How Do Inductions Lead To C-Sections?

How Do Inductions Lead To C-Sections?

Induction of labour occurs in countries like Australia, the US and the UK on average about 25% of all births.

Interventions in these countries are becoming the norm and we’re seeing c-section rates averaging around 30%.

While induction seems relatively harmless, it commonly leads to what is known as the ‘cascade of interventions’.

This means once you start labour artificially, this intervention leads to another one, which leads to another… resulting in a c-section in many cases.

There are a very few situations when inducing labour is the best option.

Medically necessary inductions are undoubtedly life saving.

Yet more and more women are undergoing elective inductions for non-medical reasons and ending up having major surgery.

How Do Inductions Lead To C-Sections?

How exactly can an induction lead to a c-section? Let’s take a step by step look.

#1: Before Time

Spontaneous labour is triggered by your baby, when they are ready for life outside the womb.

Induction skips this process and attempts to kick start things ahead of time. Research shows a higher rate of failure of induction between weeks 38-41 weeks.

Synthetic oxytocin is the most common method of induction used and is commonly known for causing strong and intense contractions.

If the mother’s body isn’t ready for labour, her uterus may not respond to the synthetic oxytocin and require increasingly higher doses. Synthetic oxytocin causes your uterus to contract more frequently and more intensely than with natural oxytocin.

These intense contractions can affect how much oxygen your baby is receiving. If your baby shows signs of distress, a c-section may become necessary.

Lower doses of synthetic oxytocin mightn’t be able to stimulate the uterus to contract effectively if the mother’s body isn’t responsive, leading to a failure of induction and c-section.

#2: High Risk

If you’ve had a perfectly healthy, low risk pregnancy and accept induction for any reason, you are automatically considered high risk and will be treated as such during labour.

This is because induction disrupts the normal physiology of labour and birth. The effects of induction often needed more intervention, which leads to even more problems and side effects.

Being high risk means you no longer have control over how your labour progresses. Your care providers need to monitor you and your baby carefully. It is hard to predict how women and their babies will respond to induction, so what is normal no longer applies.

Induction can cause more problems than if you were in spontaneous labor:

  • Hypotension (low blood pressure)
  • Postpartum haemorrhage
  • Water intoxication
  • Hypertonic uterus
  • Uterine rupture
  • Uterine inversion
  • Stillbirth
  • Abnormal heart rates
  • Nausea and vomiting
  • Diarrhoea
  • Anaphylaxis

Any of these complications requires interventions, which has the knock-on effect of needing further monitoring and management. If you or your baby are in distress, a c-section may be necessary.

Find out more about the risks of inducing labour.

#3: Restricted Movement

If you are medically induced with synthetic oxytocin, you will have continuous electronic fetal monitoring (CEFM) and an IV drip set up. The CEFM is so your care provider can monitor the rate, strength and frequency of contractions, and watch for how your baby is responding. The IV drip is to deliver a constant dose of the synthetic oxytocin into your bloodstream.

A Cochrane Review of 13 studies has shown CEFM is associated with a significant increase in c-sections and instrumental births.

CEFM restricts your ability to move during labour. Most women find themselves lying on the bed, usually on their back or semi-reclined. Being unable to move during labour can work against you, as your pelvis is static rather than flexible. These factors can cause labour to progress slowly.

If contractions aren’t frequent and strong enough, your care provider may increase the dose of synthetic oxytocin. However a stalled or ‘failed’ induction may lead to a c-section.

#4: You’re More Likely To Have An Epidural

Induction contractions are well known for being right up there for intense and painful from the get-go. First time women who are induced are more than 3 times likely to find contractions difficult to cope with and have an epidural.

Having an epidural in place means you are stuck on a bed, unable to move and your baby can find it hard to move down and through your pelvis.

Epidurals can slow down labour and unless the epidural wears off, it decreases your ability to push. Prolonged labour and stalled second stage are red flags for a c-section, especially if your baby shows signs they aren’t coping.

Many women are completely unprepared for the high level of interventions which result from an induction. They may feel completely sure these interventions are for the best, or that they have no choice to avoid them in order for their baby to be born safely.

If you are offered an induction it can be tempting to accept, knowing you will meet your baby sooner. It’s important to know the risks and benefits, and understand your risk for having a c-section increases substantially.

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Sam McCulloch enjoyed talking so much about birth she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she writes novels. She is mother to three beautiful little humans.

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