Term baby, healthy baby: Inducing labor may not always be the best choice.

In the last several years the number of women whose labor has been electively induced has more than doubled. Along with this, the number of cesarean section deliveries has also increased. There are many medical indications to deliver a baby prior to the due date, however “induction of labor” is often requested due to patient considerations of convenience.

While a full term pregnancy lasts 40 weeks, a baby born from 37 weeks on is considered still full term. Many times labor spontaneously occurs between 37 to 38 weeks with the majority of these babies delivered without any problems. Currently we still don’t know what triggers spontaneous term labor, however it may well be that a full mature fetus is somehow able to start this process. On the other hand, when labor is induced before 39 weeks, not all these babies are fully developed, in spite of having mature lungs. Some babies require care in the Intensive Care Unit, because of their inability to feed, or maintain adequate body temperature. The baby’s brain, heart, lungs, and immune system all develop at different rates, and some systems may need a little more time than others to mature. Still, many women remain skeptical of the possible increased risk, because it does not fit their experience.

I have this conversation with my patients in my practice often, and when I inform them of the possible disadvantages of a “scheduled induction”, I feel their frustration. Having gone through the process myself, the last few weeks of pregnancy are stressful and uncomfortable. But electing for an induction can make the difference between a baby going home with mom or spending a longer time at the hospital separated from mom because he or she is just a little too young. Although induction of labor after 39 weeks of gestation is considered safe, an important part of your labor plan should be to wait for spontaneous labor to occur.

Written by Elena Salerno, M.D.