Yes, it’s rough when you get toward the end of your pregnancy. Your back is hurting, your feet might be swollen, you can’t sleep because you can’t get comfortable or because you need to get up and go to the bathroom. However, think about how far you have come! Pregnancy is 40 weeks and you are almost at the finish line.

Considering an induction?

As you experience this uncomfortable time your thoughts may turn to considering being induced – having your labor medically started to birth your baby when and where you want to do so.

The number of women whose labors are being induced in the U.S. has doubled since 1990, and many of these inductions are considered to be “elective,” which means that the induction was done for a nonmedical situation. For example, you may want to schedule the birth when you can have relatives visit to help once you bring the baby home, or your doctor may be going on vacation and you really want him to attend your baby’s birth.

In 2009, the American College of Obstetricians and Gynecologists (ACOG) revised their labor induction guidelines indicating that if you’re considering an elective induction, you should be at least 39 weeks gestation or that the lung maturity of your baby should be confirmed. Lung maturity can be determined by a procedure called amniocentesis. This involves inserting a thin needle through the abdomen and into the uterus to collect some amniotic fluid for testing.

Undergoing induction

During an induction, labor medications may be given orally, through an IV or placed in the vagina in order to stimulate uterine contractions. Inductions are often done for medical reasons, this means that you or your baby have a condition that puts either you or him at risk; for example, preeclampsia, diabetes or intrauterine growth restriction (IUGR).

In these situations the benefits of delivering your baby outweighs the risks of waiting for labor to start on its own. In some circumstances induction should not be done at all, for example, if you have active genital herpes, placenta previa or if your baby is laying sideways in what’s called the transverse fetal presentation.

Considering the risks

Induction is not completely risk free. There’s a chance that it won’t work and you might have to have a c-section, or the medicine may cause contractions that are too long, too strong or too close together, which could cause problems with the baby. Just like any procedure you should discuss the pros and cons, risks and benefits with your physician or nurse midwife and come to a mutual decision as to whether induction is right for you.

And consider this: most women will go into spontaneous labor between 39 and 41 weeks of pregnancy. So if you’re beyond 37 weeks is it really that hard to wait a few more? While a week or two may not seem like very much to you, for your unborn baby it can mean a lot with regard to how mature his or her lungs are at birth.



Helen Hurst, DNP, RNC, APRN-CNM, is a nurse expert adviser to Healthy Mom&Baby.

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