Reasons for Induction
Over these last few months and in particular while we were in the depths of the pandemic, a lot of my birth clients were scheduled for inductions at around 41 weeks 0 days. However, from my doula training and the research I found that there are many factors at play when a mom to be and a care provider talk induction. Here are the main reasons why care providers want to schedule inductions and potential ways to advocate for yourself;
If the pregnancy is low risk, but has extended beyond 41 weeks, induction is usually discussed at that appointment. Most of my clients (luckily) had OB-Gyns that would encourage all natural ways to induce labour (sex, walking, pumping, etc) as well as offering to sweep the membranes during the 41 week appointment. However, they will also likely schedule an induction around 41.5 weeks.
Your options: ask for an appointment at 41 weeks instead of the scheduled induction and be sure to ask for your bishop score during this time. You can also have your care provider sweep your membranes on the 41 week visit.
Ruptured membranes without contractions will most likely lead to an induction.
Your options: if you are not GBS positive and are under the 24 hour mark of your waters being broken you can try some natural labour inducers (excluding sexual intercourse). However to keep the risk of infection low, please head to the hospital by the 24 hour mark.
If you have gestational diabetes and you do not spontaneously go into labour by 39 weeks you will likely be scheduled for an induction.
Your options: discuss how soon you can start trying natural labour inducing methods, if you going into labour on your own is something that is important to you. A membrane sweep may be performed earlier as well, if you request it.
If you conceived with assisted reproductive technology your pregnancy will be followed very closely and inductions may be discussed earlier (around 39 weeks). Your induction will most likely occur before 40 weeks.
Your options: discuss if natural labour inducers are an option and if so, give them a try.
Prolonged early labour. This is considered augmented labour. If you’re already experiencing contractions albeit inconsistently and dilation is slow or stalled, your care provider may offer inductions methods such as artificial rupture of membranes or a synthetic oxytocin drip as a way to kickstart labour again.
Your options: you’re technically already in labour therefore movement and positions as well as ensuring your bladder is empty may help kickstart labour on it’s own again.
Occasionally near the end of pregnancy baby’s growth rate slows instead of ramping up. As a precaution, care providers will discuss induction.
Your options: discuss the overall health of your baby as well as options of natural labour starters and membrane sweep. At the end of the day, do what is best for your baby’s health as well as your own.
If you have a pre existing health condition that may cause you or your care provider concern, induction may be discussed during the later weeks of your third trimester.
Your options: keep the conversation open and going throughout your third trimester, it can help put you at ease and help you make the best decisions in your care.
If this is your first pregnancy and are of advanced maternal age (read: over 35) you are considered high risk and will be followed closely. Your care provider will no doubt discuss inductions by 40 weeks.
Your options: as long as you’re healthy and you’ve checked with your care provider you can go ahead and try natural labour inducers at home. You can also discuss a membrane sweep with your care provider, ask for your bishop score, which can give you a clue as to how ready your body is for labour.
If you don’t go into labour naturally, inductions are an amazing medical intervention that has helped lower maternal death rate and stillborn rate. Having an induction does not mean that you’re more likely to have a c-section, but inductions are harder on both mom and baby therefore the medical team will monitor both mom and baby very closely. The goal being that mom and baby will be healthy and thriving.
