Reasons to induce include:
- Overdue (at least one to two weeks)
- Toxemia (elevated blood pressure)
- Premature rupture of the amniotic sac
- Infection in the uterus (chorioamnionitis)
- Problems with the baby's growth
- Low amniotic fluid (oligiohydramnios)
- Excessively large baby (macrosomia)
- Prior poor obstetrical history (prior stillborn)
- Underlying medical condition in the mother (high blood pressure, kidney disease, heart disease, etc.)
This list represents the most common indications to deliver a baby. There are many other factors to consider when deciding to induce someone.
There is also a list of patients with certain conditions who should not be induced. These would include:
- Placenta previa (afterbirth in front of the baby's head)
- Prior classical c-section (incision is up and down on the uterus)
- Breech baby or other abnormal fetal positions (i.e., sideways)
- Fetal distress
- Active herpes infection
I can't stress the importance of having a reason to induce a baby because the unexpected can happen and usually does. With regards to induction, we must all understand that it doesn't always work according to plan. As we will discuss shortly, not all attempts at delivery are successful. Sometimes, induction can increase the risk of cesarean section. Therefore, we should limit induction to real indications.
I know many obstetricians who utilize induction liberally, typically for social convenience or to accommodate their office schedule. A woman who is uncomfortable near her due date may wish to be induced. We can all sympathize with her plight, but perhaps it would be better to reassure her that what she is feeling is normal rather than induce her.
How to Induce
By detailing the process and the nuts and bolts of induction, you might gain an appreciation of my prior warning.
