It is well established that labor has to be induced in approximately 20 % of pregnancies [1]. However, induction fails in 20 % of induced pregnancies [2].
Result. Premature rupture of membrane was the most common cause of labor induction and the commonly used method of labor induction were oxytocin infusion. Cesarean section was done for 28.1% of induced women. Failed induction of labor was found to be 21%.
The vaginal delivery rate was 57% (n=89) and the rate of cesarean delivery after induction was 43% (n=66). According to gestational age, labor induction was successful in 16.7%, 50.0%, and 62.8% of patients at 24 to 31, 32 to 33, and 34 to 36 weeks, showing a stepwise increase (P=0.006).
There are some increased risks if you have an induced labour. These include that: it will not work — in about 1 of 4 cases, women go on to have a caesarean.
Labor induction carries various risks, including: Failed induction. An induction might be considered failed if the methods used don't result in a vaginal delivery after 24 or more hours. In such cases, a C-section might be necessary.
The risk of a failed induction and the subsequent risk of c-section are for the most part tied to the degree to which the patient's cervix is ready for labor, or “Ripe” as it is sometimes said. That is, when the cervix is “Ripe,” induction of labor is much more likely to be successful.
Here's what they found: About 17 percent of women who had labor induced ending up having a C-section delivery, while 20 percent of women in the wait-and-see group ended up delivering via C-section.
If induction of labour does not work
Your obstetrician and midwife will assess your condition and your baby's wellbeing, and you may be offered another induction or a caesarean section. Your midwife and doctor will discuss all your options with you.
Sometimes labor induction doesn't work. If you and your pregnancy are doing well and the amniotic sac has not ruptured, you may be given the option to go home. You can schedule another appointment to try induction again. If your labor starts, you should go back to the hospital.
Your provider may recommend inducing labor if your health or your baby's health is at risk or if you're 2 weeks or more past your due date. For some women, inducing labor is the best way to keep mom and baby healthy. Inducing labor should be for medical reasons only.
What are the risks of labor induction? With some induction methods, the uterus can be overstimulated, causing it to contract too often. Too many contractions may lead to changes in the fetal heart rate. Other risks of cervical ripening and labor induction can include infection in the woman or her fetus.
The likelihood of induction of labor varies widely by gestational age, with U.S. births at 41+ weeks for first-time mothers much more likely to involve an induction (45%) than those at 39 weeks (30%) [3].
In 2021, 44% of selected women giving birth for the first time had an induced labour. The proportion of selected women giving birth for the first time who had induced labour: increased from 26% in 2004 to 44% in 2021, with most of the increase occurring over the last decade.
Parity, pre-labor rupture of membrane, pre-induction bishop score, and age of the mother were factors that were identified to be associated with failed induction of labor [7, 11, 13, 15–19]. Failed induction usually results in a cesarean section, which is a more potential health risk to the woman and the baby [3].
The medications used to induce labor — oxytocin or a prostaglandin — might cause abnormal or excessive contractions, which can lessen the baby's oxygen supply and lower the baby's heart rate.
Risks of Induction
The cervix often needs to be softened before pitocin (synthetic oxytocin) will be effective. Pitocin causes contractions that both peak and become stronger more quickly than naturally occurring contractions. The result is a labor that is more difficult to manage.
Once Pitocin is started, you will need to remain in bed for monitoring of the baby's heart rate and contractions. Although early contractions caused by any induction medications may be uncomfortable, true labor begins when your cervix begins to change. The induction may take several days to be effective.
Typically, a normally progressing labor for a first time parent from the very first sign of labor through birth of a baby can take between 24 to 36 hours. Typically, we expect an induction to last close to 36 hours.
How Long Will My Induction Take? It can take up to two or three days to induce labor, but it usually takes less time. It may take more time if you're being induced before you're full-term or if it's your first baby.
If the cervix is closed it needs to be ripened before labour can be induced. This is done with drugs known as prostaglandins. These act like the natural hormones to stimulate contractions of the womb which soften, shorten (ripen) and open the cervix.
Stress and muscle tension and can delay labor by making it harder for the cervix to dilate. These issues can also keep the baby from descending. Many women benefit from practicing breathing exercises or meditation before and during labor. Even dimming the lights can help.
If your body still doesn't go into labor after induction, there are two options, says Dr. McKenna. “One is to do a cesarean delivery. Two is to delay the induction.
These studies typically show the caesarean rate to be twice as high when labour is induced. Part of the problem may be that if an induction is done when a mother is not ready to go into labour the process is more likely to fail or cause the baby to become distressed. These factors would make a caesarean more likely.
If this is not your first rodeo, your induction will probably go much more quickly than if you were a first-time parent, says Kate Killoran, M.D., an OB-GYN with Your Doctors Online. "Your body seems to know what to do the second time. Often, your cervix is more dilated and effaced the second time.