A common decision that many parents face today during pregnancy is whether or not they should be induced. An induction happens when a pregnant woman’s labor is artificially started, usually with the synthetic form of oxytocin,Pitocin. Sometimes an induction is medically necessary, which we encourage you to move forward and schedule an induction! You rock it, mama! But there are other times when parents choose an induction out of convenience and not for good health reasons.
Parents should be aware that it’s not always a good idea to be induced when it’s not medically necessary. They need to know why it is important to avoid an induction if your baby and your body are not ready and why it is important to allow labor to begin naturally and without any interference.
Why would I need an induction?
Your healthcare provider might recommend inducing labor for various reasons. For example:
- You’re approaching two weeks beyond your due date, and labor hasn’t started naturally.
- Your water has broken, but you’re not having contractions.
- There’s an infection in your uterus.
- Your baby has stopped growing at the expected pace.
- There’s not enough amniotic fluid surrounding the baby (oligohydramnios).
- Your placenta is calcifying (they may say “getting tired”).
- The placenta peels away from the uterus’s inner wall before delivery — either partially or completely (placental abruption).
- You have a medical condition that might put you or your baby at risk, such as high blood pressure or diabetes.
Can I wait for labor to begin naturally?
You usually have up to two weeks after your due date, and in some cases, only one week before you are scheduled to be induced (read 12 ways to induce labor naturally HERE). Why the concern after two weeks? The longer your pregnancy continues, the larger your baby is likely to be — which medical staff is afraid might complicate a vaginal delivery. In other cases, aging of the placenta might compromise a baby’s ability to thrive in the womb. An overdue baby is also more likely to inhale fecal waste (meconium) during childbirth, which can cause breathing problems or a lung infection after birth. These are the concerns.
What are the risks?
Here are the risks and reasons why you would want to avoid labor induction in childbirth:
1. You could be at risk of delivering a premature baby.
Studies are showing that babies who are even slightly premature have more problems at birth and beyond. There are no proven health benefits for forcing your baby from the womb before your baby has had enough time to develop properly. In the last few days before the birth of your baby, the final layers of fat are placed, and the lungs are receiving the finishing touches even as you are going through labor. All of this will help your baby to be comfortable in a change of environment. If you are a first-time mother, your baby will most likely be ready to be born eight days after your estimated due date.
2. Your baby may experience heart decelerations.
The medications used to induce labor — oxytocin or prostaglandin — might provoke too many contractions too close together and too strong of contractions. All of this can diminish your baby’s oxygen supply and lower your baby’s heart rate. This causes more interventions to be performed, which then increases your chances of a cesarean section.
3. You may get an infection.
Some labor induction methods, such as stripping or sweeping the membranes, breaking water, or placing a balloon catheter (also known as a Foley catheter) or seaweed rods into the cervix, might increase the risk of infection for both you and baby.
4. Your labor maybecome more painful and prolonged.
Your contractions may become too long, too strong, and too close together, causing you to be more uncomfortable, tired and potentially putting your baby in distress. Yes, the medical staff can turn your Pitocin off and/or lower the dosage, but this doesn’t always feel to the mother like her contractions’ intensity has lessened.
5. You may not be ready physiologically or emotionally to give birth.
Understanding that hormones will release from the baby, which actively starts labor, puts “waiting until the baby is ready” in a better perspective. This will, in most cases, signal the body to begin preparing at the appropriate time. And the body also will receive feedback through this hormone signaling process to begin secreting opiates to aid the body in handling the stresses it will undergo. Inducing labor could cause unnecessary stress on your body and your baby. Additionally, it prevents your body from responding and coping appropriately.
6. Your baby may experience harm caused by mechanical force.
The force of the artificial contractions could potentially damage your baby’s brain and affect your baby’s ability to breathe. Babies that find themselves on respirators inside the Neonatal Intensive Care Unit (NICU) are often the result of interventions.
7. You may be at risk of secondary infertility.
Infertility is a risk due to the increased risk of damage to your uterus caused by uterine rupture.
8. You may be at risk of bleeding throughout your labor and after childbirth.
This happens because of the damage caused to your uterus by the induction drugs creating a greater difficulty in caring for the new baby and the increased possibility of prolonged postnatal depression caused by the induction drugs. It’s common to have bloody show during labor and lochia after childbirth, but inductions cause women to bleed more.
9. You may not be able to avoid pain-relieving medication (like an epidural) due to the abnormally increased pain during labor.
Few women can have an induced birth without additional drugs to handle the increased pain from artificial contractions. However, some women do! I have personally helped several women achieve this as their birth doula, but it is still incredibly challenging.
10. You could unknowingly trigger a cascade of medical interventions.
You may have begun your induction with Cervidilto help ripen your cervix and then went to Pitocin or Cytotec to help dilate. Because of the strong medications to force your cervix to thin and open, multiple narcotic drugs for relieving increased pain are common. This means that you may choose an analgesic drug (Nubain, Demerol, Stadol, etc.) or an anesthetic (epidural or spinal block), which an epidural is the most common. Then you will need a bladder catheter, continuous fetal monitoring, checking your blood pressure every 15 to 30 minutes, potentially an assisted vaginal birth (meaning forceps or the use of a vacuum extractor or even an episiotomy). That’s a lot for your body to go through!
11. You could have a uterine rupture.
This is a rare but serious complication in which the baby breaks through the uterus wall into the mother’s abdomen. Cases like this occur in women who have a scarred uterus. (This means if you’ve had a previous C-section, you cannot be induced because that increases your chances of uterine rupture.) An emergency C-section is needed to prevent life-threatening complications if this happens.
Why you DON’T want to schedule an induction.
If you don’t induce your labor and allow your labor to begin normally, your:
- Contractions may be less painful than they would be with Pitocin.
- Labor may be shorter and more productive. (Your body will be ready for it).
- Baby may be able to breathe better.
- Health costs associated with your birth may reduce.
- The need for pain medication may be less, which helps save you money.
- Delivery may be shorter.
- Recovery may be faster.
- You and your baby may be healthier as a result.
- Baby may breastfeed more easily.
- The ability to bond and attach to your new baby may be easier.
Inducing labor is a serious decision. Again, if it’s medically necessary, do it! But if you’re just tired of being pregnant, or you want your baby born on a specific date, or because your family or doctor will be in town, it might not be worth it in the long run. Work with your healthcare provider to make the best choice for you and your baby. But I will say, avoiding a labor induction is one of the best secrets to having safe and gentle labor and delivery for both mother and baby.
FAQs
Why would you not want to be induced? ›
Labor induction increases the risk that the uterine muscles won't properly contract after giving birth (uterine atony). This can lead to serious bleeding after delivery. Occasionally blood products are needed for serious bleeding.
What if I don't want an induction? ›If you don't want an induction, your midwife will put together a plan for monitoring you. If your waters break before 34 weeks, you'll only be offered an induction if there are other factors that suggest it's the best thing to do. For example, if you have an infection or there are concerns about the baby's health.
Should you schedule an induction? ›Inducing labor should be for medical reasons only. If there are medical reasons to induce your labor, talk to your provider about waiting until at least 39 weeks of pregnancy. This gives your baby the time she needs to grow and develop before birth. Scheduling labor induction should be for medical reasons only.
Can you decline induction? ›Ultimately you hold the power to accept or decline treatment, whether it's an induction or any other procedure. There is a possibility, however, you might get some blowback from your care provider.
Why is being induced a harder labor? ›An induced labour can be more painful than a natural labour. In natural labour, the contractions build up slowly, but in induced labour they can start more quickly and be stronger. Because the labour can be more painful, you are more likely to want some type of pain relief.
What are the pros and cons of being induced? ›Researchers have found that inducing labor after 37 weeks of pregnancy can lower the risk of perinatal mortality without increasing caesarean section rates. However, babies born to mothers who are induced are more likely to be admitted to a special care baby unit.
How many weeks can you go without being induced? ›Most doctors and midwives are happy for you to go a few days over your due date as long as everything seems to be okay. Many will let pregnant women go up to two weeks over. After 42 weeks, however, the baby's health might be at risk.
How many inductions end in C-section? ›Women and their doctors chose the induction method: In general, it is done either by rupturing the amniotic sac or with hormonal medications that trigger labor. In the end, the C-section rate was less than 19 percent in the induction group, versus just over 22 percent in the standard-care group, the findings showed.
How long can you avoid induction? ›If a pregnant woman is a few days overdue but there's no sign of any problems, there's little risk for the unborn child. But if the baby is more than one week late, inducing labor will lower the risk of complications. Most babies are born around the estimated due date, usually within two weeks before or afterwards.
When are inductions usually scheduled? ›When a woman and her fetus are healthy, induction should not be done before 39 weeks. Babies born at or after 39 weeks have the best chance at healthy outcomes compared with babies born before 39 weeks. When the health of a woman or her fetus is at risk, induction before 39 weeks may be recommended.
What time of day are inductions usually scheduled? ›
Background: Induction of labour is a common intervention in obstetric practice. Traditionally, in most hospitals induction of labour with medication starts early in the morning, with the start of the working day for the day shift.
Are inductions usually scheduled at night? ›Traditionally, in most hospitals, induction of labour starts early in the morning, with the start of the working day. In human and animal studies however, spontaneous onset of labour is proven to have a circadian rhythm with preference for start in the evening.
Is induction stressful for baby? ›Inducing labor involves intervening in the body's natural processes by breaking the amniotic sac, using medication, or both. However it's done, it can lead to fetal distress (such as abnormal heart rate).
Can you refuse Pitocin during induction? ›Do I have to get Pitocin? The short answer is no. Pitocin is only for those patients that truly need labor augmentation, for various reasons, which we would first discuss together. I do not routinely use Pitocin, and no one is obligated to take Pitocin, even when it is indicated.
Does induction hurt more than natural labor? ›Induced labour is usually more painful than labour that starts on its own, and you may want to ask for an epidural. Your pain relief options during labour are not restricted by being induced. You should have access to all the pain relief options usually available in the maternity unit.
Can you refuse induction and ask for C section? ›You can ask for a caesarean birth even if your doctor or midwife doesn't think that you have a medical need for one. This is called a maternal request caesarean birth. Your hospital must listen to your reasons for wanting a caesarean birth and have good reasons for saying no.
Should I be induced at 41 weeks or wait? ›A new study today found that inducing labor for women at 41 weeks may be a safer option than waiting for labor to begin naturally. According to a major scientific review of birth records, overdue babies are more likely to be stillborn.
What are the cons of being induced at 39 weeks? ›However, elective induction may be associated with drawbacks such as increased length of labor, the potential for patient/provider impatience, Cesarean delivery, a long latent phase, increased cost, and neonatal morbidity if the gestational age is less than 39 weeks of gestation [3,8].
What are the cons of induced Labour? ›Some people report an induced labour to be more painful, and the hospital stay during and after birth may be longer. It is also associated with a more negative birth experience (Adler et al, 2020; NICE, 2021a).
How long is average labor when induced? ›Typically, a normally progressing labor for a first time parent from the very first sign of labor through birth of a baby can take between 24 to 36 hours. Typically, we expect an induction to last close to 36 hours.
What percentage of first-time moms have to be induced? ›
The likelihood of induction of labor varies widely by gestational age, with U.S. births at 41+ weeks for first-time mothers much more likely to involve an induction (45%) than those at 39 weeks (30%) [3].
Is it better to be induced or have C-section? ›Inducing Labor at 39 Weeks Might Be Safer Than a C-Section… Here's Why. Researchers say inducing labor a week or two early reduces the chances of needing a cesarean delivery. It's also better for the health of the mother and the baby.
What percent of inductions fail? ›This study showed that the prevalence of failed induction was 20.5% (95% CI: (15.7–25.3%)). The odds of failed induction in unfavorable bishop score were 4.05 higher than the odds in favorable bishop [AOR = 4.05 95%CI (1.19–13.77)].
Can induction cause stillbirth? ›In many centers in the UK and Scandinavia, induction is common no later than 42 weeks. Recent studies have shown a significantly increased risk of perinatal mortality and morbidity at 41 weeks, and of stillbirth beginning at 39 weeks.
How long does induction take if your cervix is closed? ›Induction is not a quick process. Once it has started, it may take more than 24 hours until your baby is born. If your cervix needs to be primed, it may take two days or more.
Should I schedule an induction at 40 weeks? ›Research shows that babies do best when they are born during weeks 39 and 40. A pregnancy is considered full term at 39 weeks, and the due date is 40 weeks. Sometimes a woman with a healthy pregnancy will ask for labor to be induced at 39 or 40 weeks.
Should I shave before induction? ›Things to Remember
Please do not shave or wax your abdomen, thighs, or the area around your vagina for at least one week before your induction of labor. Take a shower with an antibacterial soap such as Dial and wear freshly laundered clothes.
An employee induction can take place over a few hours, a full day, or, even a week – depending on the complexity of their job role, the number of people and systems they interact with, and the nature of their work. An induction day is often, but not always, the first day of someone's employment with a company.
How often are inductions successful? ›Successful inductions were 76% of all inductions and goes to 91.3% if we exclude the other cesarean deliveries done for indications other than failed induction; this rate is slightly higher than the studies of Addis Ababa Army Hospital (59.7%) [15], Jimma University Hospital (65.7%) [14], Hawassa (61.6%) [13].
Why are inductions scheduled in the evening? ›Why it is important to do this review. Starting induction in the evening, to coincide with the endogenous circadian rhythm, might improve the outcome of labour compared to starting induction in the early morning, organised to coincide with office hours.
How many gels for induction? ›
Sometimes just one dose is required, but many women require more with a second dose given after 6 hours. Some women will require further gel the next day. If your labour has not started after the first day with either the gel or pessary a Doctor or a Midwife will examine you internally the next morning.
Why do doctors like to induce? ›Doctors sometimes recommend inducing labor and birth for the benefit of the baby, mother, or both. Hypertensive diseases, including chronic high blood pressure and preeclampsia, are dangerous conditions that may require accelerated delivery.
What is the point of being induced? ›Labor induction — also known as inducing labor — is prompting the uterus to contract during pregnancy before labor begins on its own for a vaginal birth. A health care provider might recommend inducing labor for various reasons, primarily when there's concern for the mother's or baby's health.
Does being induced increase your chance? ›One study of more than 600 healthy women published in the New England Journal of Medicine in 2016, for example, revealed that inducing labor in women over age 35 at 39 weeks did not raise their chances of a cesarean.
How does being induced affect baby? ›Increased Risk of Complications
Inducing labor involves intervening in the body's natural processes by breaking the amniotic sac, using medication, or both. However it's done, it can lead to fetal distress (such as abnormal heart rate). 1 In addition, when labor is induced using medication, labor may take longer.
Women and their doctors chose the induction method: In general, it is done either by rupturing the amniotic sac or with hormonal medications that trigger labor. In the end, the C-section rate was less than 19 percent in the induction group, versus just over 22 percent in the standard-care group, the findings showed.
What rate of inductions end in C-section? ›35.8% (just over one in three) of the women whose labour was induced at 40 weeks had a caesarean.
What time of day are inductions scheduled? ›You will be given an induction priority number, this number tells you what order you will be invited in to Labor & Delivery. Our goal is to start your induction sometime between 5-9 am or 8-9 pm. During this call, you will be asked what time you would like to be called prior to your arrival time.
How long does it take to schedule a induction? ›It can take up to two or three days to induce labor, but it usually takes less time. It may take more time if you're being induced before you're full-term or if it's your first baby.
Why are inductions scheduled at night? ›In human and animal studies spontaneous onset of labour is proven to have a circadian rhythm with a preference for start of labour in the evening. Moreover, when spontaneous labour starts in the evening, the total duration of labour and delivery shortens and fewer obstetric interventions are needed.
What percentage of first time moms have to be induced? ›
The likelihood of induction of labor varies widely by gestational age, with U.S. births at 41+ weeks for first-time mothers much more likely to involve an induction (45%) than those at 39 weeks (30%) [3].
When is the safest time to be induced? ›When a woman and her fetus are healthy, induction should not be done before 39 weeks. Babies born at or after 39 weeks have the best chance at healthy outcomes compared with babies born before 39 weeks. When the health of a woman or her fetus is at risk, induction before 39 weeks may be recommended.
What percentage of pregnancies get induced? ›More women are scheduling inductions to start the birth process – in fact, the American College of Obstetricians and Gynecologists (ACOG) reports that 20 percent to 40 percent of labors are now induced.
What can you refuse during labor? ›For example, you have a right to refuse induction, decide whether or not to get an epidural, eat and drink during labor, and give birth in the position of your choice. You have the right to choose where to labor and give birth and leave the hospital or birth center against medical advice.