If your practitioner is recommending induction, it is important for you to know the facts before moving ahead with anything. Always ask for the reasoning behind the suggestion – why is this being recommended?
WHEN SHOULD LABOR BE INDUCED?
There are situations in which induction is medically necessary, typically when either the mother or baby’s health is in danger. Sometimes in these cases getting the baby out as quickly as possible is the best way to ensure the health of both. These situations may include:
- Cholestasis (liver issues)
- Fetal distress (i.e. lack of movement, heart rate decels)
- Other immediate concern with health of mother and/or baby
WHEN IS INDUCTION UNECCESSARY?
The following are common reasons cited for induction. While not medically necessary, the reasons behind these situations may be presented by providers in a way that makes not inducing sound scary, or even irresponsible. Be informed and trust your instinct.
Reached or Passed the Due Date
This is the most common reason given for induction, but in and of itself is not a medical reason to induce labor. To begin with, many due dates are inaccurate. Women have varying cycle lengths, which can influence a due date by up to a week. Also, some babies take longer to grow and develop than others do. Families can feel confident waiting as long as mama is feeling well, does not have high blood pressure, does not have glucose or protein in her urine, does not have any (or minimal) swelling in her legs, and the baby is active with a strong heart rate. All of these factors can be confirmed during a simple office visit. As a woman reaches 42 weeks and beyond, non-stress tests and ultrasounds can ensure that the placenta and amount of amniotic fluid are still sufficient to support baby.
This may be a valid reason when: Mother has high blood pressure, glucose or protein in urine, or significant swelling in her legs, which may indicate a health concern such as preeclampsia, gestational diabetes, or a kidney issue; or baby is inactive or shows heart rate decelerations.
For accounts from families who birthed past 42 weeks: https://www.facebook.com/TenMonthMamas
Large Baby Suspected
Ultrasounds and other measurements of baby’s size prior to birth are accurate to about 2 pounds. Which is to say, not all that accurate. Consider a measurement predicting a 10-pound baby… which may in reality be an 8-pound baby. That said, in a healthy mother bigger babies are not necessarily harder to deliver. When labor begins naturally, a woman’s body goes through some final changes that allow her ligaments to relax more. This as well as birthing positions can enable her to stretch and open to deliver her baby. With an induction, women do not have the benefit of these extra hormones and often end up in less helpful birthing positions.
This may be a valid reason when: Mother also has gestational diabetes, which slightly increases the chances of shoulder dystocia, preeclampsia, and newborn jaundice.
Sometimes women who are trying for a VBAC (Vaginal Birth After Cesearean) are told that they should be induced on the grounds that they will therefore be monitored during their labor and a problem requiring a repeat C-section can be immediately noticed. However, the use of Pitocin in women with a previous c-section actually increases the likelihood of uterine rupture! Induction should be skipped if at all possible to increase the likelihood of a successful VBAC.
For more info on VBACS: VBAC Resources
Tired of Being Pregnant
If you’ve been pregnant, you’ve been tired of being pregnant. There is often much physical discomfort in the last weeks of pregnancy, and some practitioners will offer the option of induction as relief for the mother. But as long as these discomforts are at normal levels for pregnancy, induction is not the best solution. There are countless benefits to waiting for labor to begin naturally. Instead the mother may seek relief from sources such as chiropractic care, massage, rest, warm baths, etc. The waiting can be hard on women emotionally as well; a mother can seek comfort in talking with other moms, take on a project to occupy her mind, write in a pregnancy journal, practice meditation, etc.
This may be a valid reason when: Discomfort is extreme and therefore possibly indicative of a health problem.
Benefits of spontaneous labor: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1948087/
Convenience (Provider or Personal)
Impending holidays, visiting relatives, leave time from work, school schedules, etc. – all of these have been cited as reasons for elective inductions at one time or another. Parents must always weigh the risks and benefits of their choices for both themselves and their baby. In the absence of a medical reason, the risks of an induction tend to heavily outweigh the benefits.
Stay tuned for the next blog post, coming soon:
MEDICAL INDUCTION METHODS: How each one works, its risks, and what kind of experience to expect