Induction of labor: when is it necessary?

Induction of labor is the artificial process of initiating the onset of labor. About 1 in every 5 expectant women will require induction of labor for various reasons. Induced labor aims to mimic natural labor, and is entirely safe.

One of the commonest reasons for inducing labor is when the baby is overdue, referred to as post-dates. Only about 5% of women will deliver on their due date, the rest go into labor either earlier or much later. If pregnancy has been uncomplicated, it is safe to wait an extra week after the due date for spontaneous labor to set in. After 41 weeks however, induction of labor is advisable as there are potential risks if pregnancy is allowed to continue. Other reasons for induction of labor include high blood pressure (pre-eclampsia), premature leakage of waters, poor growth of the baby etc.

Induction of labor for non-medical reasons should be avoided, and should not be done before 39 weeks. Great caution must be exercised for women who have had a previous Ceserean Section. In some situations induction of labor must be avoided, for example if the placenta is blocking the cervix or the baby is lying abnormally.

There are several methods of inducing labor. Firstly, your Obstetrician or Midwife will ensure that induction is safe for you, and determine the best method to recommend. Some women will only require their waters to be broken (called rupture of membranes), while others require tablets to be given by mouth or vaginally. It may take several hours for labor to commence. A hormone drip is usually required to sustain uterine contractions. Induced labor must be continuously monitored to ensure safety for both the mother and the baby.

Most women fear that induced labor is more painful compared to labor that sets in naturally. Various options of pain relief are available, and women should discuss this beforehand. Complications are rare, but may include uterine contractions that are too frequent and sustained (called overstimulation). This may lead to the baby getting distressed, in some cases necessitating an emergency delivery. Rarely, induction of labor fails, leading to consideration of Ceserean delivery.

What about home remedies? Sex is often mentioned as a method of induction, but scientific proof is lacking. Stimulation of the nipples may stimulate uterine contractions by initiating release of hormones. Herbs should be avoided due to potential dangerous effects. Castor oil usually causes more of stomach irritations than induction of labor.

If induction of labor is suggested, seek clarification to understand why it is necessary. If anything is unclear ask questions, or seek a second opinion especially if you or the unborn baby are not at immediate risk. If averse to being induced, please discuss your concerns with your Obstetrician to explore other options.