Most women are unaware that, in some circumstances, they can say, “No Thank You” to an induction of labor. But sometimes you may not have a choice and you must agree to what your doctor or midwife suggests for medical reasons.
But How Will You Know Induction is the Right Choice for you or your baby?
YOU MUST ASK QUESTIONS!
The only way to know for sure if induction of labor is necessary for you or your baby is to ask questions.
1. The first question is what are the risks and the benefits of induction of labor for me and my baby.
Risks of Induction of Labor
- 24% increase in your baby being born by Cesarean section
- Induced labors tend to be much longer than if labor begins on its own.
- A higher incidence of the need for pain medication.
- When mothers use pain medication they may need assistance in pushing the baby out with the use of forceps or vacuum extractor.
- Sometimes due dates are incorrect. This may cause your baby to be born earlier than anticipated and the baby may need to be admitted to a special care nursery, separated from mother in the NICU (Neonatal Intensive Care Unit).
- For the same reason babies may be born with low birth weight and may have trouble regulating breathing and body temperature.
- Mothers whose labor is induced will be in the hospital longer.
- Overstimulation of the uterus. This means contractions will be too long and too strong for baby to tolerate.
- Uterine rupture caused by medication (either Pitocin or Cytotec also known as Misoprostol) that overstimulates the uterine contractions.
- Fetal distress, also caused by contractions that are too long, too close together, and too hard. Baby is unable to recover between contractions.
Benefits of Induction of Labor:
- If there is medical evidence that baby is at risk, baby will be better off outside of the uterus.
- Signs of pregnancy complications can be avoided or stopped by inducing labor.
2. Why are you recommending induction of labor?
There can be many different reasons to induce labor. Some of the most common reasons given are not backed by medical evidence, like going past your due date, or having low amniotic fluid. Make sure you have a medical reason and clear medical evidence to back it up.
3. Do research studies confirm that inducing labor in this situation is safe & will reduce my risk of an unhealthy outcome?
From childbirthconnection.org: “Research conducted in 2010 by King and colleagues found that:
- Elective induction (induction without a well-supported medical reason) before 39 weeks clearly increases risks for babies. These risks include breathing problems, infection and admission to a neonatal intensive care unit (NICU). Much brain growth and development happens in the last weeks of pregnancy, and babies born even a few weeks before their due dates have more learning and behavioral problems than babies born after 39 weeks.
- Elective induction before 41 weeks increases the chance of having a C-section if the cervix has not already softened and started to open on its own, especially in first-time mothers. And using medications or procedures to soften the cervix does not decrease the chance of a C-section.
- Women in induced labor are more likely to ask for an epidural for pain relief than women who go into labor on their own. Epidurals have their own risks and change the experience of labor: Many other interventions are used to monitor, prevent or treat their side effects. 2010King, V., Pilliod, R., & Little, A. (2010). Rapid review: Elective induction of labor. Portland: Center for Evidence-based Policy.Can we try more natural methods of induction before using drugs?
Refer to my article on Natural Induction Techniques
Your care provider can assess your particular situation to give you more information so you can make an informed choice.
5. Is my cervix ripe? (women who are induced before their cervix is ripe are more likely to have cesareans, even if cervical ripening drugs are used.)
Often doctors and midwives use the Bishop Score to determine if your cervix is ripe. Think of an unripe peach and a ripe peach. An unripe peach is hard. The ripe peach is soft, squishy, and giving. A ripe or unripe cervix has similar qualities to a ripe or unripe peach. If your Bishop Score is less than 6, your cervix is not ripe or ready for labor.
If you have asked all of these questions, then you can participate in the decision making process with information. Though all decisions for you care should be made as a team with you and your care provider, that is not always the case. Remember that if you are able to be an active and informed participant in the decision, you will have less regrets after and feel more in control of the situation. As a result you will have a better birth experience.
Good luck and have a Happy Birth Day!