Pregnancy and Childbirth: The answers
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Other fetal indications for inducing labor

v Prolonged rupture of membranes is regarded as a risky state, as infection may ascend into the uterine cavity and affect the baby. It may be decided therefore that the baby will fare better outside the womb.

v In the case of a Rhesus negative mother who is carrying antibodies, if the fetus is seen to be affected by the antibodies, delivery may be deemed to be the best way forward and labor could be induced.

 

v In multiple pregnancy, labor may be induced because one or the other twin is not doing too well.

 

v "Unstable lie" is another indication. If the baby is changing position all the time, labor may be induced as a "stabilizing" procedure to try to prevent an otherwise unnecessary cesarean section.

 

Prolonged pregnancy and induction of labor

This is one of the most common indications for labor induction. When the pregnancy continues beyond the expected date of delivery (40 weeks), most obstetricians will adopt a conservative wait-and-see policy while monitoring the well-being of both the mother and the fetus. If all remains well, most will advocate no intervention until at some point 10 to 14 days after the "due date".

Induction of labor is advised at or soon after this point.

 

Maternal diabetes as an indication for labor induction

If for any reason, insulin-dependent diabetes is not well controlled in pregnancy, the fetus is clearly at risk and fetal demise is a real possibility. Labor may be induced when doctors are reasonably confident of fetal survival outside the womb.

 

Diabetes that starts during pregnancy (gestational diabetes) is normally not an indication for inducing labor.

 

Well-controlled insulin-dependent diabetes is also a less clear-cut indication. Many experts argue that, in such cases, intervention in the form of labor induction is not necessary, at least not before the due date. This remains a subject of debate even among experts.

 

Fetal size  as an indication for induction of labor

Some obstetricians argue that after 37 weeks, when the fetus is mature, labor may be induced before a large baby gets bigger. The argument is that you will prevent a potentially difficult delivery and probably a cesarean section. This stance remains controversial and a source of fierce debate among obstetricians.

 

Breech presentation and labor induction

Breech presentation is not an indication for labor induction; at least not in its unchanged form.

 

A breech presentation may be converted into a head-down presentation. Once this is achieved, some experts advocate inducing labor to prevent the fetus flipping back to breech, which is always a possibility, albeit a slim one. The manouver is called external cephalic version (ECV).

 

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