Labor induction is a medical procedure that artificially initiates labor before it begins spontaneously. It involves methods to stimulate uterine contractions and prepare the cervix for childbirth. While pregnancy typically lasts around 40 weeks, 38 weeks is classified as “early term.” This means a baby born at this stage is not considered preterm, but the final weeks are still important for development.
Medical Indications for Induction
A healthcare provider may recommend labor induction at 38 weeks if continuing the pregnancy poses health risks to the mother or baby. Common medical reasons include preeclampsia, a condition with high blood pressure and organ damage, and gestational hypertension, which is high blood pressure developing during pregnancy. For individuals with gestational diabetes, especially if poorly controlled, induction may reduce complications for both mother and baby. Fetal growth concerns, such as intrauterine growth restriction where the baby is not growing as expected, can also lead to induction. Other maternal health issues, like certain kidney diseases or heart conditions, might make continued pregnancy riskier than an induced delivery.
Elective Induction: When It’s Not Medically Necessary
Elective induction initiates labor without a specific medical indication, often for convenience or other non-medical reasons. It is generally not recommended before 39 weeks of gestation without a medical basis. The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) emphasize that babies born before 39 weeks may face increased risks, such as difficulties with breathing, feeding, and temperature regulation.
Before agreeing to an elective induction, healthcare providers consider the readiness of the cervix, assessed using a Bishop score. This scoring system evaluates cervical parameters including dilation, effacement (thinning), consistency, position, and the baby’s station in the pelvis. A higher Bishop score, typically 8 or above, suggests a more favorable cervix and a greater likelihood of a successful vaginal delivery with induction, comparable to spontaneous labor. Conversely, a score of 5 or less indicates an unfavorable cervix, often necessitating cervical ripening methods before induction.
The Induction Process Explained
The process of labor induction often begins with cervical ripening methods, which prepare the cervix for dilation. One common approach uses prostaglandins, synthetic hormones administered vaginally as gels or inserts, or sometimes orally. These substances help soften and thin the cervix, mimicking the body’s natural processes. Mechanical methods are also used, such as inserting a Foley catheter. This involves placing a thin tube with a balloon into the cervix, inflated with saline to exert gentle pressure and encourage dilation.
Once the cervix is ripened, or if already favorable, methods to stimulate uterine contractions are employed. The most common medication is oxytocin, a synthetic version of a natural labor hormone. Oxytocin is typically administered intravenously, with the dosage gradually increased to achieve regular and effective contractions. Another method is artificial rupture of membranes (AROM), also known as “breaking the water.” This procedure uses a sterile hook to open the amniotic sac, which can release prostaglandins and intensify contractions. AROM is typically performed when the cervix is partially dilated and the baby’s head is engaged.
Factors to Discuss with Your Healthcare Provider
Detailed discussions with your healthcare provider are important when considering labor induction at 38 weeks. Understand your individual health profile and how it relates to the recommendation for or against induction. Inquire about the specific reasons for induction, whether medical or elective, and discuss expected outcomes. This includes understanding the likelihood of a vaginal birth versus a C-section, and potential timelines for the induction process.
Discuss the various induction methods, their sequence, and potential side effects. Understanding what to expect during and after the process, such as monitoring requirements and pain management options, can help in preparation. Shared decision-making ensures all your questions are answered and you feel informed about the plan, allowing for a personalized approach to your labor and delivery.