Why labor inductions fail

Nulliparous women who had a term singleton gestation in the cephalic presentation were eligible for this analysis if they underwent a labor induction. Consistent with prior studies, the latent phase was determined to begin once cervical ripening had ended, oxytocin was initiated, and rupture of membranes had occurred, and was determined to end once 5-cm dilation was achieved.

The frequencies of cesarean delivery, as well as of adverse maternal eg, postpartum hemorrhage, chorioamnionitis and perinatal eg, a composite frequency of seizures, sepsis, bone or nerve injury, encephalopathy, or death outcomes, were compared as a function of the duration of the latent phase analyzed with time both as a continuous measure and categorized in 3-hour increments.

Results: A total of 10, women were available for analysis. In the vast majority Conversely, the frequencies of most adverse perinatal outcomes were statistically stable over time. Conclusion: The large majority of women undergoing labor induction will have entered the active phase by 15 hours after oxytocin has started and rupture of membranes has occurred. Maternal adverse outcomes become statistically more frequent with greater time in the latent phase, although the absolute increase in frequency is relatively small.

These data suggest that cesarean delivery should not be undertaken during the latent phase prior to at least 15 hours after oxytocin and rupture of membranes have occurred. These include a late term pregnancy, an infection, abnormal fetal growth, placental abruption, and others. Sometimes doctors and expecting mothers may decide to induce labor when it is not medically necessary. Labor may be induced if an expecting mother does not live near enough to a hospital to safely commute there once labor begins naturally, or if a woman has a history of rapid deliveries, as a way to avoid the dangers of an unattended delivery.

Some women may request labor induction as a matter of convenience so that they can choose exactly when and where to give birth.

There are some risks to labor induction, however, and some women who choose to have the procedure done for reasons of convenience may not be making a wise decision.

Risks related to the procedure include premature birth, having a baby with a dangerously low heart rate, infection, umbilical cord problems, and excessive bleeding. For some women, an induced labor may increase the chance that a C-section will need to be performed.

Doctors and medical providers have a legal obligation to obtain informed consent from a patient before performing a medical procedure, including a labor induction. Informed consent requires that a patient has a clear understanding of the risks and benefits of a procedure, and makes a decision to undergo the procedure while they have adequate reasoning faculties. If an expecting mother decided to have a labor induction and was not advised by her doctor of the risks of the procedure, she likely did not give her informed consent.

Medical providers can be held legally accountable for damages if they fail to obtain informed consent from a patient before performing a procedure. If a patient does not give informed consent for a procedure, and she or her child are injured or die as a result, the medical providers may be liable for medical malpractice, and the victim could seek compensation through a Maryland birth injury lawsuit. A recently published news article discusses a study performed on pregnant women in the UK that found that inducing labor in the subjects did not increase the chances that a C-section would become necessary.

These findings challenge previous studies that came to the opposite conclusion, finding that inducing labor increased the likelihood that a C-section would become necessary.