Although most women will spontaneously develop labor by their due date, there are exceptions to the rule. Some women may have to be delivered earlier because of complications such as high blood pressure, pre-eclampsia, diabetes, poor fetal growth or low amniotic fluid. Other women may have to be induced because they have exceeded their due date by one to two weeks. Why are inductions of labor necessary? When the conditions within the uterus or a medical condition pose a threat to either the baby or the mother, the baby must be delivered. While most labor inductions are successful, there are some questions that pregnant moms need to ask in order to increase their chances of having favorable outcomes.
- Is my cervix favorable? The softer the cervix, the greater the chances are of having a successful vaginal delivery. If the cervix is not “favorable” or soft, medicine will be necessary to make the cervix softer, usually in the form of suppositories.
- How long will the induction take? This is a legitimate question because the longer the induction takes to occur, the greater the risk of developing complications such as infections. Most inductions of labor and delivery occur within 48 hours of admission. First-time moms dilate 1.2 centimeters per hour while moms who have had previous children dilate at 1.5 centimeters per hour. It can take up to 20 for a 1st time mom and 14 hours for a mom with previous children to develop active labor (meaning she is dilated 4 centimeters) but thereafter she should deliver within the next 12 hours. A 3-day induction of labor is a red flag that there might be potential problems that could compromise the health of the unborn baby or mom.
- If you are being induced, break your water but are not having contractions, ask your provider whether he or she will give you antibiotics to prevent infections. The longer your membranes are ruptured, the greater the risk of developing an infection.
- A multiple-day induction of labor involves many providers and nurses who will be changing shifts. Sometimes things or information gets lost in the transition. Ask who the lead person or team leader is regarding your care and make sure everyone is on the same page regarding your information. Try to obtain this information, BEFORE you are admitted to the hospital.
- Trust your instincts. If things appear complicated during your labor, ask for a maternal fetal medicine consult. These are high risk OB doctors who specialize in managing complications.
Most of the medical malpractice cases that I have reviewed as an expert have involved the issues discussed above. To be forewarned is to be forearmed.
Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what do to.