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Inducing labor: When to wait, when to induceBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/inducing-labor/PR00117
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Inducing labor: When to wait, when to induce
Considering inducing labor? Understand who makes a good candidate for inducing labor and why the intervention isn't for everyone.By Mayo Clinic staff
Nature controls most aspects of labor — but sometimes nature needs a nudge. If your health care provider decides you and your baby would benefit from delivering sooner rather than later, he or she might suggest inducing labor.
Why would I need an induction?
Your health care provider might recommend inducing labor for various reasons, primarily when there's concern for your health or your baby's health. For example:
- You're approaching two weeks beyond your due date, and labor hasn't started naturally
- Your water has broken, but you're not having contractions
- There's an infection in your uterus
- Your baby has stopped growing at the expected pace
- There's not enough amniotic fluid surrounding the baby (oligohydramnios)
- Your placenta has begun to deteriorate
- The placenta peels away from the inner wall of the uterus before delivery — either partially or completely (placental abruption)
- You have a medical condition that might put you or your baby at risk, such as high blood pressure or diabetes
Can I wait for labor to begin naturally?
Up to two weeks after your due date, a wait-and-see approach might be preferable. Nature prepares the cervix for delivery in the most efficient, comfortable way. However, if your health care provider is concerned about your health or your baby's health or your pregnancy continues two weeks past your due date, inducing labor might be the best option.
Why the concern after two weeks? The longer your pregnancy continues, the larger your baby is likely to be — which might complicate a vaginal delivery. In a few cases, aging of the placenta might compromise a baby's ability to thrive in the womb. An overdue baby is also more likely to inhale fecal waste (meconium) during childbirth, which can cause breathing problems or a lung infection after birth.
Can I request an induction?
If you're interested in an elective induction, discuss it with your health care provider. If you live far from the hospital or you have a history of rapid deliveries, a scheduled induction might be warranted. Although there are exceptions, elective induction generally isn't appropriate for lifestyle or work reasons. Keep in mind that unnecessary intervention poses unnecessary risks — such as the need for a C-section. Trust your health care provider to help you make the best decision in your case.
Can I do anything to trigger labor on my own?
Nipple stimulation or breast massage might release the hormone oxytocin, which can lead to contractions. However, these techniques have been shown only to work if the cervix has already begun to soften, thin and dilate (favorable cervix). Further research is needed to evaluate the techniques' safety and effectiveness.
Other techniques for inducing labor — such as eating spicy food or having sex — aren't backed by scientific evidence. Get your health care provider's OK before trying any home remedies, herbal supplements or alternative treatments.
What are the risks?
Inducing labor carries various risks, including:
- The need for a C-section. Labor induction is more likely to result in the need for a C-section — particularly if you've never given birth before and your cervix hasn't already begun to thin, soften and dilate (unfavorable cervix).
- Premature birth. Inducing labor too early might result in a premature birth, which poses risks for the baby, such as difficulty breathing.
- Low heart rate. The medication used to induce labor — oxytocin or a prostaglandin — might provoke too many contractions, which can diminish your baby's oxygen supply and lower your baby's heart rate.
- Infection. Inducing labor increases the risk of infection for both mother and baby.
- Umbilical cord problems. Inducing labor increases the risk of the umbilical cord slipping into the vagina before delivery (umbilical cord prolapse), which might compress the cord and decrease the baby's oxygen supply.
- Uterine rupture. Uterine rupture is a rare but serious complication in which the uterus tears open along the scar line from a prior C-section or major uterine surgery. An emergency C-section is needed to prevent life-threatening complications.
- Bleeding after delivery. Labor induction increases the risk that your uterine muscles won't properly contract after you give birth (uterine atony), which can lead to serious bleeding after delivery.
Inducing labor is a serious decision. Work with your health care provider to make the best choice for you and your baby.
- Wing DA. Induction of labor. http://www.uptodate/com/home/index.html. Accessed March 30, 2011.
- What to expect after your due date. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp069.cfm. Accessed March 30, 2011.
- Kavanagh J, et al. Breast stimulation for cervical ripening and induction of labour (review). The Cochrane Database of Systematic Reviews. 2005:CD003392.
- Labor induction. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp154.cfm. Accessed March 30, 2011.
- Wing DA. Induction of labor in women with prior cesarean delivery. http://www.uptodate/com/home/index.html. Accessed March 30, 2011.
- Clark SL, et al. Neonatal and maternal outcomes associated with elective term delivery. American Journal of Obstetrics & Gynecology. 2009;100:156.
- Wing DA. Techniques for cervical ripening prior to labor induction. http://www.uptodate/com/home/index.html. Accessed March 30, 2011.
- Battista LH, et al. Abnormal labor and induction of labor. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Elsevier Inc.; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-443-06930-7..50015-3&isbn=978-0-443-06930-7&uniqId=243410035-2#4-u1.0-B978-0-443-06930-7..50015-3. Accessed May 11, 2011.
- Cunningham FG, et al. Williams Obstetrics. 23rd ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/content.aspx?aid=6026579. Accessed May 11, 2011.
- Belogolovkin V, et al. Umbilical cord prolapse. http://www.uptodate.com/home/index.html. Accessed May 11, 2011.
- American College of Obstetricians and Gynecologists. Induction of labor. ACOG Practice Bulletin No. 107. Obstetrics & Gynecology. 2009;114:386.
- Healthy pregnancy. U.S. Department of Health and Human Services. http://www.womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.cfm. Accessed May 11, 2011.
- Management of labor. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/labor/labor__management_of__full_version__2.html. Accessed May 12, 2011.
- Meconium aspiration syndrome. The Merck Manuals: Home Edition for Patients and Caregivers. http://www.merckmanuals.com/home/sec23/ch264i.html. Accessed May 17, 2011.
- Grotegut CA, et al. Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony. American Journal of Obstetrics & Gynecology. 2011;204:56.e1.