Labor induction is on the rise in the United States, with one in four pregnant women undergoing induction each year. However, induction is not always appropriate, and inducing labor when women do not meet certain criteria can have risks for both mothers-to-be and their babies.
An article in The National Library of Medicine explores the appropriateness of labor induction as per the guidelines from three leading organizations. It also cites patient education as a means of reducing unnecessary induction and the complications associated with it.
Four criteria for inducing labor
Per the national guidelines, there are 21 indications for inductions that doctors should look for. However, because all 21 rarely concur in women, the associations agree that, for an induction to be medically appropriate, the situation should meet four main criteria:
- The woman has a full understanding of the induction process, is familiar with the benefits and risks, and either still wants or needs an induction.
- The induction will optimize the mom’s and fetus’s outcomes and contribute to the mother’s psychological well-being.
- The decision to induce agrees with evidence-based medicine.
- The induction is cost-effective.
If a circumstance does not meet these four criteria, labor and delivery teams should consider alternative means of preserving the health and well-being of both mother and fetus.
The risks of unnecessary induction
Unnecessary induction is associated with pre-term birth, stillbirth and other complications. The March of Dimes details some of the risks associated with unnecessary induction.
To induce labor, medical providers use oxytocin and other medications. These medications can significantly lower a fetus’s heart rate, putting it at risk of severe complications.
Induction also puts both mother and baby at a higher risk of infection. In a natural delivery, the rupturing of the amniotic sac triggers labor. In induction, however, labor may trail the rupturing of the membranes by hours, thereby leaving both the uterus and the fetus vulnerable to bacteria that could cause infection.
Induction may also result in umbilical cord prolapse. This is most common in breech pregnancies. Umbilical cord prolapse can prevent the baby from getting enough oxygen and can be life-threatening.
Finally, induction can cause severe and life-threatening bleeding in the mother. One cause of severe bleeding is uterine rupture. A second is post-partum hemorrhaging, which is more common following induced labor than natural labor.
It is essential that mothers-to-be understand their rights and the very real complications associated with medically unnecessary induction. An attorney can inform pregnant women and their partners of those rights both before and following labor.