Induction of Labor

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What is induction of labor?

Induction of labor means getting the process of childbirth (labor) started before it happens naturally on its own.  This is done with the use of medicines or, in some cases, surgical methods.

When is it used?

In most cases, your pregnancy will progress as it should and labor will occur naturally. However, there are instances when a concern with your health makes it necessary to start the birth process early.  Examples include:

• The mother has high blood pressure caused by the pregnancy (called preeclampsia).
• The mother has gestational diabetes.
• The mother has chronic medical problems, such as kidney, lung or hear problems.

Sometimes minor problems with the pregnancy can require your provider to induce labor. These include:

• Your water breaking prior to feeling labor pains.
• Being 1 to 2 weeks past your due date
• Having a history of fast labor and live too far from a hospital to arrive before the birth.

Other reasons for an induction of labor can be discussed with your physician prior to induction of labor.

Before starting labor, the physician will check the opening of your uterus (the cervix) to see if it is getting ready to allow the baby to go through.  This helps our physicians know the best way to begin the induction.  We will also check the baby’s position.  In some cases, we may check the baby’s lungs by testing a sample of amniotic fluid.

When is induction not used?

In most cases, an induction of labor is not necessary and the labor and birthing processes continue regularly. However, there are circumstances in which an induction of labor is not done. In these cases, we will discuss with you the next best course of action.

• Placenta previa (the placenta located low in the uterus, possibly covering the cervix.)
• When the baby is lying transverse (sideways) in the uterus.
• Prolapsed umbilical cord which comes through the cervix before the baby.
• Previous surgery on the top or body of the uterus (fundal area)
• Previous C-section with vertical incision.
• Active genital Herpes infection.

What are the risks associated with this procedure?

While generally safe, there are risks to induction of labor. These include:

• Abnormal fetal heart rate from contractions that are too strong or frequent, or from a squeezing (compression) of the umbilical cord.
• Separation of the placenta from the uterus (abruption).
• Too much water in your body if the wrong IV solutions are used.
• Prolapsed umbilical cord (the umbilical cord falls into the birth canal ahead of the baby’s head or other parts of the baby’s body) or infections as a result of amniotomy.
• Damage to the uterus or cervix  (for example, a tear of the uterus or cervix)
• A cesarean delivery if induction of labor does not work.  It is clear that an induction increases the change that you will end up with a cesarean section if this is your first pregnancy.
• Infection from the breaking of the bag of waters with amniotomy, especially if labor is prolonged as inductions frequently are.
• Increased cost.
• Pediatric risks include issues of prematurity if the baby is delivered preterm