There are many reasons why a healthcare professional may choose to induce a woman’s labor, including because the mother wishes it or because of a medical emergency. Although it is usually a safe medical intervention, the American College of Obstetricians and Gynecologists (ACOG) recommend against elective induced labor before 39 weeks gestation.
The typical pregnancy lasts 40 weeks, which is a long time for the woman enduring it. If labor hasn’t started by 42 weeks, a healthcare professional will induce labor. After 42 weeks, the baby is at risk due to a deteriorating placenta. Most medical professionals, however, schedule an induction if labor has not begun by the 40th week.
There are many medical complications that can lead to the need to induce labor. Complications, such as hypertension and preeclampsia, which cause high blood pressure, headaches, and excessive fluid retention, often mean that labor needs to be induced for the sake of the mother and baby. Heart disease, bleeding during the pregnancy, and gestational diabetes are other complications that require a medical professional to induce to ensure that the mother and baby both receive the medical treatment they require.
If, for any reason, the baby is in distress and seems to be deprived of oxygen or nutrients, labor may be induced if the pregnancy is close to full term. Sometimes, a baby may seem very small for its gestational age, and the healthcare professional may decide that it's best to induce to see if there's a problem. If a mother’s water, or amniotic sac, has broken and labor does not start within 24 to 48 hours, a medical professional will get things moving due to the possibility of a bacterial infection. A uterine infection called chorioamnionitis is another reason to do so.
Some women schedule their labor due to their or the father’s work, or because they want to ensure that out-of-town family is present for the birth. Women carrying multiples and attempting vaginal delivery may choose to induce as well. Different healthcare professionals have different policies on why or even if they allow elective induced labor, so a woman who may want to electively induce should discuss it well in advance.
To induce labor, the healthcare professional will administer oxytocin and/or prostaglandin, which are hormones that stimulate the contractions of labor. If the cervix is ripe, these should jump-start labor reasonably fast. Two non-medicinal interventions include artificial rupture of the membranes (AROM) and stripping the membranes. While some women respond quickly, others may take two to three days to get labor going.
As with any medical intervention, there are risks involved with inducing labor. First of all, it simply may not work — every woman responds differently, and every labor is unpredictable.
Sometimes, an induction may end with a cesarean for many different reasons: the baby could not make it through the birth canal, the cervix wasn’t adequately ripened, or the long labor put the baby in distress. There is a slight risk of uterine tear due to abnormal contractions that may result from the use of the artificial hormones. Oxytocin, on rare occasions, can cause low blood pressure and low blood sodium, which can cause seizures.
Another concern is if the expected delivery date (EDD) has been miscalculated. The healthcare professional may believe that the baby is 38 weeks old, which is a safe age for delivery, but in reality, the baby may be a few weeks younger. This is called a late pre-term baby, and complications similar to those associated with a pre-term baby may result. For these reasons, the person making the decision to induce labor must carefully weigh the benefits against the risks.