A Common Procedure?
Labor induction has become a common procedure for women who are between 37 and 42 weeks gestation. It’s used when a woman hasn’t gone into labor on her own, or when doctors think it would be safer for the mother and baby if they induced labor. In this article, we’ll help you understand the risks of inducing labor and show you how to determine if labor induction is right for you.
Induction of labor has become so common that no one should be surprised if they are asked, “When are you going to be induced?” Many women think that this is a normal part of labor and birth and a normal part of the end of a pregnancy. It may appear to be a normal part of the process because it’s so common, but, is it truly normal? It’s common but not part of the normal processes of pregnancy, labor, and birth.
It’s not without risks, but everything has benefits and risks.
Alarming New Trends – Induction – 9.6% in 1990 to 25.7% by 2018
Since the percentage of labor inductions has increased from 9.6% in 1990 to 25.7% by 2018*, it’s no wonder women assume this is “normal”. What most people don’t know is that almost 50% of inductions fail. Undergoing an induction of labor can be a very challenging experience both physically and emotionally. Artificially starting or speeding up labor is not only hard on the mom but it is very hard on the baby.
Interventions, Medications, and Risks of Surgical Birth
Close to 50% of labor inductions end in a surgical birth, a Cesarean. Babies may go into fetal distress and what could have been a normal process begins a cascade of interventions, ending in medications, medical procedures, and surgery.
How Can You Be Sure You Really Need an Induction of Labor? QUESTIONS TO ASK.
One of the best ways to know if you do need an induction is to have a conversation with your doctor. Ask these specific questions from www.mothersadvocate.org if your care provider recommends Labor Induction:
- Why are you recommending induction of labor?
- What are the risks to my baby and me if I wait for labor to begin naturally?
- Do research studies confirm that inducing labor in this situation is safe and will reduce my risk of an unhealthy outcome?
- Can we try more natural methods of induction before using drugs?
- Is induction likely to be successful for me?
- Is my cervix ripe? (Your provider can tell you if your cervix is ripe. Women who are induced before their cervix is ripe are much more likely to have cesareans, even if cervical ripening drugs are used.)
Read my blog post: Avoid a Medical Induction – 10 Ways to Naturally Induce Labor
Why is induction done?
Inductions are generally done to avoid a post-term pregnancy but are also done for medical reasons. Many hospitals and care providers have a protocol that induction should happen if the mom hasn’t gone into labor on her own by 41 weeks. Since the average gestation is 41 1/7 weeks, why is 41 weeks the magic number?
Induction is recommended if you are in your 40th week of pregnancy or beyond and your baby has not yet been born. It’s believed by many that this can help ensure that your baby is healthy and ready to be born when she arrives.
If you have been diagnosed with pre-eclampsia (high blood pressure), then induction may be necessary because this condition can put both you and your unborn child at risk for serious health problems if left untreated.
Induction is also recommended if you have a condition that could lead to preterm labor. This includes placenta previa (when the placenta covers part of your cervix), intrauterine growth restriction (IUGR), and other complications with your pregnancy.
What Are Some Medical Reasons for Labor Induction?
According to the March of Dimes, “Your provider may recommend inducing labor if:
- Your pregnancy lasts longer than 41 to 42 weeks. After 42 weeks, the placenta may not work as well as it did earlier in pregnancy. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord.
- Your placenta is separating from your uterus (also called placental abruption) or you have an infection in your uterus.
- Your water breaks before labor, and contractions don’t begin within 24 hours. This is called premature rupture of membranes (also called PROM). According to evidencebasedbirth.com, 79% will go into labor within 12 hours. 95% go into labor within 24 hours.
- You have health problems, like diabetes, high blood pressure or preeclampsia or problems with your heart, lungs, or kidneys. Diabetes is when your body has too much sugar (called glucose) in your blood. This can damage organs in your body, including blood vessels, nerves, eyes and kidneys. High blood pressure is when the force of blood against the walls of the blood vessels is too high and stresses your heart. Preeclampsia is a serious blood pressure condition that can happen after the 20th week of pregnancy or after giving birth (called postpartum preeclampsia).
- Your baby has stopped growing. Or your baby has oligohydramnios. This means your baby doesn’t have enough amniotic fluid.
- You have Rh disease and it causes problems with your baby’s blood.”
If your water breaks but labor doesn’t start on its own within 24 hours, you might be offered an induction as well. This is because there’s a greater risk of infection if your amniotic sac breaks before labor – and if an infection does occur, doctors will want to deliver the baby quickly so that both mother and child can get treatment right away.
If you’ve been pregnant for more than 41 weeks (that’s about nine months), then it’s possible for them to pressure you to induce labor as well–even if everything looks okay with the baby at that point! Why not wait a few more days? Most care providers agree that being pregnant longer than 42 weeks increases the chances of problems. So reaching or passing 42 weeks of gestation is rare.
When is it not safe to induce labor?
To determine if it’s safe to induce labor, you need to consider several factors. The first thing is whether your cervix is ready for birth and able to dilate. Providers use a Bishop Score to determine if your cervix is ready for labor. “Bishop score is a tool your healthcare provider may use to determine if your cervix is ready for labor. It assigns point values to five factors of your cervix. Your total score helps estimate if inducing labor will be successful.” Clevelandclinic.org
How is labor induced?
Labor Induction can be done with medication or surgery. Medication is usually used for first-time moms and may include:
- A Foley bulb is inserted into the cervix and like a balloon is enlarged to put pressure on the nerves in the cervix. this sends a message to your pituitary gland to start to release oxytocin.
- Pitocin drip, artificial oxytocin stimulates your uterus to contract.
- Prostaglandins (a hormone-like substance), soften your cervix and make it more likely to open.
- Cervical ripening agents such as misoprostol, dinoprostone, or carboprost tromethamine (Hecar). These medications are inserted into your vagina or rectum (depending on what type you take). They work by causing contractions that slowly dilate your cervix over several hours and sometimes several days until it’s completely dilated.
What are the risks and benefits of induction?
Induction is not for everyone. It can be a safe and effective way to start labor, but it’s not for everyone. If you’re considering induction, ask your doctor about the risks and benefits of inducing labor versus waiting for spontaneous labor to occur on its own. *See questions to ask, above.
You may also want to consider your personal preferences when making this decision: Do you want an epidural? Will being induced affect how long it takes before delivery? Is there any chance that labor induction could lead to complications such as infection or bleeding? And what will happen if things don’t go as planned?
Inducing labor can be a safe way to get your baby born, but it’s not for everyone.
Induction is a safe way to get your baby born, but it’s not for everyone. If you’re considering an induction and want to know if it’s right for you, ask yourself and your provider these questions:
- Is my baby okay and healthy?
- Am I okay and healthy?
- Do I want to let nature take its course and go into labor on my own?
- Do I want a vaginal birth?
- Do I want an unmedicated birth?
- What’s the safest birth for my baby?
- Is my cervix ready and ripe for delivery? What’s my Bishop Score – effacement, dilation, baby’s position, and baby’s station?
- How would it benefit my baby for me to get an induction?
- Do I want to risk having a Cesarean?
- How can my provider reduce my risk of a Cesarean?
Labor induction can be a safe way to get your baby born, but it’s not for everyone. If you have questions about whether you should have your labor induced or not, talk to your healthcare provider.