This past week a new study was released showing that mothers who were induced into labor were twice as likely to receive cesarean surgery. We have known for sometime that induction of labor has increased the number of babies born pre-term, however, this study confirms what many birth professionals and healthcare providers have felt to be true, connecting labor induction with increased risk of cesarean surgery. Why is this an issue? When a medical condition makes the benefits of induction of labor outweigh the risks associated with it, then it is advisable. However, if a medical condition is not present, and a woman’s body is not ready (or her baby), then induction brings the risk of major abdominal surgery and threatens the health of the baby. When considering induction for the sake of convenience, then this is absolutely worth thinking about. Do you want to run the risk of making cesarean surgery necessary for your birth and the stresses that both induction and cesarean place on you body and your baby’s without there being a present medical cause?
When your baby is ready for birth and your body is ready, you and your baby both release hormones that begin the labor journey. (The exception to this is pre-term labor, which usually has another medical cause.) This will occur for most women sometime between 37-42 weeks. Induction is not recommended for post-dates until after you’ve reached 42 weeks. Natural contractions begin gradually and develop a rhythm that allows for a time of rest in between. It is not uncommon for labor to last longer than 12 hours (a first time birth averages 16 hours) when allowed to progress naturally, but can happen in less time. However, the pain associated with birthing does not make up the bulk of this time. Your body is wonderfully equipped to provide you with periods of rest in between contractions where there is no pain. Also, having freedom of movement will help you cope with any pain you feel and urge the progress of labor. In a natural labor, your body produces (in most cases) ample amounts of hormones needed for it to progress (oxytocin), for pain management (endorphins), and for bonding with your baby after birth (oxytocin and prolactin).
When labor is induced, contractions, once started, can be very intense and will often quickly become back to back, depending on how much pitocin (artifical oxytocin) is administered and when. Practitioners will most likely use prostaglandins to ripen the cervix as well before beginning the pitocin drip. Some practitioners use a drug called Cytotec (Misoprostol), which has not been approved by the FDA for use in pregnant women and has been associated with maternal death. (A more preferred, drug free method, meaning less risk, would be a Foley catheter.) One risk of labor induction is the hyperstimulation of the uterus, due to the intensity and the nature of the contractions induction produces. Another side effect is fetal distress. This means that your practitioner will then need to keep you on continuous monitoring to catch these risks before they become a real danger to you or your baby. In many cases, it is these risks that become the cause of a then emergency cesarean. Because mother is confined to the bed (for monitoring), she typically doesn’t have much freedom to move or work with her contractions. Her body then must work against gravity to bring the baby down the birth canal. Often this, along with the intensity of contractions, makes natural pain management difficult, and the mother will ask for an epidural or narcotics (though not always).
Understanding the difference between natural labor and labor induction is important when considering it for either medical or social reasons. Sure childbirth in and of itself is not risk free natural or otherwise, but there are things that we can do to help it be as safe and peaceful as possible. Considering your medical needs and the health of yourself and your baby is first and foremost for any mother :).
In the coming days, I will be writing about ways to make late pregnancy more enjoyable, and suggestions for making induction of labor as safe as possible when there is a medical need for this intervention.
For more information, watch the following video from Mother’s Advocate.