The induction of labor, or to start labor artificially, is fairly common. The rates of induction have been steadily climbing as more and more social inductions, inductions for labor for non-medical reasons, are done. These reasons can be for the convenience of the doctor, midwife or family, changing due dates, and others. The truth is that induction of labor increases the complication rates, including the use of cesarean section, which nearly doubles when induction is used, on other interventions in labor.
The American Congress of Obstetricians and Gynecologists (ACOG) talks about major reasons to induce labor:
- maternal illness (high blood pressure, diabetes, uterine infection, etc.)
- fetal illness
- 42 completed weeks of gestation
In addition to these recommends ACOG also says that inductions without medical indication should not happen prior to 39 weeks gestation. There are simply too many risks to the baby prior to that timing.
So what can you do about avoiding an induction? Here is some advice from other mothers:
"I think having a good relationship with your OB is crucial. It also depends on the reasoning for the induction. With number two my OB's partner was on call when my labs came back for pre eclampsia. My BP was trending up, and I was spilling protein, I did the 24 hour urine collection. The partner called me and wanted to induce the next morning. I was upset, and I had a long talk with him telling him I wanted a VBAC and inducing would reduce my chances of being successful. He kept insisting, then we argued about the magnesium, I didn't want it, he did. He wanted me to come in at 7 am the next morning. Around 9 pm I insisted on having intercourse with my husband, labor started at midnight, I delivered at 4 am naturally without magnesium or any crap. I was very happy when he came in at 7 a.m., and I was all done. Later I spoke with my OB, and he said he would not have induced me, nor would he have used magnesium. I am a physician as well so I understand that so much of medicine is an art, and you do things based on your past experiences and overall knowledge and comfort level. Everyone practices differently so it's important to be on the same page as your provider."
Dawn, mother of two, expecting number three:
"I think one of the best ways to avoid induction is to avoid unnecessary ultrasounds in the final months. My last pregnancy I had to have an u/s 2 times a week for the last three months- -and having small babies like I do, I just knew they'd cry IUGR. They did. I seriously contemplated not showing up for the induction. It's hard not to, because you do want to have the baby as soon as possible. :)
"Doctors seem to get it into their heads that the (ultrasound) measurements in the last trimester are accurate, when they are known to have a variable of one to two pounds."
Diane, mother of two:
"I think the first step is choosing a caregiver that has an extremely low induction rate - if it isn't normal for them they won't consider it normal for you and odds of it only being discussed for a sound medical reason are much better."
Amanda, mother of two:
"I avoided induction the by being very well informed and making sure I kept up the lines of communication with my doctor. I had had an induction for medical reasons with my first, and I told him from the outset with my second that I did not want another induction unless it was medically necessary. "My first induction was from low amniotic fluid in the 39th week. So, this time around, I drank 90 ounces of water a day instead of the 70 I drank with my first. My doctor said that would help make sure fluid levels stayed normal, which they did. I will say, though, that my son was born at a time of year that wasn't as hot as when my daughter was born. That probably also had something to do with it, as we live in a desert climate. "Mainly, though, when I went past my due date with my son, I made sure my doctor knew that I still didn't want an induction. He's been known to induce on the due date if the mother so desires, and I wanted to let him know that I did not so desire! He was very supportive, and I finally delivered at 40 weeks and 5 days."
Practice Bulletin #107, Induction of Labor. Obstet Gynecol. 2009;114:386-397.