Avoiding Induced Labor Is More Beneficial To Moms And Babies
Labor induction, or artificially initiating labor through the use of medicine, is performed for a variety of reasons. Today, one of the more common reasons for induction is "convenience." Hospitals can staff extra nurses, physicians can schedule births for times that are most convenient for them, and expectant parents can make work and family arrangements in advance according to their scheduled induction date.
At first glance, labor induction may seem more convenient; however, it's important to recognize that induction may lead to a longer labor and overall hospital stay, more medical interventions, higher costs, risk of potential for litigation, and adverse outcome for a mother or baby.
In the last weeks of pregnancy, a woman's body and her baby perform crucial functions to prepare for birth. The baby's lungs mature and he or she develops a protective layer of fat. In addition, the baby drops down into the pelvis, the cervix tilts forward and softens, and irregular contractions help the cervix thin and begin to dilate. In most cases, a woman's body goes into labor only when her body and her baby are ready.
"Research at The University of Texas Southwestern Medical School suggests that it is a signal from the baby that starts the process of labor," says Debby Amis, RN, BSN, CD(DONA), LCCE, FACCE. "The best way for a mother to know that her baby is fully mature and ready to be born is to allow labor to begin on its own."
Lamaze International recommends that a woman allows her body to go into labor on its own, unless there is a true medical reason to induce. Allowing labor to start on its own reduces the possibility of complications, including a vacuum or forceps-assisted birth, fetal heart rate changes, babies with low birth weight or jaundice, and cesarean surgery. Studies consistently show that inducing labor almost doubles a woman's chance of having cesarean surgery.
"By avoiding induction, women are less likely to encounter other medical interventions," says Lamaze International President Allison J. Walsh, IBCLC, LCCE, FACCE. "Experiencing natural contractions and laboring without unnecessary medical interventions increases a woman's freedom to respond to contractions by moving and changing positions, both of which facilitate the process of labor and birth."
Avoiding induction also decreases the likelihood of a premature birth. Because neither doctors nor mothers can determine a baby's due date with 100 percent accuracy, babies may be induced accidentally before they reach full term (at least 37 completed weeks). A scheduled induction at 39 weeks could result in giving birth to a preterm baby who is only 36 weeks gestation. Preterm babies miss critical stages of development that take place during the last weeks of pregnancy and are at risk are for several postnatal complications. A study published in The Journal of the American Medical Association examined 4.5 million births in the United States and Canada and concluded that babies born only a few weeks early-at 34 weeks through 36 weeks-were nearly 3 times more likely to die in their first year of life than full-term infants.
When medically necessary, inducing labor can be a life saving procedure. The American College of Obstetricians and Gynecologists states that labor may be induced if it is more risky for a woman's baby to remain inside her body than to be born.
Medical reasons for induction include, a woman's water has broken and labor has not begun for several hours; her pregnancy is post term (more than 42 weeks); she has pregnancy-induced high blood pressure; she has health problems that could affect her baby, like diabetes; there is an infection in her uterus; or her baby is growing too slowly.
First-time mothers are most vulnerable to the risks of inductions. Contrary to what many believe, suspecting a large baby is not a medical reason for induction. It is very difficult for a doctor or midwife to determine the size of a woman's baby before birth with accuracy, even with the use of ultrasound. Studies consistently show that inducing for a suspected large baby increases, rather than decreases, the incidence of cesarean birth.
Lamaze International has developed a care practice paper entitled "Labor Begins on its Own," which presents the research surrounding labor induction and tips for avoiding induced labor .
Childbirth education classes, such as Lamaze, provide women with the tools and information they need to make educated choices during labor and birth. To find a Lamaze class in your area, visit http://www.lamaze.org.
About Lamaze International
Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area affiliates, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers.
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