QUESTIONS TO ASK YOUR OB-GYN: INDUCTION OF LABOR, James Miller, MD (Digital)

By on April 7, 2022

You may have heard about labor induction without knowing exactly what it is. Your OB/GYN may have also mentioned it as a possibility during your delivery process. Whatever the case, it’s important to know what to expect about labor induction ahead of your delivery date. Fortunately, your OB/GYN is your best source of information about labor induction and your unique circumstances. Here are some questions to ask your care team to ensure you have a complete picture of labor induction and what you can expect.

What is an induction of labor?

Labor induction refers to methods and medicines used by your doctor to trigger labor. These methods and medicines stimulate contractions of the uterus to jumpstart the vaginal birth process. It’s a way to begin the labor process in a controlled way for various reasons. It’s actually a long process that involves multiple steps and should be discussed with your OB/GYN well ahead of your delivery date.

Why be induced?

Although it’s a common belief that labor induction is a quick and easy process, not everyone needs to be induced or even should be – inductions of labor for convenience (or elective labor inductions) are actually rare and your OB/GYN may not recommend it. Labor induction is often recommended when it’s estimated that the risk of staying pregnant outweighs the benefit. Certain medical conditions complicate pregnancy and may pose harm to mother and/or baby. Some of these conditions include:

  • Pre-eclampsia, eclampsia, or hypertension (high blood pressure)
  • Diabetes (gestational or diabetes mellitus)
  • Advanced maternal age
  • Placental abnormalities
  • Poor fetal growth
  • Uterine infection
  • Chronic maternal health problems
  • Pre-labor rupture of membranes (PROM)
  • Decreased amniotic fluid
  • Being postdates, or beyond 42 weeks of gestation.

Your doctor will assess your and your baby’s health and discuss whether a labor induction might be recommended for you.

Who shouldn’t be induced?

There are some factors that can make it unsafe for you and your baby to be delivered vaginally.  Your OB/GYN can help you determine whether a C-section is a safer route for delivery. You may not be a good candidate for labor induction in the following situations :

  • Your baby is in breech presentation or sideways in the uterus
  • Active infection
  • Previous uterine surgeries (C-section, fibroid removal, etc.)
  • Prolapsed umbilical cord
  • Placenta previa

What does labor induction involve?

Typically, it involves a midnight admission to the hospital. To begin the process of labor, the cervix needs to be softened (or ripened). If this hasn’t already begun, your OB/GYN will check your cervix and determine its readiness. Medications can be used to aid this process, called prostaglandins, as well as gentle expanders inserted into the cervical canal. Other medications like Pitocin can help stimulate contractions. Your OB/GYN may use techniques to break your water (called rupturing the membranes) as well. Induction of labor can require a lot of waiting in between steps as your body begins the process, so count on spending at least a day in the hospital.

Is there a downside to labor induction?

Many patients state a preference to avoid an induction of labor because “it isn’t natural” and because of the long-held belief that an induction of labor increases the risk of a C-section. While it’s true that an induction of labor isn’t natural, this doesn’t mean it’s bad. In fact, an induction of labor can reduce “natural” risks of pregnancy (like stillbirth). Finally, recent randomized controlled trials do not show an increased risk of C-section as a result of labor induction when compared to spontaneous labors.

There are some downsides to an induction of labor. First, the process is slow. Typically, patients arrive at midnight, and delivery usually doesn’t occur before the following evening. Second, labor inductions can require more time in the hospital relative to spontaneous labor. Third, some inductions fail, and don’t result in a vaginal delivery. As is the case with spontaneous labor, it’s impossible to know which laboring patients will need a C-section and which will deliver vaginally. The best predictor of a successful labor induction is a history of a prior vaginal birth. The best predictor of a failed labor induction is first pregnancy, advanced maternal age, and an “unfavorable” cervix.

How can I prepare?

Understand that the process is long and try to be patient. Bring things to the hospital to distract you and pass the time. Whether or not you wish to have an early epidural before the induction process begins or no epidural at all, many patients bring music, reading material, movies, birthing balls, breathing techniques, and others to support them through the day.

Finally, remember that the goal is a healthy mom and a healthy baby. We as a practice wish to provide you and your family with a safe, beautiful, and healthy delivery.

Learn More on the Healthful Woman Podcast

It’s normal to have a lot of questions around labor induction, and our team of OB/GYNs and maternal fetal medicine specialists can help. Schedule an appointment with our team at our New York City office by calling or filling out our online form.

Also make sure to check out our podcast, Healthful Women, where you can learn more about labor induction with Dr. Nathan Fox and guest Dr. Sara Kostant.

Learn More on the Healthful Woman Podcast

Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!

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