Mamas on Bedrest: Why “Not” Induce? Part II

February 2nd, 2011

This blog post is the second in a short series from Childbirth Connection highlighting the information, resources and pertinent questions a woman should ask before having a labor induction. This is must have information for any pregnant mama to have on hand or to have read when looking for a childbirth provider or when presented with the prospect of a preterm  labor induction.

How can I lower my chance of being induced unnecessarily?

You can:

  • Find a doctor or midwife with low induction rate. Some caregivers have much lower induction rates than others. Although there are many exceptions, family physicians tend to have lower rates than obstetricians, and midwives generally have the lowest rates of all. Styles of practice can also vary widely within each of these groups even when the women being cared for are at similar risk. (Choosing a Caregiver will give you detailed information.)
  • Choose a birth setting with a low induction rate. Some hospitals have far lower rates of induction than others, and some hospitals are actively engaged in quality improvement efforts to reduce their induction rates. In general, rates of intervention are much lower for out-of-hospital birth centers and at home births, compared with hospitals. (Choosing a Birth Setting will give you detailed information.)
  • Discuss your preferences with your caregivers. Find out how they will work with you to meet your goals and preferences. If their response does not satisfy you and you have other options, seek a better match.
  • Educate yourself about the different reasons women are induced, and the evidence (or, in many cases, the lack of evidence) supporting these reasons. The Best Evidence: Induction of Labor page will give you more detailed information. You may also want to review your rights to informed refusal, in case you choose to exercise this right.
  • Do your best to make sure your estimated due date (EDD) is accurate. Your EDD is 38 weeks from when you conceived your pregnancy. Since most women don’t know exactly when they conceive, an EDD is often calculated from the first day of the last menstrual period, a method that assumes the woman’s menstrual cycle is 28 days long. If your menstrual cycles are longer or shorter than 28 days, or if they are irregular in length, tell your caregiver this. Your caregiver may recommend an ultrasound early in pregnancy to determine or confirm your EDD. (You can find an online EDD calculator on the Resources page of this section.)

How can I increase my chance of having a vaginal birth if my labor is induced?

You can:

  • Find a doctor or midwife with a low c-section rate. The c-section rate in induced labors varies significantly by the individual caregiver attending the birth. Those with a low overall c-section rate may be less likely to perform c-sections in women having labor induced.
  • Prepare for labor to take a long time to kick in and progress. Inducing labor is, by definition, forcing your body to go into labor before it is ready. Changes and processes that normally occur over days or weeks are condensed into a matter of hours. It often takes 12 hours or longer for “active” labor (dilation of the cervix from about 4 cm) to begin. Once in active labor, your cervix may continue to dilate more slowly than is typical in labors that start on their own.
  • Plan for excellent labor support. Because labor may be longer and more difficult, women experiencing induced labor may benefit significantly from having a skilled labor support companion. Benefits of continuous labor support include increased chance of vaginal birth, lower need for pain medication, and higher satisfaction. (Labor Support will give you more detailed information.)
  • If your caregiver recommends a cesarean section and it is not an emergency, ask specific questions about why she/he is making that recommendation. Ask what your chance of having a vaginal birth might be if you continue to labor longer, and what risks would be involved with waiting. (The Cesarean Section pages of this site will give you more information about the risks and benefits of c-section.)

How can I protect my baby’s health and safety if my labor is induced?

You can:

  • Choose to be induced only for a medical reason. Induction without a medical reason exposes your baby to procedures and drugs that can be risky, without counter-balancing benefits. The Best Evidence: Induction of Labor page in this section can help you sort this out.
  • Be as certain as possible that the baby�s lungs are fully developed. Babies born before the lungs are fully developed may have serious breathing problems that require respiratory support in an intensive care setting. If you are certain about your estimated due date, waiting until 39 completed weeks of pregnancy is a reliable way to help ensure that the baby’s lungs will be developed. If you are not sure of your estimated due date, or your caregiver is recommending medically necessary induction before 39 completed weeks, you can find out if the lungs are developed by having an amniocentesis (using a needle to remove a small amount of amniotic fluid) and testing the fluid for certain substances. If an induction is needed before the lungs are developed, your caregiver can provide a medication to speed up lung development. Some babies may still experience respiratory distress or other poor health outcomes despite these precautions.
  • Tell your caregiver if your contractions seem to be lasting more than a minute and a half or are coming more often than every 2-3 minutes in labor. These are signs that your uterus may be overstimulated by the medications used to induce labor, a situation that can decrease the amount of oxygen available for your baby. Your nurse can adjust the dose of your medication and try other techniques to allow more oxygen to your baby.


Bates E, Rouse DJ, Mann ML, Chapman V, Carlo WA, Tita AT. Neonatal outcomes after demonstrated fetal lung maturity before 39 weeks of gestation. Obstet Gynecol. 2010;116(6):1288-1295.

Luthy DA, Malmgren JA, Zingheim RW. Cesarean delivery after elective induction in nulliparous women: The physician effect. Am J Obstet Gynecol. 2004;191(5):1511-1515.

Leave a Reply

Your email address will not be published. Required fields are marked *