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The Induction Debate

The Pros and Cons of Inducing Labor

By Kim Byrum Skinner

Although ACOG recommends a national induction rate average of 16 percent, numbers have leapt as high as 30 to 40 percent in communities where liability costs are particularly high, such as central Ohio. "Now we're hearing that those numbers are starting to come down again," says Lo. "I'm hoping that women are taking a closer look at why a physician is discussing induction or just learning that the longer you have your pregnancy, it helps the baby."

Many experts believe the risks involved in social (non-medical) inductions make naturally occurring labor more appealing. The exception? When medically necessary fetal or maternal concerns outweigh the risks posed by induction. Examples include fetal deterioration or growth restriction, pregnancy-induced hypertension, gestational diabetes or being so overdue that the placental unit struggles to supply enough food and oxygen for the baby to survive.

If induction is not medically necessary, Lo and Parker advise expectant mothers to think long and hard about the potential risks posed by non-medically necessary induction. Poor reasons for this type of induction include convenience and desired due date. Better reasons include history of rapid labor, distance from the hospital or ongoing support issues.

"Let's say it's a mother's fifth pregnancy," says Dr. Parker. "The first [labor] was 18 hours, the second was nine hours, the third was two hours and the fourth she almost had in the car. Well, certainly, if a woman's at full term a week before her due date and is walking around [dilated] at 5 centimeters you may want to bring her into the hospital so that she can have her labor induced and have her baby in a controlled, safe situation. If it's Mom's third and fourth baby and they live an hour from the hospital, it may behoove the physician, again, to [induce] in a controlled and safe environment at the appropriate time."

Want to see more?

• Birth Presentations and Delivery: A Guide for Baby's Arrival
• The Right to Choose: Elective Cesarean Sections
• The Birth Plan: Helpful or Troublesome?
• Talk about it!