Q&A: My doctor wants to induce labor at the first sign of readiness. Is that OK?
My doctor wants to induce labor at the first sign of readiness. Is that OK?
Hmm. The short answer is “it depends.” There are pros and cons to labor induction. Let your priorities guide this decision.
New research data has led to a strict rule: never induce before 39 completed weeks (seven days before the due date) unless there is a medical reason. Surprisingly, even full-term babies (more than 37 weeks) are more likely to need newborn ICU care if induced before 39 weeks gestation. This is in contrast to term babies born after labor starts on its own. In spontaneous labor, it appears that the baby sends a signal that it is ready. When we induce, we aren’t waiting for that signal and we are more likely to cause problems for the 37- to 39-weeker.
Other arguments against induction:
- Induction may make labor longer and certainly makes birth more medical. For most inductions you can expect an IV, continuous electronic fetal monitoring, and spending most of the time in bed. During the early labor part of an induction the mom doesn’t have the luxury of distracting herself with other activities at home—she will be in the hospital every minute. Also, inductions can take as long as two to three days if the cervix isn’t ready.
- Induction may increase the chance of needing a Cesarean. This is controversial, but clearly true for a first time mom with an “unfavorable” cervix—one that is firm, undilated, and uneffaced, especially if the baby hasn’t yet dropped.
- Nature developed a system that has worked pretty well for millennia. Why do we need to mess with success?
Pros for induction:
- Induction gives you and your OB more control over when the baby comes. This can help your doctor to be available for you, and you and your family to make plans.
In retrospect, if a disaster happens late in pregnancy (like stillbirth from an umbilical cord accident) it could have been prevented if the baby were delivered earlier. This is rare, though, and this benefit is usually outweighed by the negatives of induction.
If your cervix is “favorable”—meaning soft, dilated, and effaced—and the baby has dropped, there are fewer reasons to avoid induction after 39 weeks. Talk to your doctor about what is important to you, so you can come to agreement together about the best approach.