Currently 1 in 4 women are being induced in Australia.
Inductions can increase:
The need for medical pain relief most commonly epidural
Vacuum or forceps delivery
Emergency Caesarean sections
When deciding to have an induction we are often evaluating ‘risks’. This term alone can provoke fear or anxiety and can inhibit a woman’s ability to make an informed decision. There is an element of risk in everything we do and we all perceive it differently. In making a decision about induction we are balancing the pros and cons, based on evidence based information/statistics in relation to the mother and baby’s health. Equally important is the emotional impact on the Mother, her concerns, fears and anxiety about inducing or not need to be considered.
This information is based on Rachael Reed’s book ‘Why Induction Matters’ and the research is from NICE (National Institute for Health and Care Excellence) WHO and Cochrane Reviews.
Induction – Decision Making Framework
1. Reason for induction
Is your situation a complication or a variation?
Complications of Pregnancy – Medical Conditions
High Blood Pressure
Pre-eclampsia
Gestational Diabetes
Pre existing diabetes
Growth restricted baby
Reduced Fetal Movements
Prolonged pre-term rupture of membranes
Reduced fluid
Variations of Pregnancy
Variation is when Mum and baby are well but the variation may increase the chance of a complication occurring in the future.
Induction for post dates
Advanced maternal age
Vaginal Birth after Cesearean
Suspected Big baby
Multiple Pregnancy
Pre-labour rupture of membranes after 37weeks
Questions to be asked to assist with decision making:
Has the complication been medically tested and diagnosed?
What are the complications associated with your situation?
Why has the induction been offered?
Are you or baby showing signs of the complication occurring now?
Are there immediate concerns for you or your baby?
Will inducing your labour reduce the chance of these complications occurring?
2. Consider the Experience of Induction
What were you previous expectations about labour prior to this?
How will this alter your birth wishes?
What are the risks of induction?
What are alternative methods to a medical induction?
Does the induction have to be done now?
3. Consider the alternative options to induction
Waiting for spontaneous labour.
What are the risks of waiting for labour to start naturally?
Is there anything you can do to reduce these risks? Eg Monitoring blood sugars for GD
Will additional monitoring help your situation?
What are your boundaries about waiting? When would you revaluate?
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