The Induction Question

Medical reasons for induction also include post-term pregnancy (beyond 42 weeks), evidence of fetal distress, certain fetal anomalies in which deterioration progresses with advancing gestation, multifetal gestation and maternal illnesses like diabetes, hypertension, preeclampsia, cancer, or heart, kidney, liver or lung disease. Induction may be necessary when there is low amniotic fluid volume, when there's premature aging of the placenta or when the placenta becomes partially detached, when there is a history of fetal damage with a previous large baby (and the current baby is estimated at over nine pounds), and when the amniotic membranes rupture and labor does not ensue within 18 to 24 hours at term.

Nonmedical reasons for induction '- which I, and many other maternal health-care providers, consider invalid for inducing '- include discomfort in the last few days of pregnancy, a normal pregnancy that goes beyond the due date, a doctor who is going out of town, a planned visit by a family member, a new job, a trip and tax relief (in other words, having a baby on December 30 rather than January 2 so you can claim the dependent deduction for the child a year earlier).

What are your options?
When you agree to an induction that's not medically necessary, you may lose control over many aspects of the birth. It involves spending the entire labor in the hospital with an IV running and a fetal monitor attached. Once the membranes are ruptured artificially, the clock begins ticking. The baby must be delivered within 24 hours or the risk of infection climbs. Many hospitals require the use of a fetal scalp electrode and an intrauterine pressure catheter in the later stages of an induced labor. Induction increases the likelihood that pain medication, epidural anesthesia and cesarean birth will be necessary. Maternal postpartum hemorrhage can be a risk after induction as well.

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