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Does Mother (Nature) Know Best?

What Every Expectant Mom Should Know About Labor Induction

By Susan Barrett Hyde

The labor induction rate for American women climbed dramatically during the 1990s with inductions doubling to nearly 20 percent by the end of the decade. During this time, the number of elective inductions increased more dramatically than medically-required inductions. Since medical research indicates that the rate of Cesarean delivery may be as much as 10 percent higher for women with induced labors, questions emerged about the elective use of this most common of obstetrical procedures.

There are many sound reasons that might cause a medical professional to induce a labor. For instance, pre-eclampsia, pre-labor rupture of membranes, post-term pregnancy with a deteriorating uterine environment or other medical conditions may make induction necessary. However, the American College of Obstetrics and Gynecology (ACOG) advises that medical professionals only perform inductive procedures when the dangers of continuing a pregnancy offset the risks of induction.

Labor may be induced in a variety of ways, and some are more aggressive than others. A medical caregiver may encourage labor by loosening the bag of waters from its position against the uterine wall during a vaginal exam (often called "stripping of membranes"), using ripening agents such as prostaglandins to encourage the dilation and shortening of the cervix, breaking the bag of waters or administering a synthetic oxytocin hormone called Pitocin.

However, the success of any of these methods depends on the readiness of the cervix to dilate in the first place. If a woman is not physically ready to deliver, research shows that induction attempts are far more likely to fail or to result in a labor that fails to progress. In these cases, the baby may have to be delivered via a C-section.

With this in mind, women nearing the end of their pregnancies may want to discuss the pros and cons of cervical ripening agents with their health care provider. Dr. Melissa Streeter, an OB/GYN in Brunswick, Maine, says that the use of cervical ripening gels should be monitored by a medical professional. "Some women come in asking for a cervical gel to ripen their cervix at home," says Dr. Streeter, "This is an unsafe practice, as there are documented risks of hyper-stimulation with cervical ripening agents which can compromise blood flow to the fetus."

Want to see more?

• Episiotomy: Is It Necessary?
• Active Birth: The New Approach to Giving Birth Naturally
• Avoiding Routine Interventions in a Hospital Birth
• Talk about it!

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