Should you induce labor?

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A woman came into my exam room one afternoon, about 33 weeks into her pregnancy and asked to be induced because she was tired of being pregnant. I have had requests from moms wanting to deliver on specific dates (9/9/09, 10/10/0) and requests from grandmothers who are waiting (not very patiently) for the birth of their grandchild. In fact, requests for “social” inductions have become so common, more and more hospitals are adopting polices prohibiting the practice for first time moms prior to 39 weeks.

As a mother of three, I understand the physical and emotional roller coaster that is pregnancy. As a physician, I remind patients of the risks associated with each decision and find many don’t realize the risk of stimulating birth before their body is ready.

In the Unites States, approximately 22 percent of births are the result of induction. Physicians are quick to act when there is a risk to the mother or health of the fetus. Doctors may need to induce delivery prior to 39 weeks for a number of medical reasons: hypertension, diabetes, a problem in the growth of the fetus or abnormalities with the amniotic fluid. But when considering a request to be induced, also consider this: For first-time moms, induction increases the possibility of Caesarean section by nearly 50 percent. This means surgery, a longer recovery, a longer hospital stay, and higher risk of complication.

For second-and-third time moms, the risk is much lower and patients may find their provider a little more flexible depending on the request. Once a woman has delivered a child, she has what we call a “proven pelvis.” The risk of C-section drops significantly to 7 percent.

The risks

In addition, there are risks for all moms, regardless of their experience in the delivery room, based on medicines administered to induce labor. Although effective, the medications can cause the uterus to contract too frequently, leading to changes in the heart rate pattern of the fetus that could be dangerous.

There are a number of risks for the unborn child. Lungs develop fully in the final weeks of pregnancy. The further along a baby is the less likely the risk of lung problems. At 34 weeks, 20 percent of babies can have respiratory problems as opposed to only five percent of babies born after 37 weeks gestation. The lungs are not the only organ at risk. The brain is fine tuning its connections during the final trimester of pregnancy. Studies show that premature babies are at higher risk for learning disabilities and ADHD.

There are ways to stimulate labor without the use of drugs. Your doctor may choose to induce labor by either breaking water or placing a catheter inside of the cervix to help promote dilation.

As with any decision made during pregnancy, be informed. Weigh the risks and have an open conversation with your doctor or provider to determine what is best for mom and the unborn baby. Above all, be patient. The baby will come when he or she is ready.

Somi Javaid is a Board-certified OB/GYN practicing at Lisa Larkin, MD & Associates and co-founder of Mamadoc.

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