There are many possible reasons for a woman to be induced. In fact, in our current birth culture, the list is long. What situations are genuine medical indications for induction of labor? Induction most definitely saves lives and here are some sterling examples:
Pre-eclampsia: Pre-e is a life-threatening condition that develops after the 20th week of pregnancy in some women (rarely it can present up to 6wks post-partum). The disease is characterized by swelling in the hands and face, sudden weight-gain, blurry or spotty vision, terrible headaches, protein in the urine and in particularly bad cases, pain around the liver area (usually associated with HELLP). If left untreated the mother will develop Eclampsia. The only treatment for this disease is the prompt delivery of the baby.
HELLP: HELLP stands for the abbreviation of the main findings of the disease- Hemolytic anemia, Elevated Liver enzymes and Low Platelet count. According to research, this appears to be considered a variant of Pre-eclampsia; however, it was determined to be a distinct clinical entity (as opposed to just severe pre-e) in 1982. Symptoms include a marked increase and severity in headaches, as well as vomiting, “band-pain” around the upper abdomen, and arterial hypertension (though it may be mild). If seizures or coma is present, it has already progressed into full-blown Eclampsia. Around 8% of the cases of this disease don’t appear until after the pregnancy. In most cases, delivering the baby will cure the condition and, in fact, it’s the only cure for the disease that is known.
Pre-eclampsia and HELLP are referred to together as Hypertensive Disorder of Pregnancy and Toxemia of Pregnancy
Eclampsia: This is what happens when the above two diseases are not treated. It is marked by the above mentioned symptoms along with seizures or coma. Renal failure is possible, as well as pulmonary edema, liver failure and oliguria (lack of urine). Eclampsia is deadly, and the only cure is delivery of the placenta but obviously, in order for that to be possible, the baby must be born, as well.
Intra-Uterine Growth Retardation: This complication is usually referred to as IUGR. Sometimes, for various reasons, the baby isn’t growing well or thriving in the womb and when this occurs, the baby may have a better chance of survival if delivered early.
Cholestasis of Pregnancy: This disease involves decreased liver function caused by the slow-down or cessation of the flow of bile from the gall-bladder to the liver. Characteristics of this disease are itching on the palms of the hands and feet (often the only symptom for many women), dark-colored urine, light coloring of bowel movements, fatigue or exhaustion, lack of appetite and depression. Severe and less common symptoms are jaundice, upper-right quadrant pain and nausea. Cholestasis of Pregnancy affects 1 or 2 women out of every thousand. So while it’s not terribly rare, it’s not terribly common, either. This disease can have negative consequences for both mother and baby, and as such, the pair must be monitored closely. The baby depends upon it’s mother’s liver to cleanse out the impurities of its blood. Therefore, her body not being able to do so can cause stress for the baby. Cholestasis may increase the risk of fetal distress, preterm birth or stillbirth. Once again, the only cure for this disease is delivery of the baby. Induction isn’t always indicated and depends upon the severity of disease and how it is affecting mom’s liver.
Various Pre-existing conditions in the mother: These may include certain cancers, heart conditions and other unique issues that make a controlled, induced delivery necessary. These conditions can range widely, from severe illness (such as pneumonia) to congenital heart problems. The difficulty can be that the pregnancy puts an extra stress on the body, complicating the pre-existing condition or, conversely, the pre-existing condition is complicating the pregnancy. Induction considerations for these conditions are made on a case by case basis.