In most pregnancies, women will go into labor on their own after 40 weeks. But if you are past 40 weeks, it may be tempting to consider natural methods to increase your chances of going into labor. Some people swear by eating pineapples. But does it work?
When should labor be induced?
- Prolonged pregnancy: If the pregnancy goes beyond 42 weeks (two weeks beyond the due date)
- Premature rupture of the membranes: If membranes rupture and water breaks, but labor does not begin
- Maternal health problems: If the mother has hypertension, preeclampsia, diabetes, or kidney disease
- Intrauterine fetal growth restriction: If the estimated weight of the baby is low for the gestational age
- Intrauterine fetal death: If the fetus has died inside the uterus, labor can be induced if the mother is physically healthy
- Placental separation: If there is a partial or complete separation of the placenta from the uterus wall.
- Oligohydramnios: If there is insufficient amniotic fluid around the baby
- Chorioamnionitis: If there is a bacterial infection in the uterus
- Twin pregnancy: If it is a twin pregnancy that goes beyond 38 weeks
- Rh incompatibility: If there is Rh incompatibility etween the mother and fetus
- History of stillbirth: If the mother has a history of stillbirth
When should labor not be induced?
Labor should not be induced if one of following medical conditions is present:
What are the complications of labor induction?
Some of the complications of labor induction include:
- Fetal distress: The medications used to induce labor can cause excessive contractions, which can reduce the baby's oxygen supply and lower the baby's heart rate, leading to fetal distress. This can be managed with tocolytic (anti-contraction) agents.
- Pain: Induced labor may cause more intense contractions, which is often very painful. Often epidural analgesia is needed.
- Infection: Some induction methods, such as rupturing of membranes, increase the risk of infection to both mother and baby.
- Umbilical cord prolapse: Amniotomy may cause the umbilical cord to slip into the vagina before the baby.
- Excessive bleeding: When uterine muscles do not contract properly after childbirth (uterine atony), excessive bleeding can occur.
- Uterine rupture (rare): Uterus tears may open along the scar line of a previous cesarean delivery or major uterine surgery.
- Increased rate of further intervention: Risk of emergency cesarean delivery and instrumental deliveries increase.
- Failed induction (15% chance): Another cycle of prostaglandins or cesarean delivery may be required.
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Barclay L. Guidelines on Labor Induction Revised. Medscape. https://www.medscape.com/viewarticle/706359
World Health Organization. WHO Recommendations for Induction of Labour. https://apps.who.int/iris/bitstream/handle/10665/44531/9789241501156_eng.pdf?sequence=1
Galal M, Symonds I, Murray H, Petraglia F, Smith R. Postterm pregnancy. Facts Views Vis Obgyn. 2012;4(3):175-187. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991404/
Cleveland Clinic. What Natural Ways to Induce Labor Actually Work? https://health.clevelandclinic.org/what-natural-ways-to-induce-labor-actually-work/
Kids Health. Inducing Labor. https://kidshealth.org/en/parents/inductions.html
Westmead Hospital. Natural Ways to Bring on Labour. https://www.wslhd.health.nsw.gov.au/ArticleDocuments/1346/Natural%20ways%20to%20bring%20on%20labour%20v3%20AB%20June%202019.pdf.aspx