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The Induction Debate

The Pros and Cons of Inducing Labor

By Kim Byrum Skinner

Cheryl Lo realized early on that neither of her daughters' pregnancies would likely be easy. Motherly instinct – and an unshakable family tree – told her so.

"All three of my pregnancies were induced and medically necessary," recalls Lo, who is the women's service line director for Mount Carmel Hospital in Columbus, Ohio. "Unfortunately, I developed hypertension during pregnancy."

What followed – three Cesarean sections, a uterine rupture and eventual hysterectomy at age 36 – hinted at rough times ahead for both Lo's daughters who, true to inherited history, were eventually induced for medical reasons (one to offset hypertension and the other to guard against gestational diabetes).

Induction initiates the physiologic process of labor. It shifts it into gear, using a variety of procedures that range from simple (breaking a woman's water) to complex (intravenous medications). Inductions are generally performed when there's less risk involved in proceeding with delivery than waiting expectantly for labor to begin on its own.

But, given today's harried, drive-thru lifestyle, more and more women are opting for inductions that aren't medically necessary. And it's a phenomenon that concerns many experts.

"We are seeing a national trend in the increase of rate of inductions, and I think we have to be very, very careful that patients are informed regarding the potential risk," says Dr. Gus Parker, an OB/GYN at Mount Carmel East in Columbus, Ohio. "Some inductions are very low-risk and appropriate, even electively. But I think in general, the public is misinformed in terms of the risk."

Dr. Parker also warns about the medications used to induce labor, which could have harmful affects. "These are powerful drugs and medications used to induce labor," he says. "Given in the wrong amounts or not monitored appropriately, patients can put their baby at risk of hyperstimulation of the uterus – too many contractions [which cause] fetal distress. There can be uterine rupture because the contractions are too strong and hard. There can be excessive bleeding and other problems that may ultimately result in an emergency C-section. And although we do a great job at C-section, there's still going to be that small percentage of women who have complications from those Cesareans."

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!

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