Risks of induction of labor

pregnant belly

Americans are not very patient, are we?  So many mothers get a little too antsy about getting their babies out of their bellies.  It is, after all, natural to want the baby to be out, or otherwise no mother would want to give birth.  But Americans have taken it to a new extreme.

It seems so many women do not have qualms, doubts, or anxiety about induction. They tell their doctor “please get this baby out sooner! I’m just done being pregnant!”  And of course, the doctor agrees, because an induction increases the likelihood of a cesarean needing to be performed by one hundred percent! Let me say that again.  A woman who has been induced is twice as likely to have a cesarean section.  The doctor loves this fact, as I have mentioned in a previous post.  He can crank up the Pitocin, declare fetal distress, and perform a cesarean section to get out the door sooner while making more money.  Why wouldn’t he love it?

Is there really so much ignorance surrounding birth practices in the U.S.?  I think so.  About twenty three percent of women are induced to give birth.  That’s not to say that there are not medically valid reasons to be induced, but inductions are certainly over-used.  If we were to keep the baby’s best interest in mind, we probably would not be exposing so many babies to all the side effects of induction.  We also would not be exposing their mothers to the risks of induction, since their mother would not be as capable of caring for them properly if injured by induction techniques, medication, or surgery necessitated by induction.

Let me give a little outline of some of the risks associated with some induction techniques and medication:

Pitocin, by far the most commonly used labor inducing and augmenting medication, has the potential to cause:

For the mother:

  • Anaphylactic reaction
  • Postpartum hemorrhage
  • Cardiac arrhythmia
  • Fatal afibrinogenemia
  • Nausea
  • Vomiting
  • Premature ventricular contractions
  • Pelvic Hematoma
  • Subarachnoid hemorrhage
  • Hypertensive episodes
  • Rupture of the uterus

For the baby:

  • Bradycardia
  • Premature ventricular contractions and other arrhythmias
  • Permanent CNS or brain damage
  • Fetal death
  • Neonatal seizures
  • Low Apgar scores at five minutes
  • Neonatal jaundice
  • Neonatal retinal hemorrhage

Cervidil, used to efface and dilate the cervix, can cause uterine hyperstimulation resulting in fetal distress.  According to a research study published in Acta Obstetricia et Gynecologica Scandinavica, “electively induced labor more than doubled the risk of cesarean section compared with spontaneous labor onset and this risk was more than tripled when cervical ripening was used.”[1]

Artificial rupture of membranes, where a caregiver breaks the bag of waters, is performed to increase intensity of contractions, and may cause:

  • Infection
  • Prolapse of the umbilical cord
  • Fetal heart decelerations

The latter two often result in a cesarean section.

The use of a Foley catheter for the purposes of dilating the cervix may cause:

  • Infection
  • Hyperstimulation of the uterus
  • Anaphylaxis
  • Postpartum hemorrhage

Stripping or sweeping the membranes is probably the lesser of the evils of induction, and is performed during a vaginal exam by separating the amniotic membranes from the uterine wall near the cervical opening, and may cause:

  • Accidental rupture of membranes
  • Spotting or bleeding
  • Cramps/contractions/pain

And since some of these medications or methods may create the need for a cesarean section, I will go over the risks for that as well:

For the mother:

  • Infection
  • Blood loss
  • Blood clot
  • Nausea
  • Vomiting
  • Headache
  • Constipation or ileus
  • Death

During subsequent pregnancies for the mother:

  • Uterine rupture, making another cesarean section necessary
  • Placenta previa, making another cesarean section necessary
  • Placenta accreta, placenta increta, placenta percreta, which may cause severe hemorrhage and the need for a hysterectomy.

For the baby:

  • Breathing problems, especially if the infant is delivered before thirty nine weeks
  • Injury as a direct result of the cesarean section (in other words, the surgeon accidentally cut the infant, or tugged too hard on a limb or the head)
  • Increased admittance to a neonatal intensive care unit

Since all of the above may necessitate an epidural, the following are the risks of an epidural:

For the mother:

  • Dural puncture
  • Hypotension
  • Nausea
  • Vomiting
  • Shivering
  • Prolonged labor
  • Uneven, incomplete or nonexsistent pain relief
  • Respiratory insufficiency or paralysis
  • Convulsions
  • Toxic drug reactions
  • Headache
  • Septic meningitis
  • Allergic shock
  • Cardiac arrest
  • Death
  • Neurological complications
  • Backache
  • Fecal and urinary incontinence or bladder dysfunction
  • Paresthesia
  • Loss of perineal sensation and sexual function

For the baby:

  • Direct drug toxicity
  • Fetal distress
  • Drownsiness at birth
  • Poor sucking reflex
  • Fetal hyperthermia
  • Poor muscle strength and tone in the first hours
  • Neonatal jaundice

If mothers knew all this, why would they insist on being induced?  I believe it is uncommon for a pregnant woman to educate themselves about the risks of possibly necessary, or unnecessary, medications, techniques, or surgery performed or given during birth.  Are Americans just too busy to care?  Are they too gullible?  More women need to inform themselves about common birth practices in the U.S.  If more people realized the danger they put themselves and their children through, they might act with the intention to change this broken, greedy institutionalized system surrounding pregnancy and birth in America.

1.  Jonsson M, Cnattingius S, Wikström A-K. Elective induction of labor and the risk of cesarean section in low-risk parous women: a cohort study. Acta Obstet Gynecol Scand. 2012; DOI: 10.1111/aogs.12043

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One thought on “Risks of induction of labor

  1. Pingback: Self-imposed ignorance in America | My Mothering Journey

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