Inductions seem to be coming into style. across Canada, about 20% of pregnancies end with an induction rather than a natural labour. that’s about 1 in 5. it varies from province to province – in Nunavut, for example, its just 3%. (That’s more like it.)
An induction is a tool that can be used properly or used at an inappropriate time. it is up to each family to speak with their doctor/midwife and figure out what is best for them. there are many reasons that a pregnancy may need to be induced, but there are also some risks attached to induction. its your job to figure out when the risks of keeping the baby inside outweigh the risks of an induction.
A ’full-term’ pregnancy is considered anywhere from 37-42 weeks. you are technically not thought of as being post-term until you go past that 42 week marker. some babies just need longer than others to finish up getting ready to greet the world. their little bodies need to be prepared to breathe, eat, digest, filter blood through their livers and pee and poop on their own. if a baby is hanging out inside too long, there could be some risks that come up:
- placentas get old and start to deteriorate over time. No one can see how the placenta is doing on the inside of your body without an ultrasound. A placenta that starts to function not at capacity can deprive baby of blood, nutrients and oxygen.
- placentas can actually detach and peel off from the inside of the uterus, which is a huge risk for your baby and yourself. now your baby isn’t receiving anything at all from you. this is rare, but it would definitely be cause to get that baby out fast.
-babies who hang out a little longer get bigger. it’s actually very rare that babies ‘get stuck’ or can’t be born vaginally because usually your body will not grow a baby that it can’t birth, but there are some medical conditions that can override this. if you have diabetes, your body will tend to grow a bigger baby. in that case, it may be best to get the baby out earlier rather than later, or else you may have a much harder time in labour and could end up with a c-section.
-there is a higher risk of shoulder dystocia. this basically means that the baby’s shoulders get stuck during a vaginal delivery. there are many ways to deal with this, some gentler than others, but it can be dangerous for the baby to be stuck because of the compression on the umbilical cord.
- babys can pass meconium (baby poo) inside the uterus, and the risk for this happening gets greater as the pregnancy goes on past the due date. we are not quite sure what makes a baby pass meconium, but we do know that a baby who has undergone something stressful will pass meconium. you can tell if the baby has passed meconium if your water breaks and its brown or yellow instead of clear. the problem is that babies will breathe in that soiled amniotic fluid and it can cause respiratory problems after birth.
- multiples will sometimes be induced because they have to share space and possibly share a placenta. when theres two or more in there, it can get crowded a bit faster than usual. there are many other reasons why multiples may need to have a scheduled birth, but I am not focusing on them here today.
- mothers could be induced if there was some risk to them – high blood pressure, preeclampsia, or other medical conditions that made it risky or dangerous to allow a pregnancy to wait.
- if your water has broken but labour has not started after about 24 hours time (each hospitals protocol is slightly different) because the risk of infection is slightly greater for the baby, who is no longer in a sterile, enclosed environment.
the risks of inducing labour
sometimes the baby’s due date was wrong, and you end up delivering a premature baby who was not yet ready to leave to womb. not every due date is an accurate estimate, and not all women have exactly the same gestational periods. some babies just need a little bit longer.
- you are at a greater risk of needing a vacuum or forceps delivery.
- you are at a greater risk of needing a c-section. some think it doubles your chances.
- since the contractions are artificially produced and not natural, they will be stronger, longer and much harder to cope with. This is exhausting on the mother and she often required an epidural to cope with the sensations. Stronger contractions also means that baby has the risk of being stressed out as well, as some babies do not tolerate the drug that is used to induce labour very well. A baby’s heart rate will be on average, higher than a baby who was going through a natural labour. when a baby freaks out, its c-section time.
- stronger contractions can also lead to uterine rupture in rare cases.
- many inductions take several days since you are forcing the body to do something that its not ready to do yet. Your body will fight back against this. Just getting contractions to start can take a long time by itself.
- Labours that are induced will be stronger, longer, more painful and more difficult for mothers. they are greatly reduced in their ability to move and so many coping techniques that could have been used are now not applicable.
- many babies just do not like to be induced. A baby who is born after an induced labour has a harder time adjusting to the outside world, has a longer transition period and will have higher levels or cortisol.
what momma could feel:
- for a mother who does not not want an induction, its a big deal emotionally. Mothers can feel anxious, scared, angry and disappointed in themselves. They feel out of control with their own labour because it is not going to plan. Mothers are usually in bed and have to stay put, they are uncomfortable, exhausted and some may feel invaded. they may feel like a failure if they have to accept an epidural, or if the cascade of interventions begins and they were not able to have a natural birth. fear of c-sections is a big one preying on these mothers minds.
- for mothers who want or need inductions, they can feel relieved, safe, well-taken care of and protected. Perhaps they are having an induction for a medical reason for either the baby’s sake or hers, and in this case the mother may feel that the induction is a good thing and a natural labour was too risky.
Use this info and talk to your doctor or midwife about inductions. Ask them why they are thinking of inductions and what the risks are, vrs the risks of letting the pregnancy just go a little bit longer. Communicate to your doctor or midwife what you are feeling. You are an active participant in this pregnancy and labour, so you get a say in the induction as well. You can always ask for more time.
Doula, Sisterhood Wellness Collective, Toronto