The Induction of labour: To Induce or not to Induce?

The induction of labour has become a more common practice, albeit one that, unfortunately, often leads to a cascade of other interventions. 

While it is true that in some cases, labour induction can be a life-saving measure for both mothers and babies, there is a growing concern among various individuals, including women, families, researchers, midwives, and doctors, that an excessive number of inductions may be doing more harm than good. This concern has been articulated in various studies by experts such as Dr. Sara Wickham, Simpson & Thorman (2005), Lothian (2006), Keirse (2010), Berkowitz (2011), Glantz (2012), and Benoit et al. (2015).

The primary motivation behind labour induction is often to mitigate risks. However, many argue that it can paradoxically lead to additional complications. The pressure to go through with induction can be significant, arising from comments by family and friends, like, “ the baby is still not here!?, as well as warnings from doctors and midwives regarding the safety of the baby. In these circumstances, individuals may find themselves at a breaking point and reluctantly consent to induction.

My belief is that intervention should be considered when truly warranted. However, what constitutes a warranted intervention is subjective and should ultimately be your choice, made in the best interest of yourself and your family. No one can discern what is optimal for your unique situation except for you.

What supported me through making these big decisions was first and foremost tuning into my intuition and the sensations I felt in my body. If I was feeling extremely resistant to something I knew it probably wasn’t the best choice for our family. Take some time to yourself, silence the mind and listen. I find the best place to do this is in nature. Second, I had an incredible support team that made all the difference. They provided answers to my questions without fear which equipped me with even more confidence in my decisions. 

So, what is induction? It refers to the procedures utilized when labour has not commenced naturally. Some may recommend it at 41 weeks, while others may deem it unnecessary until 42 weeks, and in certain cases, women may not give birth until 43 or even 44 weeks.

As Dr. Sara Wickham shares in her book, inducing labour, "No ascribable improvement has occurred in overall neonatal mortality, which has gradually declined since 1990 irrespective of whether the cesarean section rate rose or fell." This speaks on the absence of definitive research on the topic of induction, indicating the choice between induction and natural labour; the decision ultimately rests with you.

It’s much easier to say no to induction if you’re equipped with the knowledge of miracles occurring within your body to prepare for childbirth. Your body is inherently equipped for this process. In late pregnancy and early labour, you transmit antibodies to your baby, your cervix undergoes softening and forward movement through the influence of naturally occurring hormones, the uterine muscles tighten, resulting in cervical dilation, and the baby descends, exerting pressure on the cervix, further facilitating dilation. All of these processes occur in synchrony, guided by a blend of naturally occurring hormones, including oxytocin, which aids in these changes, and endorphins, providing pain relief and fostering positive emotions.

Medical induction, in contrast, often focuses solely on the physical aspects, such as cervical thinning, stretching, dilation, and contraction continuation.

When deliberating whether to opt for induction, I strongly recommend following the BRAIN acronym (Benefits, Risks, Alternatives, Intuition, Nothing) and delving into the books,  "Inducing Labor" by Dr. Sara Wickham and "Gentle Birth, Gentle Mothering" by Dr. Sarah Buckley (pages 63-77) to make an informed decision aligned with your individual circumstances and preferences.

Trust yourself, Mama.