Inducing Labor: When Mother Nature Needs Help Making You a Mother Sooner
One of the miracles of life is how a pregnant woman's body knows when
"it's time" to start labor. One common complication of labor is preterm, or
early labor. Less common, but with steadily increasing frequency, is the need
for induced labor: when doctors intervene to stimulate labor before Mother
Nature does. According to the National Center for Health Statistics, induced
labor in the US has doubled over the past decade from one in 9 live births to
nearly one in five live births today. Dr. Donnica Moore discusses what induction of labor is, why it is done, when it shouldn't
be done, why it's becoming so common, and what its risks and benefits are.
The goal for every pregnancy is a healthy mother and a healthy baby. Often,
the timing of the delivery is an important factor in ensuring a good--or better--outcome
for mom, baby, or both. Sometimes we try to delay labor when it comes too early,
but increasingly, we are inducing labor, or making it come earlier than it otherwise
would have. There are many reasons to induce labor, but the exact reasons that
induced labors have doubled over the past 10 years are not known. The factors
which have contributed to this trend include a more aggressive approach to inducing
pregnancies that extend past 42 weeks ("postdates" pregnancies); the
development of more reliable diagnostic techniques to confirm fetal age; the
development of new techniques to confirm fetal lung maturity; the development
of new medicines to induce labor and to accelerate lung maturity; and the ability
to measure fetal size more accurately.
Induced labor is controversial in some situations. Interestingly, physicians
often find themselves in situations in which patients strongly resist induction
even when there are compelling medical indications to do so. . .and in other
situations in which the patients demand to be induced in the absence of any
medical indications. Sometimes, a "soft" indication to induce becomes
a decision to do so when it suits physician or patient convenience. In November
1999 the American College of Obstetricians and Gynecologists (ACOG) issued new
practice guidelines regarding when and how to induce labor. ACOG emphasizes
that since the reasons to induce labor are not always absolute, the physician
should consider both maternal and fetal conditions, gestational age (i.e. how
many weeks along the woman is in her pregnancy), the cervical status, and other
factors in making this decision.