What is Early Induction and When Should I Avoid it?

You're ready to have your baby - but will the baby benefit from early induction? Image by simmbarb

You’re ready to have your baby – but will the baby benefit from early induction? Image by simmbarb

Simply stated, early induction is any induction that takes place before 39 weeks gestational age. There has, in recent years, been a growing trend towards inducing women in week 37 and 38 without much concern. I heard one Labor and Delivery nurse say “37 is the new 40” – and she wasn’t talking about Mom’s age!

What’s the Problem with Early Induction?

The problem with early induction is that dates can be wrong, and early inductions are much more likely to fail – especially in first time mothers. And a failed induction rarely means stopping the medication and sending you home – if your water has been broken (standard operating procedure for many physicians) you’ll end up with a C-section surgery, whether you were planning it that way or not.

While there are some very legitimate and evidence-based reasons a high-risk pregnancy or birth may need to be induced prior to 39 weeks, the majority of early inductions have no medical reasons, or nebulous reasons.

Why Might Early Induction Be Necessary?

Reasons a woman might need an early induction include high blood pressure, maternal infections that have entered the uterus, or other serious complication that would make it unsafe for the baby to remain in the womb any longer.

Risks of Early Induction and Elective C-Section

A 2012 study in Acta Obstetricia et Gynecologica Scandinavica found that “Induction of labor for non-recognized indications was associated with a significantly increased risk of a range of outcomes, including cesarean section.” In other words, inducing labor for non-medical reasons (scheduling, preference, and fear of having a too-large baby, among others) results in a greater chance of complications or the necessity of a C-section.


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The March of Dimes credits early inductions and elective C-Sections performed prior to week 39 with an increase in neonatal intensive care unit (NICU) stays, disability, breathing problems and other complications that may have been avoided if they were allowed to remain in the womb another week or two.

Lamaze has a best birthing practice centered around this concept – to let labor begin on its own.

Induced Labor: Risks For Mom and Baby

Every induction I’ve been to has been more difficult to cope with than non-induced labors. While my sampling is obviously small, it does include both home and hospital births as well as low-risk and high-risk mothers and VBAC’s – and it reflects the current research. In every case, in my experience,  the inductions were painful and required many more interventions – and in 3 out of 5 cases, induction ended in surgical births. Talk with your pregnancy caregiver about their preferences when it comes to elective induction now, rather than later – this is another useful topic when you’re interviewing an OB or midwife

Resources

Valerie J. King MD, MPH; Rachel Pilliod BS; and Alison Little MD, MPH. Elective Induction of Labor. (2010). MEDICAID EVIDENCE-BASED DECISIONS PROJECT (MED), Oregon Health and Science University. Accessed April 21, 2013.

Rosalie M. Grivell, Aimee J. Reilly, Helena Oakey, Annabelle Chan, Jodie M. Dodd. Maternal and neonatal outcomes following induction of labor: a cohort study. (2012). Acta Obstetricia et Gynecologica Scandinavica. Accessed April 21, 2013.

March of Dimes. Why at Least 39 Weeks is Best for your Baby. (2013). Accessed April 21, 2013.

© Copyright 2013 Angela England: Childbirth, All rights Reserved. Written For: Decoded Pregnancy
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