When my OB-GYN first told me I had to be induced for medical reasons, I was terrified. I had expected and hoped to go into labor without any kind of medical intervention, so not only was an induction not part of my birth plan but I was anxious about the entire process. I worried about the pain, the potential for complications, and the possibility that it would all end with a delivery in the operating room. I eventually made peace with this change of plans, though, and I think taking the time to ask my OB-GYN questions before I was induced helped. The information my provider gave me put my mind at ease and dispelled some very problematic myths.
There are numerous reasons why a pregnant woman would need to be induced. For me, the risks of induction were far smaller than the risks of continuing my pregnancy with preeclampsia. In other words, waiting for "nature to take its course" wasn't a safe option. I didn't really consider the possibility of induction, though, so I was left wondering how the entire process was going to work. For example, did an induction automatically mean I was going to have a C-section? What were the contractions going to feel like now? Was an induction going to put my baby's health at risk? It's difficult to turn your brain off when your birth plan takes a drastic turn towards the unknown, which is why speaking to my provider was so important.
So whether or not you're preparing for every possible labor and delivery scenario, or have already planned to be induced, here are a few questions you should ask your provider before you get the show on the road:
"Is Induction Necessary?"
The answer to this question depends entirely on you and your baby's health. Trust me when I say that if you Google it or ask about it in pregnancy groups on social media, you might hear a different answer than what your doctor is going to tell you. It's critically important that you find an obstetrics provider you trust to provide you expert care.
Thankfully, I trusted my doctor when she told me that an induction was absolutely necessary, even though people in online mommy groups told me to avoid one at all cost. In the end, an actual medical degree trumps someone else's opinion.
"Will I Have To Have Pitocin?"
I won't lie, I was scared of Pitocin. But despite what other people told me about it's often bad reputation, Pitocin is safe and effective. It's also not the only method of induction available to health care providers. Other methods include using hormones called prostaglandins to thin and soften your cervix and start labor contractions, using a catheter to put pressure on your cervix and cause your body to produce similar hormones, or breaking your water manually. So ask your doctor which method they're likely to use, and explore your options if you can.
"What Happens If It Doesn’t Work?"
According to my OB-GYN, what happens after a "failed" induction depends on the induction itself, if your water has broken, or if your baby is still looks healthy and safe. There might be other medications a doctor can try using to move things along, or they might decide to watch and wait. While most inductions work — about 75 percent according to Mayo Clinic — sometimes it's necessary to do a C-section in order to safely deliver the baby.
"Will It Hurt More Than A Non-Medicated Labor?"
Pain is relative, you guys. The level of pain you feel during an induction is dependent on a variety of factors, including the method used, the dose and frequency of medication, and how your body responds to the entire process.
In my experience, back labor is hell no matter how it's started. So while your mileage may vary, labor is probably going to hurt regardless of whether or not you were induced.
"Will It Work?"
While there's no way of really knowing if an induction will work, I learned that obstetric providers don’t recommend induction for just anyone. In fact, according to the American College of Obstetricians and Gynecologists (ACOG), doctors use a measure of cervical "readiness" and the position of your baby called a Bishop score, which ranges from one to 13, to determine whether or not your induction is likely to be successful. If your Bishop score is under six, a doctor won't try induction. Mine was nine the first time I was induced, and a full 13 the second, so I felt confident that my inductions were going to be successful.
"When Can I Get An Epidural?"
If you are interested in getting an epidural, or think you may want one during labor, I highly recommend that you ask your OB-GYN about your access to the medication before you are induced. The first time I was adamant that I would not get an epidural no matter what, so by the time I changed my mind and requested one I had to wait for more than an hour for an order to be written and the on-call anesthesiologist to administer my pain relief.
In contrast, the last time I delivered I made my wants and needs clear, and they let me have an epidural before they even started my induction.
"How Long Will It Take?"
According to my OB-GYN, trying to plan an induction is like trying to plan for next week's weather. You can get a general sense of how it might go, based on a woman's Bishop score and whether this is her first baby, but it can take hours or days depending on how a person's body.
"Is Induction Dangerous?"
I was so afraid of being induced, mostly because I was worried that it would be horrible or dangerous for me and my baby. My provider put my mind at ease, though, by letting me know that it was the safest choice given my preeclampsia. But my OB-GYN also let me know that, generally speaking, elective inductions are safe, too. In fact according to one study of 6,814 expectant moms whose water had broken, induction was associated with fewer risks than waiting for labor to occur without medical intervention.
"Is It 'Better' To Wait For Labor To Come On Its Own?"
While many doctors still prefer to wait until you are past your baby's due date to schedule an induction, as the The New York Times reported a recent study actually showed that induction at 39 weeks was less likely to result in a C-section than waiting for a mom-to-be to go into labor on her own, and there was absolutely no difference in harm to mom or baby.