So you’re in late pregnancy, you’re uncomfortable, all ready for baby and want to hurry up and deliver already. Should you ask your care provider to schedule an induction?
An induction can be potentially lifesaving if the placenta isn’t supporting your baby any longer; your baby has stopped growing normally; you have started having preeclampsia, affecting your blood pressure and other body functions; you’ve got poorly controlled diabetes mellitus; you have an infection in your uterus; your baby’s blood type is incompatible with yours (isoimmunization); your amniotic sac has broken prematurely (rupture of the membranes) exposing your baby to the danger of an infection; or your baby has certain health issues.
Your doctor or midwife may also suggest that you have an induction if your baby is weeks overdue, especially if tests indicate that your placenta may be starting to decline in function. Placentas work most efficiently up to about 40 weeks, and 42 weeks is about the longest most clinicians are comfortable letting a pregnancy continue.
Some mothers opt to have labor induced when there’s no medical necessity, which is called having an elective induction. Some health care providers will gladly let you schedule an induction after 39 weeks or sometimes sooner, even if there’s no specific medical reason for it. Other health care providers will only let you schedule one if you’re past your due date.
The Risks of Inducing Labor
• Heightened cesarean risk. An induction nearly doubles your risk of having a c-section. A survey of the induction experiences of more than 14,409 women found that having an induction was associated with an 11 percent higher risk of having a cesarean section for first-time mothers. (See our list of c-section risks on page 000.)
• Immature baby. Your baby’s lungs are one of the final organs to mature during the last weeks of pregnancy, and dating a pregnancy is not an exact science. If your provider wants to schedule an induction because you’re past-date, make sure the length of your cycle and other factors are taken into account first.
• Uterine hyperstimulation. Overmedication can make the uterus cramp up and cutting off the baby’s supply of oxygen and blood, which can slow down the baby’s heart rate.
• Uterine rupture. Having an induction after you’ve previously had a cesarean section is associated with an increased risk of uterine rupture, so you shouldn’t have an induction if you have previously had a cesarean.
Other mothers at risk for rupture during induction are older mothers, women who have given birth to a large number of children, women carrying larger-than-normal babies, and women with an enlarged uterus.
An extra large baby is thought to have trouble fitting through a mother’s pelvis and to cause a mother’s contractions to be ineffective.
Current studies show that a doctor’s or midwife’s suspicions about the baby’s size shouldn’t be considered the only reason to opt for an induction. If your health care provider wants to schedule you for an induction only because the baby looks large from the outside, consider seeking a second opinion from a specialist in maternal-fetal medicine.
Excerpted from Great Expectations Pregnancy and Childbirth 2012 edition.