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I am 41 weeks pregnant and my obstetrician is encouraging me to have a labour induction. I don’t really understand what this means and whether or not I should agree. What are the pros and cons of inducing? I am so over being pregnant that knowing I could have my baby tomorrow is really appealing!

Sue – Geelong

Dear Sue,

I can definitely understand your desire to end the pregnancy and just have your baby already! 41 weeks is a long time to wait to meet your precious little baby. However, artificially inducing (or starting) your labour before you or your baby is ready is not always the best thing to do and carries a significant risk of introducing other complications in your labour and delivery.

It’s important to remember that a normal pregnancy lasts anywhere from 38-42 weeks gestation. Your Estimated Due Date (EDD) is just that – an estimate – and literally the halfway point in this four week period. You are not technically overdue until you pass 42 weeks, although standard obstetric protocol in Australia is to induce at 41 weeks.

Of course there are some legitimate medical reasons to induce early. These include:

• Your pregnancy is post-term (2 weeks past due date)
• You have a medical condition that will be alleviated or will go away after giving birth e.g. gestational diabetes
• You have health problems that could harm you or your baby
• You have an infection in the uterus
• You have premature rupture of membranes (your water has broken too early, but contractions have not begun within 24 hours – or sooner if you are GBS+)

Other reasons which are commonly stated as reasons to induce, but which are NOT backed up by research and evidence include:

• Macrosomia (in plain language this means “big baby” i.e. a baby over 4 kgs). Studies have shown that a large or even very large baby is NOT a reason to induce labour. It is also very difficult to accurately determine a baby’s weight so late in pregnancy. Ultrasounds can be as much as 0.5kgs out.
• Low amniotic fluid levels – studies have also shown that in isolation (i.e. everything else is fine) this is not a reason to induce either.

It is important to remember that an induction will lead to a more medicalised birth, with more interventions which are likely to impact on your ability to move around freely and significantly increase your risk of ending up with a caesarean section. There is also the very real possibility that the induction will fail and if this is the case, a caesarean will typically be performed.

My best advice to you is to avoid induction at all costs. Unless there is a legitimate medical reason to do so, you should not feel pressured by your doctor to go ahead with one. I also recommend you read the Lamaze Healthy Birth Practice #1 “Let Labour Begin on its Own”. There is also an excellent video which accompanies this article.

All babies find their way out eventually (!!) so enjoy the final days of your pregnancy by putting your feet up, pampering yourself a bit and savour the quiet!

Tanya Strusberg is a Lamaze Certified Childbirth Educator (LCCE) and teaches prenatal education to pregnant women and their partners in Melbourne.
She and her husband Doron have two beautiful children, Liev and Amalia.
To learn more visit www.birthwellbirthright.com

Facebook: https://www.facebook.com/birthwellbirthright

Disclaimer: The information contained in this column is of a general nature only and does not constitute formal medical advice. Any specific medical problem should be referred directly to a qualified health professional.