Previous obstetric history’s influence on labor induction

In tragic cases of previous unexplained stillbirth late in pregnancy, it may be decided to induce labor, probably at 37 - 38 weeks, when the chances of success are good and the baby is mature enough not to need any special care after birth.

Failure of labor induction

Induction failur occasionally happens. A rough guide to the chances of success is the gestational age. The more advanced the pregnancy, the better the chances of success. This, however, is not a black-and-white situation. Labor induction at 42 weeks of gestation can still fail.

Maternal indications for inducing labor

If the mother has a medical condition that is progressively deteriorating as a direct consequence of pregnancy or the condition needs treatment urgently but only after the end of pregnancy, labor may be induced. Examples include pre-eclampsia, kidney failure and cancer.

Pain as an indication for induction of labor

Pain is subjective and it is difficult for the doctor to objectively judge what pain justifies intervention to bring the pregnancy to a premature conclusion. It is true, however, that sometimes pregnancy is associated with severe debilitating pain, usually in the pelvic region. This may justify induction of labor.

Labor induction indications that are neither fetal nor maternal

v In the tragic event of fetal demise late in pregnancy, labor will be induced.

v Induction of labor may also be advised or requested in a case where a lethal fetal condition has been diagnosed late in pregnancy. Such conditions that are incompatible with life outside the womb include anencephaly (where there is no brain), chromosomal disorders (e.g. Edward's Syndrome) and the absence of kidneys.

Most of these are diagnosed early in the second trimester and termination of pregnancy is offered. However, a few do inadvertently escape detection till late in pregnancy, where induction of labor will be offered.

Social indications for induction of labor

This term simply refers to a situation where induction is carried out in the absence of any obstetric or medical indication. In other words, it is labor induction requested by the parents for their convenience.

The most common social reasons include to allow a partner or another family member to be present at the birth, to avoid certain dates and occasionally to allow the baby's arrival before Christmas or the New Year!

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