Labour induction is a controversial choice in birth. There are concerns on the one hand that it leads to more intervention, particularly epidural and caesarean, yet these beliefs are not supported by all of the research on induction. The other issue is that provided the induction is being recommended for sound medical reasons (ie, there is a risk to the baby in continuing the pregnancy), then other than induction, the only other safe option might be a caesarean.
In my practice, women are very well prepared for labour, birth and the unpredictability that this brings. With sound preparation, women respond to evolving events with flexibility and positivity. I wonder if it is this mindset that influences the outcomes of women for whom induction was the safest choice.
Of the women who have been induced in my practice, the vast majority have gone on to have normal births, free of any form of medical pain relief. For the most part, the only interventions have been the induction itself, and monitoring for the baby. Waterbirth is just as common, even physiological third stage. So my experience doesn't agree with the research that suggests that women who are induced are more likely to have an epidural and caesarean.
What sorts of situations have led me to recommend induction?
There can be many issues that arise that might make it safer for the baby to be born, rather than continuing pregnancy. Pre-eclampsia is one condition which will worsen over time, and often at term, induction is the safest course of action. Cholestasis is another condition which can be harmful for the baby, and induction is usually considered to be safer. I don't normally recommend induction for women who have gone past their due date, or with waters broken, because we have good forms of monitoring (and antibiotics in the case of waters broken) that we can use instead to ensure that mother and baby are healthy.
Induction doesn't have to be the start of the cascade of intervention. My experience is that the intervention can absolutely be limited to an induction drip and monitoring.
Melissa Maimann is an endorsed eligible midwife in private practice in Sydney. One of the first eligible midwives in Australia, Melissa now offers a range of care options for women including private midwifery care and birth support. Visit Melissa's website to learn more about her services.