Types and Perils of Labor Induction


Elective Induction of Labor

Video taken from the channel: Beth Israel Deaconess Medical Center (BIDMC)


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Types and Risks of Labor Induction Breaking the Bag of Water. Using an item called an amnihook, your practitioner will make a tiny tear in the bag of water. Pitocin.

This is an artificial version of the body’s hormone oxytocin. It is given by way of an IV line and is used to Prostaglandin. Other possible risks of labor induction include: Infection Uterine rupture Increased risk of cesarean birth Death of the fetus. Complications during delivery. This includes a bigger chance of uterine rupture.

Intense contractions also cause the placenta to detach from the wall of the uterus, called placental abruption. Elective labor induction is associated with a lower risk of postpartum hemorrhage, anal sphincter injury, and maternal thirdor fourth-degree perineal lacerations. (SOR: B, based on two cohort. Inducing labor also carries various risks, including: Failed induction. About 75 percent of first-time mothers who are induced will have a successful vaginal delivery.

This means that about 25 percent Low heart rate. The medications used to induce labor — oxytocin or a prostaglandin — might. As with everything in life, labor induction comes with some risks.

You may experience stronger, more painful and frequent contractions. You may have increased risk of postpartum depression. Labor is likely to be induced: When a complication develops such as hypertension, Preeclampsia, Heart Disease, Gestational Diabetes, or bleeding during pregnancy. If the baby is in danger of not getting enough nutrients and oxygen from the placenta. The amniotic sac has ruptured but labor hasn’t started within 24-48 hours.

Clinical Issue. Labor induction rates more than doubled between 1990 and 2005 to an all-time high of 22 percent. This increase reflects not only a rise in induction for maternal and fetal indications but also broader use of elective induction. Reasons for wanting elective induction at term might include a woman’s physical discomfort, scheduling issues, or concern for rapid progression of.

The complications of induction of labour are: Failure of induction (15%) – offer a further cycle of prostaglandins, or a caesarean section. Uterine hyperstimulation (1-5%) – contractions last too long or are too frequent, leading to fetal distress. Can be managed with tocolytic agents (anti-contraction) such as terbutaline.

A problem puts you or your baby’s health at risk. Examples are infection (chorioamnionitis), too little amniotic fluid (oligohydramnios), and placental abruption. If you have conditions like.

List of related literature:

Induction of labor increases the risk of cesarean delivery, uterine rupture, fetal distress, jaundice, and premature birth.

“Mother Daughter Wisdom” by Christiane Northrup, M.D.
from Mother Daughter Wisdom
by Christiane Northrup, M.D.
Hay House, 2006

• Labor induction is associated with some risks and disadvantages, such as overactivity of the uterus; nausea, vomiting, or diarrhea; and changes in fetal heart rate.

“Maternity and Pediatric Nursing” by Susan Scott Ricci, Terri Kyle
from Maternity and Pediatric Nursing
by Susan Scott Ricci, Terri Kyle
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2009

There are two major risks of elective induction of labor: an increased risk for cesarean delivery and an increased risk for neonatal respiratory morbidity.

“Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice E-Book” by Robert Resnik, Robert K. Creasy, Jay D. Iams, Charles J. Lockwood, Thomas Moore, Michael F Greene, Lesley Frazier
from Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice E-Book
by Robert Resnik, Robert K. Creasy, et. al.
Elsevier Health Sciences, 2008

There are few absolute contraindications to labor induction, and there can be certain clinical situations in which induction is usually contraindicated but exceptional circumstances make

“High Risk Pregnancy E-Book: Management Options Expert Consult” by David K. James, Philip J. Steer, Carl P. Weiner, Bernard Gonik
from High Risk Pregnancy E-Book: Management Options Expert Consult
by David K. James, Philip J. Steer, et. al.
Elsevier Health Sciences, 2010

Risks attributable to the specific method of labor induction.

“Oxford American Handbook of Obstetrics and Gynecology” by Errol R. Norwitz, S. Arulkumaran, I. Symonds, A. Fowlie
from Oxford American Handbook of Obstetrics and Gynecology
by Errol R. Norwitz, S. Arulkumaran, et. al.
Oxford University Press, 2007

Risks of induction Induction of labour is perceived by many midwives as the first step in an often irreversible cascade of interventions that ultimately culminates in an increased need for epidural analgesia, operative delivery and caesarean section, particularly among primigravid women.

“Midwifery: Preparation for Practice” by Sally Pairman, Sally K. Tracy, Carol Thorogood, Jan Pincombe
from Midwifery: Preparation for Practice
by Sally Pairman, Sally K. Tracy, et. al.
Elsevier Health Sciences, 2011

There is compelling evidence that elective induction of labor significantly increases the risk of cesarean birth, especially for nulliparous women (Kaul et al., 2004; Moore & Rayburn, 2006; Shin, Brubaker, & Ackerson, 2004; Vahratian et al., 2005; Vrouenraets et al., 2005).

“Perinatal Nursing” by Kathleen Rice Simpson, Patricia A. Creehan, Association of Women's Health, Obstetric, and Neonatal Nurses
from Perinatal Nursing
by Kathleen Rice Simpson, Patricia A. Creehan, Association of Women’s Health, Obstetric, and Neonatal Nurses
Wolters Kluwer Health/Lippincott Williams & Wilkins, 2008

Maternal risk factors for postterm pregnancy and cesarean delivery following labor induction.

“Obstetrics: Normal and Problem Pregnancies E-Book” by Mark B Landon, Henry L Galan, Eric R. M. Jauniaux, Deborah A Driscoll, Vincenzo Berghella, William A Grobman, Sarah J Kilpatrick, Alison G Cahill
from Obstetrics: Normal and Problem Pregnancies E-Book
by Mark B Landon, Henry L Galan, et. al.
Elsevier Health Sciences, 2020

◆ The three major potential complications of elective induction of labor are increased neonatal morbidity, increased cost, and increased cesarean delivery resulting from failed induction.

“Obstetrics: Normal and Problem Pregnancies E-Book” by Steven G. Gabbe, Jennifer R. Niebyl, Henry L Galan, Eric R. M. Jauniaux, Mark B Landon, Joe Leigh Simpson, Deborah A Driscoll
from Obstetrics: Normal and Problem Pregnancies E-Book
by Steven G. Gabbe, Jennifer R. Niebyl, et. al.
Elsevier Health Sciences, 2016

• All methods of induction carry possible risks, especially uterine hyperstimulation (contractions that are too strong or too frequent) and the higher likelihood that the baby won’t tolerate labor (as indicated by EFM).

“Pregnancy, Childbirth, and the Newborn: The Complete Guide” by Janet Walley, Penny Simkin, Ann Keppler, Janelle Durham, April Bolding
from Pregnancy, Childbirth, and the Newborn: The Complete Guide
by Janet Walley, Penny Simkin, et. al.
Meadowbrook, 2016

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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  • Question: what would be considered early fetal gestational age determination? I was given a first ultrasound at 12.5 weeks so I wonder if that’s early enough to be very accurate.

  • LOL, I was induced at 39 weeks and believed the providers that it would decrease a chance of c-section, still ended up with a c-section because I was rushed and could not advocate for myself and if I did they didn’t listen.

  • I will be getting induced at 37+4 weeks due to the blood volume putting to much stress on my heart. I’m currently 1cm dilated at 36+6 weeks. I have a good chance of delivering vaginally, but will most likely require assistance when pushing as to not put too much strain on my heart. I have a 5 year old daughter and so I am nervous how this is gonna go. I went into labor naturally at 36+6 weeks with my daughter and delivered at 37 weeks.

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  • Our doctor says I might need an induction if our baby grows a bit more next week. Currently I am 38W2D, and this week, our baby is around 3.4KG.

    Her reason for it, is that she would prefer the 1st baby to not be so big for 1st time mom.

  • My doctor tried to offer an induction. I have no health issues, I don’t want to rush the process. Only way I would do it is if it was necessary. My first time and all of this is just scary to me. But your videos are very helpful so glad I found your page.

  • So interesting! I’m being induced this Monday at 39 weeks with my second baby, he keeps tricking me and the doctors thinking he’ll come out early and then I can’t progress ����‍♀️ but he’s coming out now if he likes it or not ����‍♀️��

  • Does the study cover anything about the use of an epidural (or the addition of pitocin in that case) for the expectant group? If that wasn’t taken into account I would wonder how much that influences things?

  • Found this at the perfect time. I’m a FTM almost 38 weeks and have had SPD the second half of my pregnancy in addition to my baby sitting on my sciatic nerve. I’m scheduled to be induced at 40+5 but I just don’t know if I can do an extra week and a half with the pain. I felt guilty about even asking about elective induction, but this makes me feel a lot more confident! Thank you!

  • I like the idea of induction because it’s better for planning. I dont wanna have my baby on the way to the hospital or unexpectedly at home or when my hubbie is at work lol.�������� I’m about to have my 4th�� so it’s good to have the babysitter lined up and not worry about being too far from the hospital. There were a lot if comments in support physiologic labor which is great that there is a choice. That is why they call it ELECTIVE induction for moms that choose it and to accommodate different circumstances.. I think It’s nice we have options in this day and age I have never had a problem being induced so to me it’s great! Physiologic labor was stressful for me and took just as long…

  • I was induced for medical purposes with my daughter and never was given statistics but he told me that I could very well end up with a csection luckily my hospital was patient with me took 4 days to birth my daughter but I did get a few unhappy nurses the last day on delivery day because they were ready for me to go! But this time I had no need for it and I asked for an elective one and he told me no and to wait it out and now I’m just irritated because I’m about to be 41 weeks and we went from 2 cm to 1/2 a cm in a week and I don’t know how that’s possible?

  • I’m curious about your nails…. every time you talked about the bishop score and gestured with your hands how you check cervical ripeness, I couldn’t help but notice the length of your nails…. and they also appear to be acrylic or gel….. aren’t length and nail coatings usually regulated in hospitals? I know they were in the hospitals I worked in. We could not have nails past our fingertips and we could not have any artificial coatings on our nails. I could see those poking through gloves and definitely hurting a patients cervix while also harboring bacteria and germs. Yikes.

  • I am not afraid to be induced. I am terrified to need a csection. I hope things go well. Oh I am being induced at 39 weeks because of gestational diabetes. I have had a baby naturally before. Not induction needed for him. I am confident will go well. But I am 32 weeks and he is still not flipped so I am a little nervous about that. I went into labour with my first baby at 39 weeks 3 days. My water ruptured and continued to leak and I had small contractions and I was dilated to a 3 and 50% effaced. I will keep thinking positively but I do no want a csection. So I hope I won’t need one

  • Thanks for doing this, you have provided much more information than my doctor did even when I asked him where I could actually read the study myself, he couldn’t tell me. Using the link for the New England Journal of Medicine I was able to actually read THE study myself not just articles in response to the study. What I learned is really important. The Arrive study compares moms who had Induction at 39 weeks to moms who are termed “expectant management” which means they were induced at full term 40 weeks. So the comparison is between two types of induced labors NOT comparing induction at 39 weeks to non-induced labor. That is a crucial detail. Pay close attention to Figure 1 of the study which shows the break down of what constitutes “expectant management”. People who had non induced labor were excluded from the study, therefore there is zero data comparing induction at 39 weeks to non induced labor.

  • I’m trying for a vbac my due date is August 15th I feel like I won’t be able to push this baby out if I get induced at 41 weeks my other baby was to big can I ask to be induced now when I turn 39 weeks? I feel more comfortable if they induce me then going in to labor naturally which I know won’t happen

  • I go in for induction tomorrow and when I was 36 weeks and 3 days they said I am 1 centimeter dilated and baby’s head is.. Negative 2? I am hoping it wont take too long.

  • This is bullshit. He is biased and isn’t giving all of the facts. Inducing before 39 weeks has led to more babies in the nicu. Also when doctors induce they are trying to rush labor and this leads to higher c section rates and more unnecessary medical interventions such as epidurals (which raise the c section rate and the complications rate by 60%).

    What he means by induction being more convenient is that doctors prefer them because of their own schedule.

    Women go on maternity leave before our due dates so his points are just rediculous.

    NO medical interventions come without risks. The interventions are only good when the risks do not outweigh the benefits.

  • Unless you know what date you likely ovulated and conceived I’m not sure that even early utlrasounds can be that accurate with dating can they?

  • I have my induction appt set for 41 + 3 (did not know about the magic number). If my Bishop score is 8+ and I’m likely to have a vaginal birth can I opt out of the induction?

  • Wasn’t brought up I brought up being electivly induced at 39 weeks due to my husband crazy truck schedule. Shes here and healthy ebf and going on 6 months

  • I had failed induction at 37weeks, after painful contractions of about 12 hours and unsuccessful attempt at pushing for 1 hour (vaginal birth) and subsequently delivered by c-section. Wasn’t a birth experience that I expected or wanted. �� The induction wasn’t my choice, but doctor put forth to me for unclear reason. I thought my water drip out a bit the night before, but it wasn’t much or continuous, so it probably was just mucous plug leaking.

  • So, for an induction, is being in the water for some or all of the time not an option anymore? My doctor discussed with me pesseries like having a tape inserted or to have tablets/gel. I’m 40 weeks and 6 days and really wanted a water birth…:(

  • Thank you so much for this video!!!! I really appreciate it. The option has been brought up to me by my OB & I wasn’t educated enough to make an informed decision but this video made me feel better. Truly thank you!! ����❤️ Thumps you for this video (:

  • I’m looking into an elective induction and hoping my doctor is okay with it. We’re military and it’d be great to have a set date to have the baby to have family come help. My first labor I was medically induced at 35 weeks and it lasted 6 hours, and my second I was in labor for 30 minutes and pushed for almost an hour so I’m really worried to go into labor myself. I was 5 cm dilated at 37 weeks and had him on his due date waiting. I wish my doctor would of helped with my second. So fingers crossed this new doctor understands my concerns since we’re 45 minutes from the hospital.

  • At my last appointment doctor said if I don’t have my baby by my next doctors appointment he’ll talk about inducing ��
    P.s. my next doctors appointment is in 5 days!!

  • I had a medically necessary induction at almost 41 weeks and wish I would have been induced earlier to prevent the stress that preeclampsia brought. I gave birth in a hospital where there wasn’t a time limit and when I developed an infection from my water being broken so long there still wasn’t a time limit as long as we were both doing ok. Took 36 hours but we got there eventually. They started the pitocin at a low enough rate and gradually increased it to mimic how my body would naturally progress.

  • This study is very unreliable. If you read it, it Is missing so much information. Also the women in the expectant management group did not let them go in to labor on their own. They had to be induced at 42 weeks. I know I was at over 43 weeks on 3 of my children. My longest labor was 6 hours. I was out of the hospital in 1 day. My 4th kids I was induced at 42 weeks and ended up in labor 36 hours and a cesarean. I’m a nurse too and I saw so many flaws with this study. I’m not sure why you would encourage to spread this with all of the missing information and not letting the women who were in the expected management, not actually go into labor on their own. So this study is NOT accurate or unbiased. Women need to be allowed to go into labor by their own body’s regulatory system. Mother nature knows better than any doctor. We encourage induction way to much in the medical field. Read the comments by the Doctors who tear this study apart. They have very valid points. No one likes being pregnant at the end of their pregnancy. We’re tired, anxious, and just want our babies out. I know I’ve been there. We need to teach more patients and the same thing my first Dr. told me, “No woman is pregnant forever.” I was already 42 and a half weeks. Unless there is a medical reason to be induced it should be avoided. I’m speaking as a mom and as a nurse.

  • Enjoyed this video. My doctor and I have talked about inducing at 39 weeks because baby girl (my first) is projected to be 10+ lbs at my due date and we are both concerned about her getting stuck and having to have an emergency C-section.

  • Why are you saying the outcome for baby is the same? The risk of still birth increases substantially after 41 weeks. You should go over that, that’s part of informing. Also evidence based birth isn’t a very good resource at all. They’re very biased.

  • My OB, also our good friend ( maybe more hubbies friend ��) said to have sex…if cervix is ripe, the prostaglandins in the sperm may kick start labor..it works��

  • I’m 38 weeks and am being induced at 39 weeks in 4 days and I’ve never heard of a bishop score… why wouldn’t my doctor talk to me about that or tell me my score? I’ve tried asking what are my chances but it’s more of a we’ll have to see. I’m being induced because my baby is big.

  • I had an induction at 39w5d for medical reasons and it was a catastrophe. Every intervention but a csection. My second was a 32 wk csection and now that I’m pregnant again, I’m leaning towards a repeat csection unless I have spontaneous labor.

  • Thank you for this video. My fourth birth was my first induction (due to hypertension) and statistics aside, like you said, it was an incredibly different experience. I was in an wonderful hospital with unlimited resources and was super supported, thankfully with a vaginal birth as the outcome. I appreciate you breaking down the statistics and supporting parents to make informed decisions. I wanted to show moms just a little bit of the differences between an induction and a natural labor so I vlogged my birth. I’m not nearly as cute or fun as you, haha, but I hope it’s ok that I post this video here giving a direct view of just what an induction can look like. Love your videos, keep up the good work!

  • Thanks for this amazing information.
    Am 38weeks it’s my first baby and my Doctor wants to induce me because baby is 8pound!
    Is this normal?
    Need your advice please guys

  • Hi guys I have a c section before now it my 2 baby am 39 weeks I don’t know if induce will be good for me for not going into c section again

  • this makes me so sad because why don’t OBs tell you everything you’re saying. From Bishop scores and what they mean to how likely you are to have a csection ��. I get induced with my 2nd child tomorrow night and I’m terrified. You’re amazing Sarah♥️

  • My doctor told me briefly about this study and said that I should consider being induced at 39 weeks if my baby girl hasn’t come yet!! ❤️

  • My doctor was telling me I should get induced because I’m overweight. But as I look online, I keep seeing things that say being induced while overweight, you’ll more likely have to get a csection? I dunno…

  • I was induced at 39 weeks, although it was due to having complications. I had the gel and God damn it was intense. Glad my labour only lasted 11 hours!!

  • My first two labors…water broke…two hours later 2-10cm in 20 minutes.
    Third labor, kind of unproductive contractions, came in at 3cm, broke water, 1 cm /hour…baby was face sideways…

  • I was induced at 40+2 with my first due to low fluids. It was great, I was already 4cm dilated before they began the induction. With this baby I may just schedule an induction at 39 weeks because I need someone to care for our daughter. Its that simple lol

  • Yikes! I’m 38weeks! I’m told to schedule for induction at 39weeks. It feels like they’re looking for an excuse to get me induced and they seem forceful about it! Their reason is, I have lots of fluids! I’m healthy and so is baby, her heartbeat rate is perfectly fine and healthy with lots of daily movements! I do not want to get induced but I’m going in tomorrow for consultation ����

  • With my first I was induced(actually induced for all 3) at 41+4 with a thick, high cervix and wasnt dilated at all. That induction took 5 days. Took me 4 days to get past 1.5cm. (And that 1.5cm I got in the first 2hrs of my induction.)