Increased Chances of Birth Complications with Elective Induction
a study, published in Acta Obstetricia et Gynecologica Scandinavica,
Dr. Rosalie Grivell from the University of Adelaide’s Robinson Institute and
School of Paediatrics and Reproductive Health studied the data of more than
28,000 births from across South Australia, from 2006 to 2007. She compared cases
in which women had undergone spontaneous onset of
labor, induction of labor for recognized medical reasons, and induction of
labor for “non-recognized” reasons.
Compared with women who entered labor spontaneously, induction for
non-recognized reasons was associated with
A 67 percent increased chance of requiring a
caesarean section: Sometimes induction might not be successful. As
the bag of water has been broken, either naturally or via an amniotomy. The
risk of infection is greater, and the baby will need to be born via
c-section. A cesarean in an induced labor is also more likely reason for
Significantly increased chances of
newborn infant requiring nursery care in a Special Care Baby Unit
(an increased risk of 64 percent): Babies who are born via induction aren't
yet ready to be born. The risk is worth it if the baby or mother's lives are
in danger, but simply to take this risk for elective reasons may not be well
advised. When a baby is in the intensive care unit there is less ability for
you to be with your baby or to hold your baby.
Breastfeeding usually gets off to a rocky start as well. This can
usually be avoided by giving birth when your body and baby say it is time.
Requiring treatment (an increased risk of 44 percent) compared
with infants born following spontaneous onset of labor. Your baby may also
be more likely to suffer from jaundice at or near birth because of the
induction. This can lead to other medical treatments as well as stays in the
hospital for your baby.
Other Risks included are:
Placental Abruption: The nature of induction like contractions
may also be more forceful than natural labor. This can cause your baby to
assume or stay in an unfavorable position for labor making labor longer and
more painful for the mother.
Fetal Distress: Labor induction is done by intervening in the
body's natural process, typically with powerful drugs to bring on
contractions or devices that are used to break the water before labor
starts. Both of these types of induction can cause the baby to react in a
manner that is called fetal distress as seen by fetal monitoring.
Uterine Rupture: a full-thickness separation of the uterine wall
and the overlying serosa.
Increased use of interventions including pain relief, continuous
fetal monitoring and other interventions. When labor is induced babies
tend to stay in unfavorable positions, the use of
epidural anesthesia is increased and therefore the need to assist the
baby's birth via the use of forceps and vacuum extraction is also
increased. Being born even a week or two early can result in your baby
being a near term or late preterm infant. This means that your baby is
likely to have more trouble breathing, eating and maintaining temperature.
The risks can be considerably lowered both for mother and baby with the
spontaneous onset of labor between 38 and 39 weeks.
Induction of labor has recently been on the rise for purposes of convenience
or to accommodate busy schedules. However, according to the American College of
Obstetricians and Gynecologists (ACOG), labor should be induced only when it is
more risky for the baby to remain inside the mother's uterus than to be born.
Medical Reasons for Labor Induction
Labor can be induced for many reasons. Labor should only be induced for valid
medical reasons because of the risks involved with induction of labor.
Possible indications for labor induction include
gestational or chronic
preeclampsia, eclampsia, diabetes,
premature rupture of membranes, severe fetal growth restriction, and
post-term pregnancy(42 weeks completed). However, physicians should decide
whether labor induction is warranted on individual basis, after consideration of
maternal and infant conditions, cervical status, gestational age, and other
Contraindications to labor induction include
transverse fetal position, umbilical cord
prolapse, active genital herpes infection, placenta
previa, and a history of previous myo-mectomy.
When labor induction is deemed necessary, the
gestational age of the fetus should be determined to
be at least 39 weeks, or there must be evidence of
fetal lung maturity.
The first step in labor induction is cervical
ripening using drugs or mechanical cervical dilators
to dilate the cervix sufficiently before labor is
induced. The next step is to induce labor using
oxytocin, membrane stripping, rupture of the
amniotic membrane, or nipple stimulation.
Misoprostol, which is approved for treatment of
peptic ulcers, is often used off-label for cervical
ripening as well as for labor induction. In women
who have had any previous cesarean delivery,
however, inducing labor with misoprostol may
increase risk for uterine rupture and should
therefore be avoided.
The result of the study suggest that for women whose pregnancy is
uncomplicated, awaiting the spontaneous onset of labor is best.
Dated 02 April 2012