My doctor says it’s fine to induce labor once I’ve gotten to 39 weeks. Do you think this sounds like a good plan?

You ask:

I’m due on Christmas day and my doctor wants to induce me the week before. I’d like to spend the holiday with my family and introduce them to our new little one. My doctor says it’s fine to induce labor once I’ve gotten to 39 weeks. Do you think this sounds like a good plan?

I answer:

This post on Lamaze’s “Giving Birth with Confidence” blog addresses your question. It’s about Thanksgiving, but it applies equally well to Christmas. As you can see, it lists some of the drawbacks of induction. Knowing these can help you decide whether the “pros” in your case outweigh the “cons.”

Also, you don’t say whether this is a first baby. If it is, and you decide you want to go ahead, there’s another consideration: is your body ready for labor?

Readiness for labor is measured by the Bishop score. A Bishop score of 7 or more predicts high probability of induction success, and as the number decreases below 7, it becomes progressively more likely that induction will end in cesarean delivery.

Many doctors believe this problem can be solved by treatment that readies the cervix for labor. It turns out though, that while these treatments do a great job at this, cesarean rates increase dramatically when the cervix wasn’t ready for labor despite cervical ripening treatment. Studies find anywhere from 15 to 24 more cesareans per 100 first-time mothers who were treated with cervical ripening agents as part of an induction compared with women beginning labor on their own.^1-6 On the other hand, if the body was ready to go into labor, the studies found no difference between women being induced and women beginning labor spontaneously.

So here’s what I suggest: if induction is your plan, when you reach 39 completed weeks, i.e., the beginning of your fortieth week of pregnancy, ask your doctor to check you and tell you your Bishop score. If your score is 7 or more, go ahead, but if it is less than this, you might want to rethink inducing labor.

One more thought: you might also want to ask your pediatrician what they think about having a lot of people around your newborn.

References

1. Prevention of perinatal group B streptococcal disease: a public health perspective. Centers for Disease Control and Prevention. MMWR Recomm Rep 1996;45(RR-7):1-24.
2. Dunne C, Da Silva O, Schmidt G, et al. Outcomes of elective labour induction and elective caesarean section in low-risk pregnancies between 37 and 41 weeks’ gestation. J Obstet Gynaecol Can 2009;31(12):1124-30.
3. Gibson KS, Waters TP, Bailit JL. Maternal and neonatal outcomes in electively induced low-risk term pregnancies. Am J Obstet Gynecol 2014;211(3):249 e1- e16.
4. Laughon SK, Zhang J, Grewal J, et al. Induction of labor in a contemporary obstetric cohort. Am J Obstet Gynecol 2012;206(6):486 e1-9.
5. Le Ray C, Carayol M, Breart G, et al. Elective induction of labor: failure to follow guidelines and risk of cesarean delivery. Acta Obstet Gynecol Scand 2007;86(6):657-65.
6. Vahratian A, Zhang J, Troendle JF, et al. Labor progression and risk of cesarean delivery in electively induced nulliparas. Obstet Gynecol 2005;105(4):698-704.

Medical Disclaimer: Henci Goer is neither a physician nor a midwife. Content and information on this website are for informational and educational purposes only and do not constitute medical advice. Users are advised to consult their physician or midwife when making decisions about care.