Artificial Labor Induction: Is it Necessary?

Why wait?--Because Mother Nature knows best.

Labor induction works best when labor is about to start on its own anyway. When your body and baby are not ready for labor, induction tends to lead to a long drawn out labor that often necessitates or precipitates other interventions.

Our bodies and our placentas do not stop functioning correctly at some predetermined point. Your baby does not go from perfectly fine and healthy one week, to in danger and needing to be rescued from your body the next.

Our bodies are very wise. Our babies are very wise. They work together to grow and birth the baby in their own perfect timing.

Methods Used in Artificial Labor Induction

Pitocin is artificial oxytocin. Oxytocin is one of the hormones involved in starting and maintaining labor. It is also known as the "love hormone", as it is responsible for helping you to bond with your baby.

Pitocin is administered through an IV and the dosage given can be adjusted. It can be stopped if contractions become too strong.

Labor is initiated by an extremely complex system of hormones and chemical messages between mother and baby. Doctors mistakenly assume that by giving a woman one of those hormones they can start labor effectively and with no consequences to the health of mother and baby.

Cervical Ripening Agents (These are often used in conjunction with Pitocin.)

Prostaglandin E2 (Prepidil or Cervidil) These are gels or a tampon inserted into the cervix. They are artificial prostaglandins that are used to soften the cervix. Cervidil has a string attached so it can be removed if contractions become dangerously strong.

Prostaglandin E1 (Misoprostol also called Cytotec) Cytotec is also inserted vaginally, but cannot be removed. Cytotec has not been approved by the FDA for inducing labor and has had particularly disastrous results. It has a high rate of uterine rupture and adverse effects for both mothers and babies.

Rupturing Membranes (Amniotomy)

The doctor or care provider inserts an amnihook (which looks like a sharp crochet hook) up through the vagina and cervix and snags the bag of waters.

If it ain't broke don't break it!

Stripping or Sweeping the Membranes

The caregiver inserts a finger into the cervix and lifts the amniotic sac off the cervix which triggers a release of prostaglandins.

All of these methods come with risks.

Common Reasons Given For Artificial Labor InductionThat Should Be Questioned:

The length of pregnancy was arbitrarily set at 10 lunar months or 40 weeks by an obstetrician in the 1800s.

Most first-time mothers have pregancies that last 8 days longer than the 40 weeks considered to be full term. Pregnancies average 3 days longer in women who have already had a baby.

Some women and their babies just take longer to gestate than 40 weeks--and some take a shorter amount of time.

Just like all children do not develop at exactly the same rate after birth, they don't before birth either. Some babies simply take longer to "bake".

Dating pregnancy by ultrasound is not accurate. Even when done during the first trimester, ultrasound can be in error as much as five days plus or minus. This means your due date would fall within a 10 day window.

The later in the pregnancy an ultrasound is done, the less accurate it is.

As long as you can know when your baby is past 37 weeks (past the time when he would be considered premature), then you are good to go:)

If you know when you conceived, then calculate your own due date, and stick to your guns.

Perhaps we should be thinking more in terms of a "Birth Month" than a "due date". Baby can arrive anytime within a 5 week time period (from 37 to 42 weeks) and still be considered fine.

2. Prelabor rupture of membranes--

The theory goes that once your water breaks, the baby must be born within 24 hrs because of the risk of infection. So, women who are not having contractions, or are not having strong contractions are given medication to start or speed up labor.

But, actually, there is no danger in waiting 24 hours or more for labor to start, as long as nothing goes up the vagina. Yes, this includes vaginal exams! The more vaginal exams that are done after your water breaks the higher the rate of infection.

Vaginal exams give a free ride to bacteria up to the uterus. Severely limit the number of vaginal exams that you have after your water breaks, if you even have any.

Internal fetal monitoring and internal contraction monitoring (which are often used in conjunction with an induced labor), further increase the chance of infection. They provide a pathway for infection to move into the uterus.

Even if you are Group B Strep positive, this is not an indication for inducing labor after your water breaks. Rupture of the membranes combined with lots of vaginal exams, internal monitoring devices, and time causes your rate of infection to increase.

3. Suspected large baby--

Doctors often want to induce labor if they think that your baby weighs more than 8 lbs 13oz, or is in the upper 10% of babies for that week of pregnancy. They claim that this will reduce your risk of c-section (baby will get too big for you to birth) or shoulder dystocia (baby's shoulders getting stuck).

However, even if baby is large (and ultra-sound weight estimates are highly inaccurate), artificial induction of labor actually increases the cesarean risk.

Shoulder dystocia happens equally in women who are induced and in women who are not induced, and size of the baby is not necessarily a factor.

Shoulder dystocia is also fairly straightforward to remedy by a knowledgeable caregiver.

4. convenience--

If you haven't guessed this already--babies are not convenient ;) But, increasingly labor induction is being done either for the doctor's convenience or for the mother's.

Let your body and your baby work in their own time...

Risks To The Mother

First-time mothers who are induced have double the risk of c-section, and women who have already had a vaginal birth have five times the risk of c-section.

It increases epidural use and epidurals have their own risks and side effects

It increases instrumental deliveries (forceps and vaccuum extraction)

Labor induction increases the risk of uterine rupture from overly strong uterine contractions

The risk for women without a prior cesarean is 1-3%. This risk is even greater if your prior birth was a cesarean.

Artificial labor induction requires the use of other interventions

IV fluids and fetal monitoring either externally or internally must be used with artificial induction. These interventions come with their own risks.

Labor is more painful because the contractions are unnaturally strong.

It increases postpartum blood loss

Misoprostol (Cytotec) has a higher rate of uterine hyperstimulation than Prostaglandin E2 (Cervidil or Prepidil) and uterine rupture. Once it is given the effects cannot be reversed.

Risks To The Baby

It increases the risk of prematurity

Because ultrasounds and other methods for determining the "due date" are often inaccurate.

Increases jaundice in the baby

Rupturing the membranes "breaking the bag of waters" can cause an umbilical cord prolapse.

This is a very serious condition requiring an immediate cesarean section.

Rupturing the membranes increases the risk of abnormal fetal heart rates

Rupturing the membranes can increase the rate of infection if it is also accompanied by many vaginal exams and/or the woman is colonized with Group B Strep

Find out how you can avoid an unnecessary induction

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