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Avoid Labor Induction: Risky For Mom & Baby

In the September/October issue of AWHONN’s Journal of Obstetric, Gynecologic, & Neonatal Nursing (JOGNN), researchers have demonstrated that inducing labor without a medical reason increases the risks for complications for both mother and baby, and should not be done except when medically necessary, and especially not for convenience. Today doctors are likely to induce an overdue pregnancy at 41 weeks instead of 42. And rather than waiting up to 24 hours after a woman’s water breaks, labor is now often initiated after four hours.


Nurses are on the frontlines of healthcare and see first-hand the harmful effects for moms and babies of using medications to help start or speed labor when there is no medical reason to do so. Furthermore, most people are unaware that giving such medication without a reason causes significant unnecessary immediate and long-term risks for a mother and baby.

Medical Ground for Inducing Labor

  • You’re still pregnant one to two weeks past your due date and experts advise not to wait longer to avoid a host of problems. For example, the placenta may become less effective at delivering nutrients to your baby, increasing the risk of a stillbirth or serious problems for your newborn.
  • Your water bag breaks and your labor doesn’t start on its own. In this case, you’ll be induced to decrease the risk of infection to your uterus and your baby, which is more of a concern once your membranes have ruptured. (However, if your baby is still very premature, your practitioner may hold off on inducing labor.)
  • Tests show that your placenta is no longer functioning properly, you have too little amniotic fluid, or your baby isn’t thriving or growing as he should.
  • You develop preeclampsia, a serious condition that can endanger your health and restrict the flow of blood to your baby.
  • You have a chronic or acute illness – such as high blood pressure, diabetes, or kidney disease – that threatens your health or the health of your baby.
  • You’ve previously had a stillbirth.

While induction is generally safe, it does carry some risk, which may vary according to the methods used and your individual situation.

For Moms:

Induced labor is associated with

For Babies:

Induction can result in

“The medication commonly used to induce labor, oxytocin, is a high-alert medication and pregnant women and their fetuses are a vulnerable population,” said AWHONN’s Chief Executive Officer Lynn Erdman, MN, RN, FAAN. “Until we better understand the implications of administering artificial hormones to women and fetuses, nurses’ advice is to limit induction and allow labor to begin on its own when all is healthy.” High-alert medications are those that carry an increased risk of causing significant harm, when used in error, compared with other medications.

Health Benefits of Normal Labor

There are significant health benefits for the woman and fetus when labor starts on its own. Since 2012, AWHONN nurses have advocated for women and infants to gain the benefits of spontaneous labor through a national public health campaign, Go the Full 40. Naturally occurring hormones prepare the woman and fetus for labor and birth. These hormones make labor more efficient, with less stress for the fetus, than induced labor.

Spontaneous labor triggers hormones that provide:

Research on the risks of elective augmentation of labor (speeding up labor with medications or other means without a medical reason) is limited, but many of the risks associated with elective induction also may extend to augmentation, since the same high-alert medication is used.

“As inductions are becoming increasingly common, the health care community, mothers, and families need to understand the risks and the potential ‘cascade of medical issues’ that can be caused by inducing labor without a medical need,” Erdman said.

“We strongly recommend that women with healthy pregnancies wait for spontaneous labor to begin and progress on its own. AWHONN bases this recommendation on research that shows that babies benefit from the full 40 weeks of gestation and waiting reduces the risks associated with inductions,” Erdman said.

Reference

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