Can Inducing Labor Lead to Cesarean?

A labor induction uses medication, like Pitocin, or other techniques to bring on (induce) contractions in a pregnant woman. Induction occurs in more than 23% of births (Census.gov) in the United States every year. That is, one in five women will have their labor induced. Studies show that there is increased risk for cesarean as well as neonatal ICU for baby when an elective induction is done. One study found that elective induction was associated with 67% increase in cesarean risk as well as 64% increased risk of baby requiring neonatal ICU treatment. (wiley.com)

There are a variety of reasons that women are induced, some elective, some not. The elective reasons for induction include wanting baby to be born before a care provider goes on vacation, mom getting eager to be done being pregnant, desire to birth by or on a particular date, etc. Some other reasons are twins, maternal illness such as gestational diabetes or high blood pressure, suspecting a big baby, going past due date, small pelvis, low amniotic fluid, etc. The list could go on.

There is an important distinction to be made here regarding induction: I am concerned about elective induction or non medically-indicated induction. If your care provider suggests that you be induced, you owe it to yourself and your baby to really understand why the induction is being recommended. You deserve to have informed consent—to know and understand the facts, implications, and future consequences of your decision. You may choose to go forward with the induction, to commence a natural induction, or to buy some time and reassess at a later date. When a care provider suggests induction, they often present it as a medical need; but, under direct scrutiny, you may discover that what your provider considers to be a medical indication might not be in line with your ideas about birth.

Bishop’s Score and Induction

One tool that is often used to assess the possible outcome of an induction is the Bishop’s Score. Bishop’s Score is a chart that can be considered before a woman is in labor to determine the likelihood that an induction would be successful. Bishop’s Score looks at the baby’s position and station as well as the consistency, effacement, and dilation of a woman’s cervix and a number is applied to each position. If a total score of 8 or 9 is achieved, this indicates that an induction is likely to be successful.

If your care provider suggests induction, you may want to ask them what is your Bishop’s Score? If you feel that your score is not in a range your are comfortable with, you may want to discuss the risks involved with waiting until your body goes into labor on its own or your Bishop’s Score becomes more favorable. You can also discuss the options available to you for induction and talk about maybe using some natural induction techniques.

Talking to Your Doctor About Induction

If you feel that your Bishop’s Score is not sufficient enough to warrant an induction or you just want to wait until your body goes into labor on its own, here are some suggestions for how to talk to your doctor:
• Is something wrong with with momma or baby that requires an induction?
• What is happening with this pregnancy that has you concerned?
• Do you have any literature that explains our situation?
• Can you explain what the effects of doing the induction may be? What is the worst case scenario in doing it?
• Is there a true medical indication for the induction?
• What harm is there in waiting and giving  my body time to go into labor on its own?
• Are there other options that we could attempt before doing a medicated induction?

Natural Means to Induce Labor

There are lots of methods—some wives’ tales, some tried and true—for initiating labor. They include: hot and spicy foods, making love, nipple stimulation, acupressure, acupuncture, warm baths, walking, relaxation, castor oil, primrose oil, etc. Any of these methods can be successfully used to bring about labor when mom is already showing signs of readiness.

Yes, inducing labor can lead to a cesarean. Any intervention that changes the course that labor might naturally take can lead you down a path that requires more and more intervention to keep things going. When mom and baby are both healthy and there is no well-documented reason for an induction, I believe that it is better to give baby time to come on their own. If mom and dad are both on the same page and trusting in their birth, they can remain relaxed and calm and take each challenge on their journey in stride with plenty of patience and lots of love.

We would love to hear your stories about successful or unsuccessful induction. Did you know about your Bishop’s Score and do you feel that your score helped or hindered your induction?

Smiles,

Jennika Cook, ICAN Blogger

References:
http://www.census.gov/compendia/statab/2012/tables/12s0088.pdf

http://en.wikipedia.org/wiki/Bishop_score

http://www.wiley.com/WileyCDA/PressRelease/pressReleaseId-102740.html

Mongan, Marie F. HypnoBirthing, The Mongan Method. Florida: Health Communications, Inc. 2005. Print.