Induction of Labor

Articles, blog posts from midwives, doctors, researchers, handouts, etc. Please take the time to read and educate yourself about this inervention including it’s risks and any medical benefits which are different for each individual.

Induction: a step by step guide - Dr. Rachel Reed

Postdates Induction of Labor - Balancing Risks- Midwife Thinking - by Dr. Rachel Reed

“Summary - A significant minority of babies will not be born by 41 weeks gestation. Whilst the definition of a prolonged pregnancy is 42 weeks+, induction is usually suggested during the 41st week. Women need to be given adequate information about the risks and benefits involved with either waiting or inducing in order to make the choice that is right for them. There is no risk free option. The risk of perinatal death is extremely small for both options. I know women who have lost a baby in the 41st week of pregnancy, and women who have lost a baby as a result of the induction process. For first time mothers the induction process poses particular risks for themselves and their babies. Each individual woman must decide which set of risks she is most willing to take – and be supported in her choice.”

Beyond the Shot: Preventing Postpartum Haemorrhage ~ Wisdom from a Traditional Birth Attendant: In this blog you’ll read the risks of synthetic oxytocin, or Pitocin, how having a hospital birth increases the chances of a postpartum hemorrhage, and ways to reduce the risk of a hemorrhage.

Drug Facts: Pitocin - most people have no idea the associated risks that go along with synthetic oxytocin, and care providers rarely discuss them. Considering how often this is used in technocratic birthing facilities, reading through the drug facts insert is important.

 When Research is Flawed: Management of Post-Term Pregnancy-

“Comment: A major conceptual problem with routine induction at 41 weeks is that the median length of pregnancy in healthy first-time mothers is 41 weeks 1 day. The conventional 40 weeks is just that: a convention. It is based on nothing more than a German obstetrician's fiat two centuries ago that since women cycle according to the moon, pregnancy lasts 10 moon months, that is, 10 months of 4 weeks each. Practitioners may argue over how great a deviation from normal warrants intervention, but in the case of routine induction at 41 weeks, they are arguing for intervening when there is no deviation from normal. The same study that reported a 41 week 1 day median pregnancy length in primiparous women found a 40 week 3 day average pregnancy length in women who had had babies before. First-time mothers are notoriously more likely to have problem labors and cesarean sections than multiparous women. This means that the increasing complication rates and cesarean rates seen with advancing gestational length may well be nothing more than an artifact created by having a higher and higher proportion of primiparous women in the mix as the days roll by after 40 weeks.

Practice philosophy aside, a policy of routine induction at 41 weeks produces more than a conceptual problem. Primiparous women have roughly double the risk of having an induced labor end in a c-section. A policy of routine induction at 41 weeks exposes large numbers of a vulnerable population to a greatly heightened risk of surgical delivery with all of the attendant problems of a major operation as well as all the future reproductive consequences of having a uterine scar. In addition, crowding the labor ward with women undergoing an unnecessary intervention means there may be no room for a woman who really needs care. In their paper criticizing routine 41-week induction, Menticoglou and Hall (2002) cite a case where admission was delayed for a pregnant woman requiring IV antihypertensive drugs for severe hypertension because no beds were available. Several were filled with women undergoing routine 41-week inductions. The woman died of a stroke before she could be admitted. To quote Menticoglou and Hall's conclusion: “Routine induction at 41 weeks is ritual induction at term, unsupported by rational evidence of benefit. It is unacceptable, illogical and unsupportable interference with a normal physiologic situation.”

Routine induction in late-term pregnancies: follow-up of a Danish induction of labour paradigm-

“Conclusions Evaluation of a more proactive regimen recommending induction of labour from GW 41+3 compared with 42+0 using national register data found no differences in neonatal outcomes including stillbirth. The number of women with induced labour increased significantly.”