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    Learning About Your Health

    Labor Induction

    What is Labor Induction?

    Labor induction is labor that is started with medicines which begin the process of childbirth. Often, an induction of labor is done because of pregnancy complications, like an overdue pregnancy (1-2 weeks past the due date). Labor induction may also be needed if there is a concern for your health or the health of your baby.

    You and your doctor may choose labor induction after deciding that it is best not to wait any longer. Be sure to discuss the risks, benefits and alternatives of this procedure with your doctor.

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    When is Labor Induction Recommended?

    The following are some examples for recommending induction of labor:

    1. Pregnancy that has continued at least 1-2 weeks past the due date

    2. High blood pressure or preeclampsia

    3. Breaking the bag of water (rupture of membranes) without labor

    4. Infection

    5. Diabetes in pregnancy

    6. Baby's abnormal heart rate pattern

    7. Chronic medical conditions of the mother or baby

    8. Stillbirth
    Please note that there may be complications if inductions are put-off when a medical condition exists. It is important to discuss the risks and benefits of labor induction with your doctor or midwife, and any other possible options.

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    Before You Come to the Hospital

    • Your doctor (or the doctor's office) will arrange the date and time of your labor induction.

    • It is important to call the OB Reception Center at (415) 600-2100 one hour before your scheduled induction to confirm your appointment. Depending on your condition, the doctor may request you go on a "wait list" for the induction.

    • To speed up the admission process, please send your hospital pre-admission forms before you come to the hospital.

    • Bring your "hospital suitcase," as well as the book, A Guide to Your Pregnancy and Newborn, to the hospital with you.

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    When You Arrive at the Hospital

    Check in for labor and delivery at the OB Reception Center, located at 3700 California Street. You may drive down the driveway off Cherry Street and enter through the back of the hospital on the lobby level.

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    What to Expect at California Pacific Medical Center

    The Labor and Delivery department is committed to maintaining a safe and comfortable environment for all of our patients. Please understand that all women coming to our birth center are admitted according to medical need and medical priority.

    In some cases, and after consulting with your doctor, we may need to change the time of your induction or we may need to re-schedule your induction for another day.

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    What Can I Expect During a Labor Induction?

    • You will have an IV placed in your hand or arm before the start of the induction of labor.

    • Depending on your medical and pregnancy history, labor may be induced using medicine inserted into your vagina. This is necessary when the cervix is not yet "ripe" or soft and ready for contractions. This medicine may be started in the evening and continue through the night.

    • When your cervix is ripe, another medicine (oxytocin/Pitocin®) will be started through your IV; the "Pit" will be gradually increased until you are having good, strong contractions which are 3-4 minutes apart, lasting 40-60 seconds.

    • The goal of a labor induction is to match the pattern of natural labor as much as possible, although the latent (early) phase of labor may be much shorter.

    • It is important to remember that labor contractions are painful, whether they are natural or induced. We want to help you cope with these contractions so please let us know how you would like to manage this pain during labor and delivery. It is still possible to have a "natural childbirth" (without pain medicine) even with induction of labor. Please refer to the handout "Pain Options in the Hospital" to help guide your decisions.

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    Facts About Labor Induction

    Some inductions are recommended by your doctor for medical reasons and some are "elective." An "elective" induction is one in which the doctor and the patient choose to start labor. It is important to understand the risks, benefits and alternatives of any "elective" procedure before you decide to choose this option.

    What Do I Need to Know About Labor Induction if This is My First Birth Experience?

    Your first labor and delivery is very different from your second or later births. First labors are longer and more challenging than second labors. Labor complications, such as cesarean birth, are more likely to occur with first births.

    The same is true for first births that are labor inductions. If this is your first birth and you are having a labor induction, your risks are typically greater. Medical studies have found differences in first birth induction risks as compared to second or later births.(Mercer)

    As compared to mothers who begin labor naturally, labor induction risks include:

    • A doubling (or more) in the cesarean birth rate.

    • If the cervix (opening of the uterus) is not "ripe" (unfavorable for labor), the chance for cesarean birth may be even higher.

    • A longer labor and an increase in the use of vacuum or forceps for delivery.
    Note: these findings are true whether the induction was done by choice ("elective" induction) or if the induction is done for medical reasons recommended by your doctor.

    What if This is My Second Labor and I Have an Induction?

    Induction in a second (or later) labor and birth: If a woman has had a successful vaginal delivery in the past, labor induction can often be safely considered.

    There do not appear to be higher rates of complications to the mother or baby from labor induction in the following cases:

    • If a woman has given birth to a baby vaginally,

    • and if her cervix is already beginning to shorten and open ("ripen"),

    • and she is at or beyond 39 weeks of pregnancy (so there are no concerns about the baby's maturity).

    References: Mercer, Brian, M.D. Induction of Labor in the Nulliparous Gravida With an Unfavorable Cervix. American College of Obstetricians and Gynecologists. April 2005. pp 688 – 689. Vol 105, No.4.

    Produced by the Center for Patient and Community Education in association with the Women and Children’s Center at California Pacific Medical Center. Date: 3/06

    Funded by: A generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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