CWC Article - Exercise In Pregnancy

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Induction of Labor

By: Bradley G. Goldberg, M.D.

Induction of labor refers to the initiation of the labor process by a physician with medication. Reasons to induce a woman's labor range from purely medical indications to more social types of indications.

Medical indications include pre-eclampsia (or pregnancy induced hypertension), premature rupture of the membranes, intra-uterine infection, growth restriction of the fetus, and being significantly past the due date. There are of course other medical indications, but these are some of the more common.

Social indications include certain family situations, such as the father of the baby may only be in town on a certain weekend, or the parents live a long distance from the hospital. These are also considered valid indications for labor induction by The American College of OB/GYN.

When induction is performed for medical reasons, such as pre-eclampsia, it may be necessary to induce labor several weeks before the due date. Although this may put the baby at risk for respiratory problems, this is necessary when the risk of continuing pregnancy poses a greater threat to either mother or baby.

However, when a woman's labor is induced for purely social indications, it should be done no earlier than 1 to 1 1/2 weeks prior to the due date, or at least 38 1/2 weeks pregnant. In addition, an early ultrasound must have been obtained prior to the 20th week of pregnancy to confirm that the due date is accurate. The cervix should also be favorable, which means there should be some degree of dilitation or shortening (effacement) already ocurring, if not, induction should probably be reconsidered.

There are several methods available to start the Induction process. Usually a medication known as a cervical ripening agent is given to soften the cervix and then pitocin is usually given IV to start contractions.

Cervical ripening agents include prostiglandins such as prostin suppositories, and cytotec tablets. The cytotec tablets are currently very widely used. The medication was actually first used to treat ulcers, but for more than 10 years now, doctors have been using it with great success to induce labor.

Of course all medical procedures have risks, and you should discuss this with your physician. However, when labor induction is performed according to proven guidlines and protocols, it should be a safe proceedure.