Being induced for labor refers to having labor started artificially using medical interventions rather than waiting for labor to begin naturally. There are several different methods for inducing labor, such as using synthetic hormones like Pitocin or manually breaking the amniotic sac. Induction is often recommended when the pregnancy is post-term (more than 40 weeks) or if there are medical concerns that make continuing the pregnancy risky. However, induction does come with downsides and risks that make it generally less preferable than spontaneous labor if possible.
Increased Use of Medical Interventions
One of the main reasons being induced is often seen as worse is that it frequently leads to increased use of medical interventions during labor and delivery. When labor is induced, contractions tend to be stronger and more painful. This makes an epidural or other pain medication more likely to be requested.
| Intervention | Spontaneous Labor | Induced Labor |
|---|---|---|
| Epidural | 61% | 76% |
| Forceps/Vacuum | 3% | 6% |
| C-section | 11% | 22% |
As shown in the table above, women who are induced are significantly more likely to get an epidural, require forceps/vacuum assistance, or end up having an unplanned C-section compared to women who go into labor spontaneously. These extra interventions can lead to a more difficult recovery or negative birth experience for the mother.
Increased Risk of C-Section
One of the biggest worries with induction is the heightened risk of ultimately requiring a C-section. As noted above, women who are induced have around double the chance of having an unplanned C-section compared to women who go into spontaneous labor.
There are a few reasons for this increased risk:
– The contractions caused by induction drugs can stress the baby and cause fetal distress, requiring an emergency C-section.
– Induced contractions may not dilate the cervix as efficiently, leading to failure to progress and a C-section.
– Induced labor may begin before the baby is in an optimal position, increasing chance of malpresentation.
– Artificially starting labor too early can lead to an underdeveloped cervix, making vaginal delivery difficult.
C-sections come with longer recovery times, more postpartum pain, risks of surgery complications, and make future vaginal births less likely. The cascade of interventions that often accompany an induction make a C-section much more probable.
Increased Chance of Prematurity
Ideally, labor should not be induced until at least 39 weeks of pregnancy. However, sometimes inductions are scheduled slightly earlier or the due date is miscalculated. Going into labor prematurely increases the baby’s risk of complications. Their lungs, brain, and other organs may not be fully matured yet.
According to research, induction at 37-38 weeks is associated with a higher chance of the baby requiring intensive care compared to induction at 39 weeks or later. Babies born early are also more likely to have trouble breastfeeding or maintaining their body temperature. Even apparently “term” babies still benefit from those last 1-2 weeks in utero.
Longer, More Painful Labors
For first-time mothers especially, induced labors tend to run longer on average. The synthetic oxytocin administered during inductions can cause very strong, painful contractions right from the start. This can lead to exhaustion and distress before the cervix is fully dilated. Labors stalled by an under-ripe cervix may drag on for hours.
Without the natural hormonal shifts of spontaneous labor, the mother’s body is less prepared for delivery. The NHS reports the average first stage of induced labor is 14 hours vs 8 hours for spontaneous labor. The heightened pain and duration of induced labors often lead to more interventions being requested.
Negative Emotional Impact
Beyond just the physical challenges, being induced can negatively impact the mother’s mental and emotional well-being around childbirth. Women who were induced have higher rates of feeling like they lost control during labor or had an emotionally traumatic birth.
Starting labor medically before the mother and baby are fully ready can contribute to feelings of frustration, disappointment, and failure. An induction gone wrong can lead to mourning the loss of the desired natural childbirth experience. Processing these emotions postpartum is an added challenge for induced mothers.
Potential Risks to the Baby
In addition to prematurity risks, inducing labor can potentially put the baby in other forms of distress as well. As mentioned earlier, induced contractions may be longer, stronger, and more frequent than natural contractions. This can reduce oxygen flow to the baby by interrupting uterine blood flow.
Methods like rupturing the amniotic membranes remove the protective cushion of fluid around the fetus. Mechanical induction methods like a Foley catheter balloon carry a small risk of infection. While serious issues are rare, induction does expose the baby to some additional hazards compared to spontaneous labor.
When Might Induction Be Medically Necessary?
Despite the downsides, there are certainly medical circumstances where inducing labor is warranted to avoid even greater risks. Here are some situations where the benefits may outweigh the risks:
– Preeclampsia or other maternal health conditions that make continuing pregnancy hazardous
– Post-term pregnancy beyond 42 weeks when the placenta may be failing
– Premature rupture of membranes where risk of infection rises if labor does not start
– Intrauterine growth restriction where the baby is not thriving in utero
– Previous history of fast labor where delivery before hospital arrival is a risk
– Fetal issues like restricted growth or low amniotic fluid
– Placental problems like placenta previa blocking the cervix
– Need to deliver for maternal medications or health treatments
– Suspected macrosomia with high birth weight that risks shoulder dystocia
The decision to induce should always involve thorough discussion with your OBGYN or midwife about personal risk factors. For many low-risk pregnancies, it may be healthiest to remain patient for labor to begin naturally. However, when medical factors necessitate it, induction can be life-saving for mother and baby.
Conclusion
While induction of labor is very common, occurring in over 20% of deliveries, it tends to make the birthing process more difficult, risky and traumatic compared to spontaneous natural labor. Inductions often cascade into a snowball of interventions like epidurals, episiotomies, vacuum/forceps assist and c-sections. Recovery is longer and the emotional impact is more negative. The medications used for induction can also cause fetal distress and prematurity issues. However, there are certainly medical indications where labor induction is preferable for the safety of mother and baby, despite the increased risks. When a medical professional makes the judgement that outlasting the pregnancy poses greater risks than induction, it can be the right choice. But for most healthy pregnancies that have reached full term, letting natural labor begin on its own is generally ideal to avoid the heightened challenges of being induced.