What is labor induction?
The final weeks of pregnancy can feel like they will never end. Your belly is large. Sleeping is tough. You have to pee every 15 minutes. And your baby’s adorable kicks now feel like karate chops to your ribcage! Once you get close to your due date, or breeze past it, your maternity care provider might bring up the subject of inducing labor. Labor induction means using artificial methods to get your contractions started, instead of waiting for labor to begin on its own. You might like the idea of giving birth sooner rather than later, but there are several questions to consider before choosing an induction. Your doula can help you talk though the options with your doctor or midwife and decide what’s best for you and your baby.
Why induce labor?
Most of the time, waiting for labor to start naturally is the safest choice for birthing people and babies. Sure, your care provider calculated your due date to be 40 weeks after conception, and it seems like a good plan. But your baby doesn’t actually know the plan. In fact, no one knows exactly what triggers labor to begin. But research suggests there’s a kind of hormonal conversation between your body and your baby that eventually decides: it’s time to get moving! Many healthy pregnancies last longer than 40 weeks. However, there are complications and health issues that can make a longer pregnancy risky for you and your baby.
Here are some situations where your provider might medically recommend labor induction:
- Your baby is growing more slowly than expected
- There’s not enough amniotic fluid around your baby
- Your water has broken, but labor hasn’t started
- You have gestational diabetes
- You have high blood pressure or preeclampsia
- You have a uterine infection
- Your placenta is separating from the wall of your uterus too early
- You have a health condition like diabetes or kidney disease
- Your baby has complications from Rh Disease (an issue with your baby’s positive or negative blood type)
What if my baby and I are healthy?
If there’s no medical reason to induce labor, it’s best to let your body call the shots. The World Health Organization has stated that induction methods should only be used if there is a clear medical reason and the benefits outweigh the risks of staying pregnant.
But there are other reasons why your provider might suggest labor induction or even pressure you to have one. A common concern is the “big baby.” Pregnant people are frequently told that their babies are too large and so induction is necessary. In reality, ultrasound estimates are wrong about babies’ size more than half the time. Even when babies are large, worries about their shoulders getting stuck during delivery or the risk of stillbirth are not supported by evidence. In fact, interventions have been been shown to be more risky than the big baby itself for most healthy pregnancies. People with diabetes, before or during pregnancy, do have large babies more often, but this risk can usually be managed through diet, exercise, and medication.
Your provider might also suggest that scheduling your baby’s birth is convenient. Major holidays often bring pressure from providers or family members to plan your labor around celebrations or travel. Trust your gut if you feel this type of coercion. Your doula can support you during these conversations to make sure your decisions are informed and based on evidence.
How is labor induced?
Inducing labor can involve medications or other techniques. Your doctor may use drugs called prostaglandins to soften or “ripen” your cervix. The most common medication is Pitocin, which stimulates contractions.
There are also physical methods like a membrane sweep where a care provider stretches and separates the membranes around your baby through your cervix. Another is using a balloon catheter or “Foley Catheter,” a small rubber tube that is placed in the cervix and slowly inflated. Artificially breaking the amniotic sac can also cause contractions to start or speed up.
And then there are the thousand-and-one methods that your mom or your girlfriends or a random person in the grocery store will swear sent them into labor. Unfortunately, things like acupuncture, taking long walks, having sex, eating spicy foods, pineapple, or date fruit don’t have a lot of research that shows they work. Some, like taking castor oil, can have uncomfortable side effects or even be dangerous.
What are the risks of labor induction?
Any method of inducing labor can cause side effects. The induction may not work, which can be stressful and might lead to a C-section. Membrane sweeps can be painful and cause bleeding. Pitocin makes contractions faster, more intense, and more painful, so if you prefer not to use pain medication, that can be more difficult. If the contractions are too strong, it can have an impact on your baby’s heart rate and oxygen supply. Breaking the amniotic sac also increases the risk of infection.
You have the right to informed consent and refusal of any medical treatment or procedure. That means you are the final decision-maker about inducing labor or not. Also, you will not be pregnant forever! The heartburn and swollen feet can feel endless, but one way or another, your baby’s birthday will come.
Interested in how a doula can help you decide about labor induction? Schedule your free 15-minute consultation on Mae.