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Avoiding Inductions
by Cynthia Flynn, CNM, Ph.D.

Q. What does it mean to 'induce labor' and how can I avoid it?

A. To induce labor means to use a procedure to begin labor before Mother Nature does.

The easiest way to avoid induction is to simply refuse--it cannot be done without your permission. There are several reasons why induction may be suggested by your provider, however, and you should understand that if your provider suggests induction and you refuse, s/he has the right to refer you to someone else so that if things turn out badly, s/he won't be the one being sued.

Common reasons for suggesting induction include:

  1. convenience for the provider or the patient. This is the easiest one to refuse, but if your provider is going on vacation, you may be delivered by someone else if you wait for Mother Nature;

  2. you are past your due date. How far past depends on your provider, but the most common cut-off is two weeks. Again, you can just refuse, but the risk of problems with the baby does go up slightly each day the pregnancy goes on;

  3. your membranes (bag of waters) breaks and you do not go into labor in some specified amount of time (varies from immediately to 48 hours depending on the provider). As long as your fluid remains clear, your baby is moving (or you pass a non-stress test), you put nothing in your vagina, you take your temperature every four hours, and you have not tested positive for group beta strep or other infections, some providers will let you wait for spontaneous labor longer than their normal cut-off. There is not a whole lot you can do about this one except lobby for more time, but it's probably not a great idea to wait if you don't meet the criteria above IMHO;

  4. other medical conditions such as uncontrolled gestational diabetes or pregnancy induced hypertension (aka pre-eclampsia, toxemia). Diet can help prevent many of these conditions (so eat healthy!), but sometimes they can't be controlled no matter what the effort of everyone involved. Either can represent a threat to the lives of mother and/or baby in extreme cases. If things are getting worse, your provider will want to get you delivered sooner rather than later, and short of a cesarean, the only option may be induction.

It should be pointed out that "induction" can include a whole range of procedures, some more "natural" than others, and if you are (or are becoming) at risk for a medical induction, you may want to consider some of the less invasive versions of induction before you get that far. Also, remember that "Mother Nature gets a vote," and as a midwife, I am often grateful that we *do* have many ways to induce, as induction helps me get a healthy mom and babe without a cesarean.

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