This article is part of my series on pregnancy. For more on pregnancy, see the articles on my content producer page. Also see my articles on homebirth.
As you approach the end of your pregnancy, your doctor may recommend labor induction. Most doctors don’t sit and explain the risks of such a common procedure adequately with their patients, so I’m hoping to inform you of the potential complications that can affect you and your baby when you undergo a medical labor induction.
Contractions that are more painful or difficult to deal with – this leads to the increased use of drugs during pregnancy. The contractions on pitocin are longer and stronger than natural contractions in part because of the way that it is delivered. When you go into labor naturally, you have hormonal spikes which control your contractions, but pitocin is on a continuous drip with no breaks.
Risk of failed labor induction leading to a c-section – if your body isn’t ready to deliver, it will hamper the induction. This can lead to a failed induction or other complications that can lead to a c-section. There is now an even bigger problem with c-sections, as many hospitals are now denying women the right to try vaginal birth after a c-section because of the low but serious risks associated with it and to cut down hospital costs. If you end up having a c-section, you may never be able to try for a vaginal birth.
Headaches and back aches – labor induction, even when it fails, can lead to headaches and back aches that make labor more difficult to cope with.
Poor positioning of the fetus – if your baby hasn’t gotten into position to deliver but you get an induction, this may not give your baby enough time to get into proper position to make labor go smoothly.
Longer labor – in part due to malposition of the fetus, and in part because the contractions are unnatural and typically premature, this can lead to a longer labor. Longer labors also lead to the use of pain medication or epidurals, both of which can cause complications with the baby and increase your risk of a c-section.
Higher chance of a forceps or vacuum delivery – no, they’re not completely obsolete. You may be so worn out that you push ineffectively, or the contractions may not be the right kind to help you push the baby out. More importantly, if your baby is malpositioned, this can lead to a longer delivery and the use of forceps or vacuum delivery to help you get the baby out.
Longer and stronger contractions can interrupt blood flow and oxygen to the fetus, which can lead to drops in the heart rate. This is why women who are undergoing a labor induction are placed on continuous fetal monitoring. This can increase your risk of getting a c-section.
More bleeding or infection can also occur with medical induction, including postpartum hemorrhage.
Some women report a longer hospital stay or a longer length of recovery with a medical induction.
Studies have reported higher levels of admissions to the ICU for babies born from an induction, as well as a higher rate of neonatal resuscitation due to fetal hypoxia or asphyxiation because of the induction. There is also a higher risk of needing phototherapy for jaundice.
Hyperstimulation – this can lead to other complications. If the level of pitocin you are receiving is too high or isn’t handled by your body well, you can end up with hyperstimulation of the uterus, where it contracts too hard, too long, or too many times. This can cause other complications that I’ll get to later and could result in a c-section.
Premature separation of the placenta/placental abruption – the unnatural contractions caused by a medical labor induction can lead to early separation of the placenta from the uterine wall. This is a very dangerous complication that is most often resolved by an emergency c-section.
Uterine rupture – hyperstimulation can cause contractions that could cause or exacerbate tears or weak spots in your uterus and cause it to rupture or tear. This is a potentially fatal complication for both mother and baby and requires and emergency c-section.
Requiring a c-section – for the many reasons I’ve listed above, you could end up having a c-section if you are induced. Not only for failure to progress, but for the complications that could occur during your labor that put you or your baby at risk. Studies show that first time moms who receive an induction increase their risk of needing a c-section by two to three times the average…and the average c-section rate in this country is tipping the scales at 30%. If you factor in pain medication or an epidural, you raise your risk of needing a c-section even higher.
Prematurity – the ultrasound dates can lie, and if you’re not on the ‘average’ 28 day cycle or have your dates wrong, you could be bringing a premie into the world who could need more help because your dates were off. Though we can get an estimate of fetal age, this is best done near the beginning of pregnancy and can be highly inaccurate near term. If you deliver a premie, it could end up having to stay in the NICU and developing complications with its lungs or infection. No stay in the NICU is ever fun for baby or parents, they’re best avoided if at all possible. Guilt over causing the premature birth or even anger that you were pressured into it can cause or worsen guilt or post partum depression.
I hope that I’ve outlined well the risks of induction to help you make an informed choice, should your doctor bring this up as an option. No matter what you choose, at least after reading this article, you’re informed of the risks and will evaluate them against the benefits of letting your pregnancy continue naturally.
Please feel free to read my other_articles on pregnancy, labor and delivery, and homebirth, including my series_on_homebirth. Any feedback would be appreciated. Thank you for reading!
