What are my options if I don't want to have my labor induced?
Assuming you don’t have any medical reasons for inducing labor, you can wait for labor to begin on its own. In that case, going into labor on your own is generally safer than having labor induced or having a C-section.
If you decide to wait for labor to begin on its own, it’s important to understand that things can come up that could lead to labor induction or even a planned cesarean before labors starts. In every case that is not an emergency, it would be wise to understand the situation, your options, their pros and cons and whether there is truly clear evidence that intervening is the best approach.
To watch for problems that may develop at the end of pregnancy, your care providers may recommend more frequent prenatal visits, tests to check on the wellbeing of your baby or both. Sometimes they can find complications early enough to deliver the baby safely before the situation worsens.
Unfortunately none of the testing methods are perfect and “false positive" results (when the test indicates a problem that doesn't really exist) are common. These may lead to unnecessary inductions or C-sections. Research has not proven whether or when these tests lead to better health outcomes.
The tests that are used to monitor fetal wellbeing at the end of pregnancy include:
- A fetal nonstress test involves monitoring the fetal heart rate for 20 minutes or longer to see if the heart rate goes up (a good sign) or down (a sign that the baby may be in danger). Trustworthy research has not clarified whether use of electronic fetal monitoring for a brief period in pregnancy improves pregnancy outcomes.Grivell, R.M., Alfirevic, Z., Gyte, G.M.L., & Devane, D. (2015). Antenatal cardiotocography for fetal assessment. Cochrane Database of Systematic Reviews, 9.
- A biophysical profile uses an ultrasound to measure fetal movements, breathing and muscle tone and estimates the amount of amniotic fluid. Use of this test is associated with increased labor induction and cesarean birth, but we lack information to know about possible benefits for high-risk pregnancies.Lalor, J.G., Fawole, B., Alfirevic, Z., & Devane, D. (2008). Biophysical profile for fetal assessment in high risk pregnancies. Cochrane Database of Systematic Reviews, 1.
- Counting how often the fetus moves, either throughout the day or during a certain time frame (like a few hours after eating) can help show if the baby is getting enough oxygen. Decreased fetal movement may be a sign that the baby needs to be delivered. However, trustworthy research has not clarified whether fetal movement counting improves pregnancy outcomes.Mangesi, L., Hofmeyr, G.J., Smith, V., & Smyth, R.M.D. (2015). Fetal movement counting for assessment of fetal wellbeing.Cochrane Database of Systematic Reviews, 10.
In a few cases, the best alternative to induction of labor is to schedule a cesarean section. Your care provider may recommend a C-section if there are severe complications that make labor unsafe for you or your baby.