Natural labor induction

is the artificial starting of labor with the use of pitocin, castor oil, or herbal preparations such as blue or
black cohash. Other methods used to start labor include breaking the amniotic sack (an amniotomy), stripping of the
membranes (separating the membranes of the amniotic sack from the uterine wall), and inserting prostaglandin gel,
or pieces of Misoprostol tablets into the vagina to soften the cervix. The idea is to get labor going artificially, by
starting contractions of the uterus. The most commonly used agent is pitocin, an imitation of the natural hormone,
Oxytocin, which stimulates labor contractions spontaneously. This is administered by an intravenous drip, and the
major side effect is violent and extremely painful contractions of the uterus. Castor Oil is frequently proscribed by
midwives, and causes diarrhea, which can stimulate the body to produce natural oxytocin, and start labor
contractions.

While induction is a common practice in present day childbirth (in the United States) it is a controversial one.
Interference in a natural process such as birth can cause negative side effects, as well as lead to more risky
interventions. It is important that all pregnant women educate themselves on the pros and cons of all interventions
(medical and otherwise) before agreeing to them.

Many labors are induced because women are deemed to be past their due date. The medical community fears
postmaturity syndrome, which means that the baby is past due, the placenta may have started to function less
efficiently, depriving the baby of nutrients, oxygen, and sufficient amniotic fluid. While this is a very serious
condition, it is also rare. In her book Obstetric Myths vs. Research Realities, author Henci Goer discusses research
indicating that postmaturity syndrome may actually be caused by Intrauterine Growth Retardation, a disease of
malnutrition or system failure, rather than being overdue. More research needs to be done to confirm this, but it
brings into question the practice of automatically inducing because a woman is considered overdue.
More recently a trend has emerged to induce women for “big” babies, also known as macrosomia. It is important to
note that methods used to determine a baby’s size can unreliable, measuring up to 2 lbs. off in either direction.
However it is most common to over estimate the size of a baby.

A study done in 1993 by Combs, et al, noted that:

“We conclude that elective induction of labor after sonographic diagnosis of macrosomia increases the cesarean rateand does not prevent shoulder dystocia”. Shoulder Dystocia, when a baby’s shoulders get stuck during birth,ususally resolves easily with the use of the Gaskin Manuver (turning the mom on to her hands and knees), andgentle, gradual mother-initiated pushing. Another study done in 1983 by Boyd, et al, showed that an increase of csections for macrosomia did not improve perinatal out comes, yet this is still done frequently. Both Obsteteric
Myths vs. Research Realities by Henci Goer, and Understanding Diagnostic Testing in the Childbearing Year by
Anne Frye, CNM cite important research on this topic.

Next to the increased risk for cesarean surgery, one of the other most common negative side effects is actually the
possibility that the baby will be premature, and unable to sustain life outside the womb. This means that the baby is
born too early, and may suffer serious health and developmental problems. According to a 1990 study published in
the Journal of Obstetrics and Gynecology, the average length of pregnancy is actually 41 weeks and one day. This
would extend the overdue period to 43 weeks. Additional reasons commonly given for induction include medical
complications such as pre-eclampsia, diabetes, fetal growth restriction (AKA: intrauterine growth retardation),
oligohydramnios (too little amniotic fluid), and blood incompatibility. Sometimes, however, inductions are done
simply for the convenience of the parents, or medical personnel.

Obstetrics Illustrated lists the following complications of  induction of labor: failure to induce effective contractions;
placental separation (abruption); bleeding; prolapse of the cord; infection; pulmonary embolism of amniotic fluid;
poor uterine action; abnormal fetal heart rate patterns; hyperstimulation; rupture of the uterus; water intoxication;
50% increased risk of a cesarean section, and a general trend toward the need for more invasive and risky medical
interventions. This last one is known as the domino theory of obstetrical interventions, in which one intervention
leads to another, and more increasingly invasive, and thus more risky, interventions, and so on, until the woman
ends up with complications that require a cesarean section. It is important that parents also educate themselves
regarding the risks of major surgery, which are numerous, as well as potentially life threatening.

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