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It's been said that induction has reached epidemic proportions in this country, but I dispute that statement. Induction is so common that it is no longer of 'epidemic' proportions; it [...]

A vaginal gel containing prostaglandin E2 may be effective in ripening the cervix in some women with prolonged pregnancies. Cervical ripening is the term used for the softening of the cervix, which must occur if it is to open wide enough to allow the baby to pass through the birth canal. Researchers randomly assigned 90 women past their due date to receive a vaginal gel containing prostaglandin E2 or a placebo at the time they came for fetal heart rate monitoring. Women with a Bishop score between 3 and 6 who received prostaglandin E2 required fewer labor inductions compared to the other groups.

Induction of labor may reduce the number of complications and deaths among newborns with a prolonged gestation, or those who are delivered 14 or more days past their predicted due date. Among 12,930 infants who were delivered at the same hospital between Jul 1980 and Dec 1984, 707 were delivered 14 or more days past their predicted due date. The number of deaths was significantly higher among infants with prolonged gestation than among infants with a normal gestation length. Of the women with prolonged gestation, labor started spontaneously in 62% and was induced in 38%. None of the infants for whom labor was induced died, compared with approximately 2% of those for whom labor started spontaneously. One of the complications that can occur in infants with prolonged gestation is passage and inhalation of meconium, a green mucilaginous material in the intestines of a full-term fetus.

Prolonged pregnancy (a pregnancy that continues several days past the due date) is often treated by routine induction of labor after 10 days or more, but recent evidence suggests that the decision to induce may be influenced by somewhat arbitrary criteria. Many women want to avoid obstetrical intervention whenever possible. To learn more about women's attitudes regarding prolonging their pregnancies with conservative medical management, a study was carried out with 500 women. The subjects were 37 weeks pregnant when the study began. They received written information informing them of the prenatal clinic's new policy, which was to offer them the option of continuing their pregnancy under careful supervision after the 42nd week of gestation. Each woman completed a questionnaire indicating her preference for induction of labor or conservative management. During week 37, 226 (45 percent) agreed to conservative management. By 41 weeks' gestation, 122 women (24.4 percent) had not delivered. Thirty-eight of these (30 percent) wanted conservative management, a significant shift when compared with attitudes expressed earlier in pregnancy. All changes in desired care were away from conservative management; no subjects changed to this position. Reasons (at 37 weeks' gestation) for not wanting conservative management included: inability to stand the thought of being pregnant for more than 42 weeks (34 percent); perception of no benefit to waiting (21 percent); concern regarding fetal size (20 percent); and no family member available after 42 weeks' gestation (20 percent). The subjects' opposition to conservative management is discussed; such a position is of particular concern when the fetus's gestational age is unknown. It is recommended that the concept of 'expected due date' be abandoned, since women often become alarmed if the baby has not arrived by that date. It is concluded that pregnant women, as well as the medical profession, are inclined to chose induction of labor for prolonged pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Homeopathic induction is one of the most challenging and important aspects of my job as a homeopath. I sit with the mother and baby and talk to them about their [...]

Balancing the risks of prolonged gestation against those of induced labour is difficult. Risks to the fetus increase slightly after 42 weeks' gestation but women having labour induced are more [...]