Most pregnant women hope that their labor will occur naturally, on time, without medication. When this doesn't happen, or a woman has a condition or complication, inducing labor may be necessary. In certain cases, some doctors will allow a woman to schedule her labor even when it is not medically necessary — this is called an elective induction. There is much debate in the field of obstetrics about whether elective inductions should be performed simply out of convenience to the mother and/or the doctor.
Inducing labor is deemed medically necessary if a woman has developed certain conditions such as preeclampsia, high blood pressure (pregnancy induced hypertension) and gestational diabetes. Other medical conditions that may put a woman or her baby at risk may necessitate inducing labor early, or around the due date. Another reason a mother may be induced is if she is past 42 weeks gestation, due to the risk of the breakdown of the placenta at this point. A woman may be induced if her baby is showing signs of stress or if the amniotic sac has broken without contractions.
An elective induction may be scheduled if a woman wants or needs to schedule the birth of her child. Perhaps she has family who wants to be in town for the birth, or to take care of older children. If her spouse travels for work, inducing labor may be necessary to guarantee that he is present and not stuck in an airport if labor starts earlier than expected. If a woman wants a particular doctor in a practice to deliver her baby, she may schedule labor induction.
Unless your induction is due to a medical emergency, your doctor will schedule it for first thing in the morning at the hospital of your choice. Depending on the doctor's and hospital's policy, you may be instructed not to eat anything after a certain time the night before. After you check in, your nurse will check you and the baby, and most likely start the IV where the medication will be administered.
Artificial hormones are typically used in inducing labor. Depending on how your doctor chooses to go about inducing labor, you may be given either prostaglandin or oxytocin. Prostaglandin is administered either through a suppository, which is inserted into the vagina, or a gel applied in the vagina. This softens and ripens the cervix in order to facilitate dilation. Prostaglandin is given the night before a planned induction so that the cervix will be ready first thing in the morning. Oxytocin, or Pitocin, may be administered to stimulate contractions of the uterus, much in the same way that the natural hormone does.
Labor can also be induced by breaking the amniotic sac by performing an artificial rupture of membranes (AROM) or an amniotomy. The doctor inserts a long, plastic hook into the cervix, and catches it on the membranes of the sac. Once it is broken, the baby will move further down and becomes better applied to the cervix, resulting in stronger contractions. One benefit of breaking the amniotic sac is that it can shorten the duration of labor. It does have risks — the umbilical cord can become prolapsed and infection can set in if the baby is not delivered soon enough.
There are many benefits to inducing labor. You get to choose your baby's birth date, plan ahead for time off from work for you and your spouse, arrange childcare and make other necessary arrangements. If you're planning to use pain medication such as an epidural, you can arrange one ahead of time, before you are too far along. If you're a planner, inducing labor is an option you may be interested in.
As with any medical intervention, inducing labor may not go according to plan. Your body may not be ready for labor, and the induction can fail, necessitating further interventions, and possibly a cesarean delivery. Contractions can stall out and your cervix may not fully dilate. It may also be too early for the baby if your due date is off, resulting in a premature baby who may not be ready to be born. For these reasons, many doctors will not schedule an elective induction — you may just have to wait for labor to start naturally!