Most pregnant women get to 37 weeks gestation and sigh a breath of relief. They've made it past the preterm stage.
Then the waiting begins. And the incessant questions: Have you had that baby yet, and if not, when are you being induced?
Induction of labour seems to be so common these days. And nearly every other woman you know had to have some help getting labour started.
In fact, in Australia, the UK and the US, inductions occur in 20-35% of births.
8 Reasons To Say No To Labour Induction
So why aren’t you being induced? Leading health experts, such as the World Health Organization, agree that induction of labour should only occur when medically indicated.
But surely doctors don’t induce for any other reason?
Well, according to the 2013 Listening to Mothers III survey, 41% of mothers in the United States said their care providers tried to induce labour.
Almost 25% of women were induced, and almost half of those were for a non-medical reason (full term or close to their due date).
So what happens if your care provider suggests being induced? You need to be savvy about when induction is and isn’t necessary.
Here are 8 very good reasons to say no to labour induction:
#1: You’re Ready
You’re really ready to have this baby. You’ve had enough of the big belly, the never empty bladder, and not being able to see your feet. You’re over the lack of sleep, the Braxton Hicks, and the never ending questions about when you’re due.
Just because you’re ready, it doesn’t mean your baby is. That magical estimated due date might’ve arrived but it doesn’t mean labour is imminent.
Estimated due dates are exactly as advertised – a guess at the time your baby will arrive. Only 3-5% of babies actually do arrive on that date so it’s clearly not a very good guess.
Despite leading health experts, such as American College of Obstetricians and Gynecologists (ACOG), defining full term as the period between 39 and 42 weeks, many care providers are still focused on pregnancies going past the 40 week estimated due date. That’s why inductions tend to be booked once a woman reaches 41 weeks, as a ‘just in case’.
You can read more about this in Estimated Due Dates And The Myth Of The 40 Week Pregnancy.
Inducing labour runs the very real risk your baby will be born before he or she is ready. In the last weeks of pregnancy, some very important finishing touches are taking place. Your baby’s lungs need to mature. Fat needs to be deposited.
Just because an ‘average’ length of time has been established for pregnancy doesn’t mean every baby will be ready within that time frame.
#2: You Might Have A Big Baby
According to the ‘person on the street', you are so huge you must be having twins! Although you can (sort of) laugh off those comments from strangers, when your care provider starts muttering about big babies that’s when you freak out.
The thing about big babies is there’s no way of knowing how big, or small, or average-sized they will be until they are actually born.
Ultrasound screening for weight is acknowledged to be very inaccurate. There is a recognised 15% margin for error in ultrasound fetal weight estimation. That means your baby can be either 15% smaller, or 15% larger, than the estimated weight given at your ultrasound.
You can read more about this in How Accurate Is Ultrasound For Weight?
To top it off, the closer you are to your due date, the harder it is to estimate your baby’s size. Many women are induced for a suspected big baby (macrosomia), and then discover their baby was actually average-sized, after interrupting a perfectly healthy pregnancy.
1 in 3 women in the United States report being told their babies are too big. Suspected macrosomia isn’t a medical indication for induction or c-section but it is one of the most common reasons given for either of these procedures.
In 2001, ACOG issued guidelines to care providers, recommending “Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes”. Yet this remains a common reason women are encouraged to consider labour induction.
Want to know more about big babies? Check out Macrosomia – 5 Myths About Big Babies and Birth.
#3: Your Care Provider Might Be Absent
Your care provider has reminded you he or she will be on leave around your due date.
You can take your chances and hope you go into labour beforehand, or you can just schedule an induction!
Sounds easy. But again, it’s not that simple. Your baby might not be ready to be born. Your body might not be receptive to induction and fail to get the hint. This often leads to what is known as ‘failure to progress’, which sounds a lot like it was your body’s fault things didn’t work out and you had to have a c-section.
If your care provider has back ups, ask to meet them so you can feel more at ease if they end up being your support on the day you spontaneously go into labour.
If you don’t have a choice of doctor, it’s unlikely to make any difference whether you’re induced or not – chances are you will not have met the on-call obstetrician anyway.
Read more about why care provider preference isn’t a good excuse for induction in How To Avoid An Induction or C-Section These Holidays.
#4: It’s More Convenient
Your mother is flying in from interstate the week before you’re due. Your partner is working at least an hour away from the hospital. And the babysitter you’ve lined up to look after your other kids has exams that week.
Wouldn’t it just be easier to organise an induction, and know exactly the day your baby will be born, so it’s more convenient for everyone else?
If your baby and your body aren’t ready for labour, an induction is more likely to fail than succeed. Once an induction has been started, there’s no going back – even if that means having an unplanned c-section.
Find out more about why elective induction for convenience might be a letdown in Why Do Inductions Fail? When Inductions Of Labour Don’t Work
#5: You’ve Been In Prelabour For Weeks
Prelabour is hard. You’re anxious, impatient, bored and tired. In fact, there are 7 Reasons Why Prelabour Sucks.
This is the time when it is most tempting to turn up at your birth setting and beg for an induction. Your care provider might be sympathetic and ask whether you want to wait or not.
The difficulty with prelabour is no one can tell you how long it will last. But while it is incredibly tiring and frustrating, it’s a sign your body is doing plenty of gearing up for the real thing.
Induction has many risks and it’s important to weigh those up when considering getting things moving along faster. Your baby won’t be in there forever. Promise.
Do Babies Really Need To Be Induced To Ensure They Are Born? Find out the answer to this question here.
#6: Your Placenta Is Going To Stop Working
Apparently, when your gestational clock ticks over 42 weeks, your placenta stops working.
If you frequent online birth forums, you might have read this in relation to why women shouldn’t be allowed to go past full-term.
There is absolutely no evidence that shows a direct correlation between the length of pregnancy and placental deterioration. The idea evolved from the early 1900s, when a Scottish obstetrician observed what he called a ‘wasting condition of the newborn’.
Fifty years later, post-maturity syndrome was described by a Dr. Clifford, who attributed this wasting condition to placental deterioration.
Placental insufficiency is a real thing and does occur, but it’s not generally related to time. Post-maturity syndrome can only be diagnosed after birth and is defined as a pregnancy that has gone post dates. It has the following newborn observations:
- Absence of lanugo (fine body hair)
- Very long nails
- Abundant hair on head
- Calcified fetal skull
- Wrinkled skin with the appearance of loss
- Peeling skin.
Post maturity syndrome affects less than 10% of pregnancies that go beyond 43 weeks and some studies show less than 3% of women actually gestate beyond 43 weeks. This shows the chances of the placenta deteriorating magically at 42 weeks are pretty slim.
#7: Because It's Hospital Policy
Hospital policy on induction of labour varies. In one hospital it might be at 10 days post due date; in another might be as soon as you reach 39 weeks.
Depending on your care provider’s attitude, and the influence of litigation where you live, you might be booked for an induction because active management is perceived as a way of preventing things going wrong.
Hospital policy is not law. Many women aren’t aware they can decline an induction if there is no medical reason (and even if there is, but that’s unlikely to happen). You can ask your care provider to check your baby’s health, and yours, until such time as labour begins spontaneously.
#8: You Might Develop A Complication
As stated earlier, induction should be undertaken only when medically necessary. There are risks to induction, as there are with all medical procedures, and it’s important to balance those risks against the chance you might develop a complication.
If you are having a healthy pregnancy and your baby is healthy, it’s not likely you will develop a complication. It can happen, but it doesn’t mean it will. It makes no sense to interrupt a healthy pregnancy and force a healthy developing baby out ‘ just in case’ you develop a health condition, which in most cases is very unlikely to happen.