There are many reasons why a doctor may choose to induce a woman’s labor. Inducing labor may be elective, or it may be the result of a medical emergency. Although it is usually a safe medical intervention, the American College of Obstetricians and Gynecologists (ACOG) recommend against elective induced labor before 39 weeks gestation.

The typical pregnancy lasts 40 weeks, which is a long time for the woman enduring it. If labor hasn’t started by 42 weeks, the doctor will induce labor. After 42 weeks, the baby is at risk due to a deteriorating placenta. Most doctors, however, schedule an induction if labor has not begun by the 40th week.

There are many medical complications that dictate induced labor. Complications such as hypertension and preeclampsia, which cause high blood pressure, headaches, and excessive fluid retention, necessitate induced labor for the sake of the mother and baby. Heart disease, bleeding during the pregnancy, and gestational diabetes are other complications that require a doctor to induce labor to ensure that the mother and baby both receive the medical treatment they require.

If, for any reason, the baby is in distress and seems to be deprived of oxygen or nutrients, labor may be induced if the pregnancy is close to full term. Sometimes, a baby may seem very small for its gestational age, necessitating induced labor. If a mother’s water, or amniotic sac, has broken and labor does not start within 24 to 48 hours, a doctor will induce labor due to the possibility of a bacterial infection. A uterine infection called chorioamnionitis is another reason to induce labor.

Some women schedule induced labor due to their work or the father’s work. Others prefer to have out-of-town family present for the birth, so they elect to induce labor. Women carrying multiples and attempting vaginal delivery may choose to induce labor as well. Different doctors have different policies on why or even if they allow elective induced labor. If you believe that you may want to electively induce labor, discuss it with your doctor well in advance.

To induce labor, your doctor will administer oxytocin and/or prostaglandin, which are hormones that stimulate the contractions of labor. If the cervix is ripe, these should jump-start labor reasonably fast. Two non-medicinal interventions to induce labor include artificial rupture of the membranes (AROM) and stripping the membranes. While some women respond quickly, others may take two to three days to get labor going.

As with any medical intervention, there are risks involved with inducing labor. First of all, it simply may not work. Every woman responds differently, and every labor is unpredictable.

Sometimes, an induced labor may end with a cesarean for many different reasons: the baby could not make it through the birth canal, the cervix wasn’t adequately ripened, or the long labor put the baby in distress. There is a slight risk of uterine tear due to abnormal contractions that may result from the use of the artificial hormones. Oxytocin, on rare occasions, can cause low blood pressure and low blood sodium, which can cause seizures.

Another concern is if the expected delivery date (EDD) has been miscalculated. The doctor may believe that the baby is 38 weeks old, which is a safe age for delivery, but in reality, the baby may be a few weeks younger. This is called a late pre-term baby, and complications similar to those associated with a pre-term baby may result. For these reasons, the person making the decision to induce labor must carefully weigh the benefits against the risks.