Inductions: Elective or Medical

Induction of labor is the use of any method to start labor. The most common method is the use of medications. The medications can be given orally, intravenously, or vaginally. It depends on your sterile vaginal exam (SVE). The SVE is evaluating five components that calculate a "Bishop score". For more information about the SVE and Bishop Score, there will be a blog entitled, "They checked me...but what does that mean"? Other forms of induction can include stripping (sweeping) your membranes, mechanical devices such as a foley balloon, laminaria, or an amniotomy, which is an artificial rupture of membranes.

Induction of labor can be elective or medically indicated. Elective induction is when the patient chooses to be induced. Both mom and baby are healthy, there are no medical indications. The most common reason is physical discomfort. Other reasons may include a history of rapid labor or distance from the hospital. The one requirement for an elective induction is a minimum gestational age of 39 weeks.

Medical inductions of labor are indicated when there is a medical diagnosis, either with mom or baby, giving rise to the need for delivery. Some medical inductions result in preterm deliveries, others are indicated after the patient is considered post-term i.e. 41-42 weeks. Common causes of medical inductions include uncontrolled hypertension (HTN) or pre-eclampsia, gestational age past 41 weeks, problems with the placenta, complications affecting fetal growth and amniotic fluid levels, medical history with diabetes (DM) or HTN, pre-labor rupture of membranes (PROM), multiple gestations (twins, triplets, etc).

All risks involved in inductions of labor can happen whether elective or medically indicated. The common risk includes hyperstimulation of the uterus (too many contractions), which can lead to fetal heart rate changes, infection, cesarean section, or rupture of the uterus. The risk should be discussed prior to obtaining consent. As a matter of fact, It's very important to keep an open line of communication with your provider to discuss your plans for your delivery prior to admission to the hospital. I can't stress the importance of making your plans known at the beginning.