Induction of Labor
The International Cesarean Awareness Network strongly advises women and health care practitioners to avoid induction of labor unless a true medical indication exists. Induction of labor frequently leads to further intervention in birth including the need for fetal monitoring, epidural anesthesia, instrumental delivery and cesarean section. Each of these interventions increases risks to babies and mothers.
First time mothers are especially vulnerable: Induction itself doubles a first-time mother’s risk of having a cesarean section.1,2
A cesarean puts a woman’s entire reproductive life, including subsequent pregnancies, at higher risk.
For all women, induction of labor increases the use of forceps and vacuum extraction as well as rates of shoulder dystocia.2,3
Women with a prior cesarean who are induced have a 33-75% risk of having another cesarean.4,5
Induction of labor has been shown to increase the risk of uterine rupture for women with a prior cesarean scar.6-9
Babies whose births are induced more often experience resuscitation, admission to the intensive care unit, and phototherapy to treat jaundice, which generally require separation from the mother. 10
References:
1. Maslow AS, Sweeny AL. Elective induction of labor as a risk factor for cesarean delivery among low-risk women at term. Obstet Gynecol 2000 Jun;95(6 Pt 1):917-2.
2. Dublin S, Lydon-Rochelle M, Kaplan RC, Watts DH, Critchlow CW. Maternal and neonatal outcomes after induction of labor without an identified indication. Am J Obstet Gynecol 2000 Oct;183(4):986-94
3. Nesbitt TS, Gilbert WM, Herrchen B. Shoulder dystocia and associated risk factors with macrosomic infants born in California. Am J Obstet Gynecol 1998 Aug;179(2):476-80
4. Learman LA, Evertson LR, Shiboski S. Predictors of repeat cesarean delivery after trial of labor: do any exist? J Am Coll Surg. 1996 Mar;182(3):257-62.
5. Sims EJ, Newman RB, Hulsey TC. Vaginal birth after cesarean: to induce or not to induce. Am J Obstet Gynecol 2001 May;184(6):1122- 4.
6. Blanchette H, Blanchette M, McCabe J, Vincent S. Is vaginal birth after cesarean safe? Experience at a community hospital. Am J Obstet Gynecol 2001 Jun;184(7):1478-84; discussion 1484-7.
7. Baskett TF, Kieser KE. A 10-year population-based study of uterine rupture. Obstet Gynecol 2001 Apr;97(4 Suppl 1):S69.
8. Shimonovitz S, Botosneano A, Hochner-Celnikier D. Successful first vaginal birth after cesarean section: a predictor of reduced risk for uterine rupture in subsequent deliveries. Isr Med Assoc J 2000 Jul;2(7):526-8.
9. Ravasia DJ, Wood SL, Pollard JK. Uterine rupture during induced trial of labor among women with previous cesarean delivery. Am J Obstet Gynecol 2000 Nov;183(5):1176-9.
10. Boulvain M, Marcoux S, Bureau M, Fortier M, Fraser W. Risks of induction of labour in uncomplicated term pregnancies. Paediatr Perinat Epidemiol. 2001 Apr;15(2):131-8.
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