidural,” fine, then come in maybe on the earlier side. And so these things really are individualized.

And I think that that’s one of the takeaway, you know, points of this podcast is that there’s things we use to help evaluate on the phone and in conversations and in person. But ultimately, there isn’t one way to do this. And a lot of it depends on the patient’s circumstances and her desires and her pain level. And we try to individualize it as best as possible for her to sort of match what’s going on with what she’d like to go on.

Dr. Mobeen: Exactly.

Dr. Fox: Beautiful. We we covered earlier a little bit about if someone’s water is broken. That’s a separate podcast. But yes, you are correct. The typical recommendation for someone whose water is broken, is to come in and have the baby to be, it’s not technically being induced because your water is broken, we call it to be augmented. It’s its own separate podcast, why that is and what the risks are of not doing it. It does not tend to be a life or death decision, but it is something that is typically recommended and we do in our practice as well. Again, but that’s also individualized to some degree. Dr. Mobeen, good stuff. Thank you for clearing that up for us. And now that everyone’s heard this, they’ll either be calling you more or less based on how they view this podcast. But thank you for your sage advice.

Dr. Mobeen: You’re welcome. Thanks for having me on.

Dr. Fox: Thank you for listening to the “Healthful Woman” podcast. To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s healthfulwoman.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day. The information discussed in “Healthful Woman” is intended for educational uses only and does not replace medical care from your physician. “Healthful Woman” is meant to expand your knowledge of women’s health and does not replace ongoing care from your regular physician or gynecologist. We encourage you to speak with your doctor about specific diagnoses and treatment options for an effective treatment plan.