In some women's opinions, doctors are trying to get their patients to be induced a lot more lately than ever before. And many believe it's not necessarily for medical reasons every time. What are your rights as a patient? Do you have to be induced? When is it medically necessary to be induced and how long can you wait before it is crucial that baby comes out? This OB-GYN says you have some options.
If you’re a low-risk pregnancy, and really don’t want to be induced, Dr. G. Thomas Ruiz, an OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, California, tells Romper that typically, most doctors won’t discuss induction until about 41 completed weeks of pregnancy, and if they do discuss it, it will be done gently. “We will allow a woman to safely continue the pregnancy until 42 weeks, provided that patient has normal antepartum testing. Once a patient gets to 42 weeks, we typically recommend delivery,” he says.
However, some medically necessary reasons your doctor may highly recommend or insist you are induced include “medical complications such as hypertension, cholestasis of pregnancy, poor fetal growth, or very large babies,” Ruiz says. This is “where we will recommend induction of labor prior to 40 weeks. Women with medical complications of pregnancy are typically on antepartum testing protocols from 34 weeks gestation, which helps us time when the induction should occur.” According to the Mayo Clinic, some other reasons include when there's no longer enough amniotic fluid surrounding your baby, your water has broken prematurely but labor hasn't begun, you have an infection in your uterus, you have diabetes, "your placenta peels away from the inner wall of the uterus," either partially or completely, you have kidney disease, or you're obese.
How does induction work? To be “induced” is when doctors use medications to start the labor process with the intent to “soften the cervix to allow the uterine contraction process to begin on its own or to use an IV medication to create regular uterine contractions,” Ruiz explains. “The agents we use to soften the cervix are referred to as cervical ripening agents. Cervical ripening agents can be either medications that contain prostaglandins, or a mechanical device such as a Foley balloon or Cook balloon. Cervixes that are not ripe will generally not respond to a Pitocin induction only. Pitocin is the IV medication used to create regular uterine contractions.”
When do most doctors think it’s absolutely medically necessary to induce for the health and safety of you and your baby? The Mayo Clinic noted that you have two weeks after your due date. Why is that? "When a pregnancy lasts longer than 42 weeks, amniotic fluid might begin to decrease and there's an increased risk of having a baby significantly larger than average (fetal macrosomia). There's also an increased risk of C-section, fetal inhalation of fecal waste (meconium aspiration), and stillbirth," according to the website.
Unless you're a good candidate for induction, the Mayo Clinic noted risks of being induced include, "a failed induction, low heart rate for the baby, infection for both you and the baby, a uterine rupture," and an increased risk of bleeding after delivery because your uterine muscles didn't properly contract.
So if you're having a healthy and not-high-risk pregnancy so far, it looks like you have until 42 weeks before your OB-GYN highly recommends you get induced. And the only reason they would ever "force" you to be induced is if there is a risk of horrible complications to you or your baby. If you feel as though you're being forced to do something with your body you don't want, and your baby or your life isn't in danger, then you can always get a second opinion from another doctor.
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