When Is It OK To Induce Labor?

I was talking to my sister-in-law on the phone the other day and it got me to thinking about childbirth and how advice from our doctors isn’t always the best advice. Let me share her story with you.

My sister-in-law was due with her first baby on March 25th. As happens with many first-babies, she is “late”. She went to see her OB and he told her that if she didn’t deliver by Thursday of this week, he will induce her. I asked her all kinds of questions and there doesn’t seem to be any medical indicators why they would need to induce her. She is healthy and has passed every stress test and has never had high blood pressure or protein in her urine and the baby also seems healthy, is head down and doesn’t even appear to be very large (they are guessing 7 lbs). So my question is – why induce? On Thursday of this week, she will only be ONE week past her due date. Everyone knows that a due date isn’t a “firm” date, but more like a guess as to when your baby will arrive. Anytime TWO weeks prior to TWO weeks post is considered “ON TIME” and not late or early (they really should call it a “due month”…but that’s another post all together…)

So I told her that she knows her body better than anyone. I personally don’t recommend letting them induce her when she is only one week past her due date. Besides, her due date is “less certain” than most since she didn’t realize she was pregnant until she was about 4 or 5 months in – so who knows if she is even late yet! She is not effaced or dilated at all, the baby hasn’t dropped and she hasn’t had any of the “typical” pre-labor occurrences (nesting, passing her mucous plug, bloody show, etc).

I’m not saying inductions aren’t ever necessary…but an induced labor can be a very HARD labor. Labor doesn’t start naturally, so it is much harder on mom’s and baby’s bodies. There is also a higher likelihood of ending in a c-section with an induction vs a natural labor. So I told her that she has choices. She doesn’t have to just “do what her Dr. says”. I encouraged her to ask questions – “Is it medically necessary to induce”; “What will happen if we don’t”; “What are the risks and what is the likelihood of that risk actually happening.”

Then I reminded her that she knows her body best and I told her that she should go see the Dr. on Thursday and see what they say. She can listen to what I have told her, she can listen to what they tell her and then she can make a decision herself about what she wants to do. I told her to “follow her gut” – because it is usually right.

Then she told me that her regular appointments with her OB are usually on Friday’s but they scheduled next week’s for Thursday because Friday is Good Friday. **DING DING DINNNNGGGG** Well the bells are going off in my mind. It now clicks as to why they are insisting on inducing her when she is barely a week past her due date. ITS A HOLIDAY and they don’t want her to “go naturally” over Easter. Because that means (god forbid) that they would have to leave their own holiday celebrations to go to the hospital to be with her! That just made me very angry!

Why is it that Doctors give this advice and make it sound like you don’t have a choice (we are taking the baby if you don’t go on your own…) when in reality all they are doing is thinking about the CONVENIENCE of their own schedules. I’m sorry, but why did you become an OB, of all professions, if you want a regular “schedule?”

Babies are born when babies are READY to be born – not when it is convenient for mom, dad or the doctor.

I told her to move, move, move; try nipple stimulation and engage in some “activities” with my brother to try to get labor progressing on it’s own. And, as it turns out, my sister-in-law is currently at the hospital because her water broke this AM. I’m eagerly awaiting a new niece!! But very sad at the way the medical profession has handled their her birth. They have already told her that since her water broke and her contractions haven’t started yet, they will likely need to put her on pitocin and she has a high risk of needing a c-section. I realize that they are trying to give her a clear view of what may happen – but when you start out saying “You aren’t going to be able to do it” – you have just decreased her belief that she can do it – and you’ve come one step closer to insuring that all of those interventions will be necessary.

I’m so happy to have a new niece, but so sad at how this story has evolved….and if this happens to my sister-in-law – just think of all the other first time moms who are in the same situation. They are told they don’t have choices – when they do. It’s made something as beautiful and wonderful as childbirth into a process that is very sad indeed.

17 comments to When Is It OK To Induce Labor?

  • Generally speaking, I think the less intervention the better. But induction doesn’t have to mean a hard labor. Of my 3, only one was induced, and that was the easiest one I had! I was very blessed, and my midwife managed things beautifully. Hospital, midwife, and doc were all fantastic! I had sound reasons for needing to induce, and all signs pointed to labor within the next day or so anyway, though. I would never, ever consider being induced if my body weren’t showing any signs of labor.
    .-= Cindy ´s last blog ..Oh, My Gosh, I’m a Troll! =-.

  • Yikes. I’ve definitely heard of a few stories where women were induced at the convenience of their doctor’s… it’s just awful. You’d think that if someone went into that profession, like any birth profession, they would expect a disruption of their own life at times — baby’s aren’t trains! They shouldn’t be expected to come on schedule.
    Best wishes to your sister — and many congrats!
    .-= Desiree Fawn´s last blog ..Vintage Plaid Love =-.

  • […] This post was mentioned on Twitter by Judy Masucci, Shelly. Shelly said: RT @MommyNews: When Is It OK To Induce Labor? http://bit.ly/dkHvcS – please come by & read this story of my sister-in-law […]

  • Wow, this is going to get me going. I was induced with both children. My first was very medically necessary, though we were only 2 days past my EDD, ihad pre-e and she was not doing well. Neither of us were doing well, and so I understand that. With my son, I think, in retrospect, that it was a matter of convenience. Bolessedly, with my son, I didn’t need any pitocin, and both were birthed naturally, but I truly feel indictions are done much too often, and that women need to fight for the right to not have their labors forced for anything but medical necessity.

  • Jocelyn

    I am a first time Mom and my baby came late two weeks to the day. Labour came on its own in its own time. I had absolutely no signs of pre-labour, I was not effaced at all (so not dialated at all either) at 12 days past. My doctor told me that she did NOT want to induce because it would likely end in a cesarean birth as my body was not yet ready. I don’t know if being in Canada made difference, but I know I was thankful that she did not push induction!

  • I feel very bad for your sister-in-law. That isn’t fair at all. They should teach some of this stuff that we experienced moms know about in pre-natal classes so this kind of thing can be avoided more often.
    .-= Melodie´s last blog ..March Love Links =-.

  • I was induced with my little guy — I was 11 days late, which was no-never-mind for my midwives, but my fluid was low and he was BIG. Plus he hadn’t dropped or engaged in any way at all, so there was concerns that if he got much bigger it wouldn’t be possible. After 28 hours of hard labour (where I declined the epi), I had a c-section to deliver my 10.5lb baby whose head was swelling from being punched into my pelvis with every contraction.

    I would love the c-section and induction to have not been necessary, but I suspect in my case that they were — my midwives and doula agreed in a frank rehash of my delivery experience. I guess I feel the induction was a little pointless or at least didn’t directly lead to the section; it was my large baby/small pelvis that led to both the induction and the section.

    Given that I had no medical reason for the large baby/section/induction, I would try to have a homebirth next time. Oh, and I’d drink a lot less milk during pregnancy!

    There is an interesting phrase bandied about by some (perhaps militant) midwives: “you buy the hospital ticket, you get the hospital ride.” If ‘everyone’ knows that doctors like to schedule births around their holidays, like to perform surgeries, like to have a woman flat on her back for delivery etc. etc., why on earth are women not choosing to have their babies with midwives?
    .-= Lorien´s last blog ..Almost six months… =-.

  • I hope everything goes well for her today. Hopefully she’ll have an easy labor. Inductions stink for most women. I educate all of my clients about the Bishop’s Score which helps predict the success of induction so they know going into an induction how likely it is to work.

    Fetal Macrosomia, convenience, post-dates by less than two weeks are not reasons to induce even according to ACOG. Inductions are more likely to result in c-sections due to failure to progress and fetal distress. Inductions are sometimes necessary if someones water has been broken for 24 plus hours, concerning results on a bio-physical profile or in cases of hypertension/pre-eclampsia but they can be done gently so as to make things easier on mom and baby.

    I could go on and on but I’ll stop there. I hope everyone does well today and look forward to hearing that you have a new niece.

  • Hi Lorien, thanks so much for sharing your story! I too had a long labor, failure to progress and an emergency c-section (after 26 hrs and my son started showing signs of distress) and I am a huge fan of both doulas and midwives! Not every birth is perfect – but I always hope that we can prepare enough to make our births be something we can be proud of. Thanks so much for sharing again! I love that quote that you referenced. — Judy

  • Hi Amy! Thanks for your info. I don’t know anything about the Bishop’s score – that is definitely something to teach new moms! It is so great that you are there to help them!! Thanks for your comment — Judy

  • Thanks for your note Jocelyn – it sounds like you were very lucky to have the Dr that you had!! I’m sure being in Canada has something to do with it too! Thanks for sharing your story — Judy

  • Thanks Slee! Yes, there are definitely times when an induction is needed, but this is not one. Thanks for sharing your story too! — Judy

  • ilanna

    I was induced right at 40 weeks with my daughter. It was medically indicated (gestational diabetes controlled at least partially by insulin) Unfortunately it did not go well – after 17 hours on pitocin and my body burning through 3 epidurals with the effort, I had a C-section. Her ‘bouncing” because she wasn’t ready caused cervical swelling, and she went into distress. This time is a scheduled c-section b/c i’m in the same boat with GD and it’s safest option we feel.

    That being said – i know a lot of dr’s go for the only 1 week late. My doctor told me (before GD became apparent) he would be fine with me going up to two weeks before we had to do induction – which is good. 1 week i think is too early/convenient…

    I do however understand/agree with the water breaking. If it’s broken – 24 hours is safety zone with infection so i can understand induction in that case… i think the key is to be informed and not be a pushover…

  • Liz

    Oh, brother! I hate it when doctors act like there is no other option! My baby was breech, and I was told so many horror stories about trying to turn the baby that I just went with the c-section. BIG MISTAKE! The c-section went fine and I recovered amazingly well (I was up and walking the same day), but I wasn’t aware of my doctor’s No VBAC policy. So now, I am stuck having another c-section if I want to use my doctor, or I have to find another doctor or midwife. I wish I would have been told ahead of time that I wouldn’t be able to deliver VBAC with the next one. I’m trying to talk my doctor into a VBAC with my concent, and I’m not even expecting yet…probably won’t be for at least another year. It’s rediculus what we women have to go through just to give birth in the way GOD intended! Sheesh!

  • We have a baby girl!! I am so PROUD of my sister-in-law! She went through nearly 18 hours of labor without an epidural! She worked so hard to get that baby out!! I can’t wait to see pictures!! (and I really wish I lived closer!!)

  • Krista

    I just had my first 7 months ago and was induced — not a pleasant experience, but probably necessary. I also had gestational diabetes, and after pushing my doc to let me go a week past, after a consult with a homebirth midwife, we went ahead with induction because she felt that though she does everything possible to avoid unnecessary interventions, this is one of those times it’s a bad idea to push too far. It was heartbreaking for me because we’d gone through Bradley classes and planned an epi-free birth. I ended up with 10 hours of pit (ugh) before I succumbed to the epi. The birth went well, no problems, just 15 mins of pushing, and goodness knows it felt better once the drugs went in. I relate all this because one thing I learned in this experience that I preach to other mamas now is NOT TO BE SCARED OF BIG BABY PREDICTIONS. Size estimates can be really off, and size is so often used by doctors to scare women into inductions and c-sections. Your body grows the right size baby for you — trust it. My little one was estimated in the high 9s and nurse after nurse looked at me with scared wide eyes while I was in labor, but she was a full pound smaller than they thought, and she slipped right through with no problem. That’s not to say that if the baby is distressed or you go endless hours without progress that you shouldn’t consider yours and baby’s health and move to other options, but please, DON’T let them talk you into an induction just because they “suspect” a big baby.

  • I just had my second baby 3 weeks ago. I went with the midwife this time and it was a night and day experience better from the hospital with my first. I was 2 weeks early with my water breaking and Strep B positive so they “induced” me with castor oil when my labor wasn’t starting after 12 hours. But I had him in less than 18 hours total and was only at the birthing center for 5 hours.
    With my first the doctor scared me by saying that I would have to be induced at 41 weeks when I wasn’t even 40 weeks yet and I KNEW that I had long cycles so by my calculations that wasn’t my due date. Thankfully I went into labor on my own right on my “due date”. Basically I had 36 hours of labor at the hospital and was so scared of them forcing me to do something I didn’t want to that I couldn’t relax. I did manage to have him naturally with an epidural when I finally got a good on call doctor who was relaxed about the whole thing and offered firm suggestions, but didn’t pressure me into anything. Crazy times!

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