Is Induction Right for You?

Once you hit the forty week mark, you may start to think about your options in terms of inducing. Here's what you need to know


 

Pregnancy is likely the longest waiting game you will ever play. After 40(ish) weeks spent planning, preparing and waiting to meet your baby, a large number of expectant mothers, especially first time moms-to-be, will continue waiting past their due date. While excitement and impatience may have you googling “ways to induce labour”, many women are now turning down inductions of the medical variety. When making the decision of whether or not to be induced, women should weigh their options.

Is it a necessity?

Most medical professionals in Canada begin to consider medical inductions for their patients once they reach 41 weeks in their pregnancy, with 42 weeks being the maximum many practioners will allow their patients to remain pregnant. Occasionally inductions will be recommended before 40 weeks gestation due to medical complications such as severe gestational diabetes, preeclampsia, and fetal growth restrictions, among others. If no pre-existing medical conditions exists mothers-to-be can forego the induction route, with close medical attention ensuring the fetus is still thriving in utero.

Why is induction recommended past 41 weeks?

The Society of Obstetricians and Gynaecologists of Canada recommends induction be considered when the risk of continuing the pregnancy, for either the mother or the fetus, exceeds the risk associated with induced labour and delivery. Beginning at 41 weeks, risk factors including fetal death as while as meconium aspiration syndrome, in which the baby passes its first bowel movement while still in utero and thus inhales a portion of it, begin to increase. 

Are induction rates on the rise?

According to the SOGC, induction rates have risen in recent years, from 12.9% of pregnancies recquiring induction in 1991/92 to 21.8% in 2005, a statistics that has remained relatively stable through 2013. Due dates are merely an educated guess on when the baby will arrive, with only five percent of babies being born on their actual due date.  This knowledge may be why there seems to be a trend of women turning down inductions, opting to wait for spontaneous labour. 

Why do some choose to avoid induction?

The act of induction comes with it’s own set of risks including an increased risk of requiring a C-section or use of forceps. The inadvertent delivery of a preterm infant is also possible if the due date has been miscalculated.

Alternatives to nedical inductions

While the Internet is chalk full of “natural” labour induction techniques, ingestion of castor oil and nipple stimulation are not endorsed by the medical community. However, new research suggests that women who receive a “membrane sweep” after 38 weeks, are significantly less likely to require induction, with over 90 percent of women going into spontaneous labour before 41 weeks, compared to 70 percent who did not receive the “sweep” (SOGC). The jury is still out on whether sexual intercourse can actually help bring on spontaneous labour.  Medical professionals agree that sex can only help a women’s chances of avoiding induction since female orgasms can trigger uterine contractions and sperm contains prostaglandins, which can help to prepare the cervix for labour.

Decided to avoid induction?

The SOGC recommends women who remain pregnant past their due date should receive twice weekly assessment for fetal well being including non-stress test (NST), and measurement of amniotic fluid.

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