Induce Labor - Part III
What risks are associated with inducing labor?
While induction is generally safe, it does carry some risk, which may vary according to the methods used and your individual situation. Oxytocin, prostaglandins, or nipple stimulation (explained below) occasionally cause contractions that come too frequently or are abnormally long and strong. This in turn may stress your baby.
In rare cases, prostaglandins or oxytocin also cause placental abruption or even uterine rupture, although ruptures are extremely rare in women who've never had a c-section or other uterine surgery.
One commonly used prostaglandin, misoprostol, is associated with a relatively high rate of rupture in women attempting a vaginal birth after a cesarean (VBAC) and should never be used in women with a scarred uterus. Some experts don't think women attempting VBAC should be induced with oxytocin, either.
To assess the frequency and length of your contractions as well as your baby's heart rate, you'll need to have continuous electronic fetal monitoring during an induced labor. You'll probably have to lie or sit while being monitored, but some hospitals offer telemetry, which lets you walk around during the process.
Inducing labor can take a long time, particularly if you start with an unripe cervix, and this process can be hard on you and your partner psychologically. (On the other hand, among women who go past their due date, the seemingly endless wait for labor to begin may be even more trying.)
And if the induction doesn't work, you'll need a c-section. Having a c-section after a long labor or unsuccessful induction is associated with higher rates of complications than you'd face with a planned c-section.
Remember that your practitioner will recommend inducing your labor only when she believes that the risks to you and your baby of waiting for labor to begin on its own are higher than the risks of intervening.
Are there any circumstances in which my labor shouldn't be induced?
Yes. You'll need to have a c-section rather than an induction whenever it would be unsafe to labor and deliver vaginally, including the following situations:
• Tests indicate that your baby needs to be delivered immediately or can't tolerate contractions.
• You have a placenta previa (when the placenta is lying unusually low in your uterus, either next to or covering your cervix).
• Your baby is in a breech or transverse position, meaning that he's not coming headfirst.
• You've had more than one c-section. (Some practitioners believe that women with even one previous c-section shouldn't be induced.)
• You had a previous c-section with a "classical" (vertical) uterine incision or other uterine surgery, such as a myomectomy (surgery to remove fibroids).
• You're having twins and the first baby is breech, or you're having triplets or more.
• You have an active genital herpes infection.