Inducing Labor

What if women could schedule childbirth just as they'd schedule a root canal? In fact, more and more pregnant women in the U.S. are opting for induced labor — and not necessarily for medical reasons.

In the last decade, the number of labor inductions has doubled — from 9 percent of live births in 1989 to 18 percent in 1997 (the latest year for which statistics are available), according to the American College of Obstetricians and Gynecologists (ACOG). No one knows how much of the rise is due to elective inductions versus those that are medically indicated. But it's unlikely that the reason for the increase is strictly medical.

There are a variety of medical reasons for which women are typically induced. Being overdue, carrying a large baby, pregnancy-induced hypertension, and preeclampsia are but a few reasons. But lately more women and their doctors have imposed some predictability on Mother Nature by hastening delivery for nonmedical reasons, such as wanting to schedule a maternity leave or coordinating care for older children. And this trend is sparking its share of controversy.

Inducing Labor: A Matter of Convenience?

Anecdotally, many experts say the reason for the upswing in inductions is that women are demanding them. ACOG recognizes some nonmedical reasons as legitimate, such as a history of quick labor combined with a long distance to travel to the hospital. However, this is open to interpretation, as there are no specifics on what is too far or too fast.

Some women ask to be induced for reasons that have little to do with safety or health. Some want to schedule their baby's birth for personal convenience, because they are uncomfortable in late-stage pregnancy, or to accommodate a work schedule.

Some doctors give in to nonmedical patient requests for induction. One reason for giving in, according to Valerie Schulz, MD, an ob-gyn at Long Island Jewish Medical Center in New Hyde Park, New York, is that managed care has forced practices to become bigger. "There used to be many more solo practitioners, where it was very likely that a patient's own doctor was going to deliver," she says. "Now, in order to deliver their own patients, doctors might induce on a night they're on call."