Big Baby: Is Induction of Labor Necessary?

What’s involved in inducing labor?
Many obstetricians and some midwives recommend inducing labor if you are near or at full-term, and they think the baby is larger than average -- macrosomia, literally, “big body.” Typically, they use an estimation that the baby weighs or will soon weigh 4,000 grams (8 lbs. 13 oz.) as the threshold. Inducing labor usually involves the following:

Prostaglandin treatment if the cervix is still long, firm, and thick: Prostaglandins are a family of compounds, two of which are known to soften a cervix that isn’t ready for labor. These same two can also stimulate contractions. Prostaglandin E2 is inserted into the vagina either in gel form (Prepidil) or in a tampon (Cervidil). Prostaglandin E1 (Cytotec) comes only as a pill because it is not formulated for the purpose of inducing labor. A piece of the pill may be inserted vaginally or the pill may be given orally.
Breaking the bag of waters (amniotomy or artificial rupture of membranes): During a vaginal exam, the birth attendant snags and tears the membranes using an instrument that resembles a crochet hook with a small sharp tooth under the curled tip.
Oxytocin (Pitocin or “Pit”): Pitocin is given intravenously via a pump that controls the dose.

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