As you approach the end of pregnancy, circumstances may arise where you may choose to have your labor prematurely started. This is known as an elective labor induction. It's considered an elective induction when it's scheduled for convenience and not for a medical reason. There are pros and cons to this process.
What Is Elective Labor Induction?
When your body starts labor artificially and has not gone into labor on its own, the process is known as elective labor induction. It can be started with medication or any other means to start contractions by opening your cervix.
You and your doctor or another medical professional can choose to begin labor near your due date. If it's done for reasons that are not medical, it's considered elective. It's not elective when there is a problem with your pregnancy. This could include issues like high blood pressure or fetal stress. Medicine is given to start or strengthen contractions.
How Does Inducing Labor Work?
Labor induction uses medication or other means to begin labor. The induction starts your contractions if they have not started by themselves. The goal of induction is for the uterus to contract and the cervix to open. Pitocin is a popular medication used to start contractions via IV infusion. Other ways to begin labor could include popping the baby’s bag of water or using a device that stretches the cervix so that it will open up. Your medical provider could recommend another medicine to begin softening and opening of the cervix.
Reasons to Get an Elective Labor Induction
So why would you want to get your labor started early? Reasons can include:
- Nervousness about not making it to the hospital on time
- Having a difficult or painful last trimester of pregnancy
- Making sure your spouse or family can be at the delivery
- Making sure your preferred doctor is available for delivery
- Issues with a schedule at work or childcare
Labor Induction Process
Labor is begun via one of the above-mentioned methods. When you're in labor, your uterus gets hard and then relaxes again. This process is a contraction. Your contractions will get closer and stronger as you continue through labor. The contractions help your cervix to open, and your uterus to push the baby out. The cervix is the opening of the uterus. While you're in labor, your cervix will dilate, or open up. Your doctor will keep measuring your cervix to see how much it has dilated. When it reaches 10 centimeters, it is all the way open. Usually, this is when you can begin to push.
Pros and Cons of Elective Induction
Choosing to have your doctor begin labor early could be ideal for a personal situation. The birth can be planned around a special date, like a religious holiday, or around your partner or healthcare provider’s schedule. Or you may want to schedule a labor induction during the last few weeks of pregnancy just because you're ready.
There could be problems getting the labor started. When it is induced, labor may take longer to start and progress. This includes the cervix taking a long time to dilate. If this is the case, there could be other options. Your doctor may let you go home and take a break because the labor may progress later.
Once the water bag breaks, the chance of infection increases. You can't leave the hospital if your water is broken or if you and your baby aren’t healthy. When labor is induced with medication, you need to check the baby's heart rate constantly with a monitor. This means you can't move around too much during labor. Inducing labor with medication can cause you to have stronger, more painful contractions earlier in labor than without.
It usually isn't safe to induce labor electively before 39 weeks, as the baby would be born too early. A baby that is premature can have issues with feeding, temperature, or breathing. But if either of you has problems like diabetes or high blood pressure, induction earlier than 39 weeks may be medically necessary. The risks of being born early may be lower than those of the health problem.
There have been some studies following the results of babies born through elective induced labor. Pooled results showed that infants who were born after elective labor induction had lower mean birth weights than babies that were born after or during normal gestation.
A retrospective cohort study of over a million pregnancies weighed elective labor inductions against mothers of up to 41 weeks' gestation. Outcomes were measured for postpartum hemorrhage, NICU admission rate, outcomes of perinatal mortality, anal sphincter injury, and cesarean delivery. The moms had no contraindications and no previous history of C-sections. Their babies had markedly more NICU admissions and higher levels of birth via C-section.
How Long Does Induction Take for First-Time Moms?
Labor induction can take from a couple of hours to two to three days to go through, depending on your body's response to treatment. It will usually take longer if you're a first-time mom or if you're at less than 37 weeks of gestation.
Regardless of which pregnancy this is for you, there are certain things that must align for you to have elective labor induction:
- Your doctor or provider has to be sure of your due date to prevent starting labor too early before your baby is fully developed.
- You have to be at least at 39 weeks of gestation.
- Your doctor or provider must make sure that you have not had a prior C-section or major uterine surgery.
- Your cervix has to be soft and ready to open. Your medical provider will determine this by examining your cervix to get its Bishop Score. This score determines your likelihood of having a vaginal delivery after induction comparable to spontaneous labor. A Bishop Score of at least 10 is the goal for a first-time mom. It is 8 for previous moms.