Elective Induction of Labor

Elective Induction of Labor

28 November 2022

University of Mary
Elective Induction of Labor

Labor is the beautiful process of a mother bringing life into the world. This process has a

numerous number of hormones that are involved. Sometimes the process needs a little help,

elective or medically indicated. An induction can only be done if the woman fully understands

the whole process with the benefits and risks that are involved. It is the nurse’s role to make

sure that the mother’s voice is heard, and you support the decision she makes. The elective

induction of labor is relevant to the healthcare process due to reducing several risks, including

risks of having a stillbirth, having a large baby (macrosomia) and developing high blood pressure

as the pregnancy advance (Mayo Foundation for Medical Education and Research, 2022).

The topic of ‘Elective Labor Induction’ topic was chosen due to the controversy that I

have heard between healthcare providers. The Association of Women’s Health, Obstetric and

Neonatal Nurses (AWHONN) has made a statement that they are against an elective induction

until the 39th week or beyond. There are many ways to elect an induction and there are also

many ways where the induction is needed due to the health of the mom and the baby. Since

1990 the rate of elective and medical indicated inductions has nearly doubled (Association of

Women’s Health, Obstetric and Neonatal Nurses, 2019). The process to decide to do an

elective induction is a conversation between the mother of the child and the provider. The

providers opinion weighs on mothers quite a bit, and with the pressure provided by the

provider to schedule the birth, most women elect to then do it.

The nursing role during the pregnancy and labor process is to be an advocate for the

patient and the baby, as well as to make sure that safety is a huge priority during care. To have

a safe induction requires an adequate number of staff on the unit. If a patient receives oxytocin

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to help facilitate labor, then there should be a one-to-one nurse to patient ratio. The nurse

needs to perform maternal-fetal assessments every 15 minutes during the first stage of labor

and then every 5 minutes once the second stage starts. If an elective induction is done then

labor length is usually longer than a labor that started with a spontaneous rupture of

membranes (Association of Women’s Health, Obstetric and Neonatal Nurses, 2019). In

conclusion, the AWHONN is against an elective induction unless the pregnancy is at the 39 th

week or beyond.

There are only a number of outcomes on how you can have an elective induction. These

include: you are at least 38 weeks along in your pregnancy, you are having only one baby, you

have not had a previous C-section or other major surgery on your uterus, your cervix is soft and

ready to open, your placenta is not blocking your cervix, your baby is lying in the correct

position (head down), and not sideways or breech (with their bottom coming first) (Stryker

CNM, 2022). Once confirmed, we can determine that this would reduce health problems if

elective induction is decided upon. If you meet any of these qualifications you might consider

an induction due to you live far from a hospital/birthing center, you’re approaching or you are

past your due date, and you have a history of a fast birth.

There are many risks due to an induction as well. Some of these risks include a failed

induction, low fetal heart rate, infection, uterine rupture, and bleeding after delivery (Mayo

Foundation for Medical Education and Research, 2022). A failed induction is classified as a

delivery that did not happen within 24 hours. In this case, a Cesarean section would be

considered. A low fetal heart rate might be due to the medications given during an induction.

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Oxytocin would be an example. Rupturing the membranes increases the risk for infection. The

uterine rupture is a rare complication of an induction but if it happened a cesarean section

would happen due to life-threatening complications. Bleeding after delivery is a complication

due to the muscles not completely contracting after giving birth (uterine atony).

Other risks due to having an elective induction before the 39th week of pregnancy, your

baby is 2 to 3 times more likely to be admitted to the NICU unit. This means that a harder

transition for you and the baby in this new way of life. Due to being admitted to the NICU, the

baby might have to be put on a ventilator to help the baby breathe, as well as not being able to

keep his/her body temperature up. This would require the baby to have more time in the

warmer and not with the parents. (Intermountain Healthcare, 2022)

An induction of labor is a serious choice to make for you and your baby. It is a decision

to not make lightly. You need to know all the risks, benefits, and the whole procedure before a

final choice is made. If an induction of labor is the choice you are going to make for yourself,

family, and for your baby. It is not just a choice for yourself. If an induction is what is advised

to you by your provider, make sure you get all the information from your doctor and the

pamphlets from your nurse to understand what is being proposed to you. Even though the

doctor is proposing this option, it might not be the best option for you. Do not let the doctor

“bully” you into this choice due to the easy scheduling of a birth, that baby will come when it is

ready to come. If an induction is the right thing for you, then make sure you have all the risks

understood by yourself from the provider. Every step should be clear to you, and you should

have no questions due to the induction. So, ask yourself. Is an induction right for you?

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References

Association of Women’s Health, Obstetric and Neonatal Nurses. (2019). Elective induction of

labor. Retrieved from https://www.jognn.org/action/showPdf?pii=S0884-

2175%2819%2930005-X

Intermountain Healthcare. (2022). Elective induction. Retrieved from Intermountain Healthcare:

Women and Newborn: https://intermountainhealthcare.org/services/women-

newborn/treatments/elective-induction/

Mayo Foundation for Medical Education and Research. (2022, May 04). Inducing labor: When to

wait, when to induce. Retrieved from Labor and delivery, postpartum care:

https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/inducing-

labor/art-20047557#:~:text=Research%20indicates%20that%20inducing%20labor,at

%2039%20to%2040%20weeks.

Stryker CNM, A. (2022, April 15). 3 reasons you might consider an elective induction. Retrieved

from UNM Health: Women's Health: https://unmhealth.org/stories/2022/04/3-reasons-

might-consider-elective-induction.html