- Induction: Offer is
tempting [q&a] - Bishop's score:
Induction by the... [article] - Laminaria for labor
induction? [q&a] - Stripping
membranes: Can it... [q&a] - Oxytocin... [q&a]
The theory goes that inducing labor will prevent:
- Cesareans, due to the baby growing too large to fit through the pelvis.
- Shoulder dystocia, a situation where the head is born, but the shoulders hang up behind the pubic bone.
- Birth injuries, namely, broken collar bone, or injury to a complex of nerves controlling the shoulder and arm (brachial plexus injury). Birth injuries often, though not necessarily, occur in conjunction with shoulder dystocia.
However, studies consistently show that inducing labor for suspected big baby accomplishes none of the above (2-3,5,7,9-10,15-16). These studies include two trials, randomly assigning women thought to have big babies either to induction or to await spontaneous labor (7,15). Random assignment trials produce the strongest evidence because they eliminate bias by ensuring that the two groups are truly similar.
Why doesn’t inducing labor help?
Whether a woman carrying a big baby has a cesarean depends largely on her caregiver’s management, not her pelvis. In proof of this, the cesarean rate for babies weighing 4,000 grams or more was three percent in 1958 in Great Britain (4). These days, U.S. obstetricians may perform cesareans on as many as half of women with babies of this size (11,16).