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Pregnancy Bliss | Reproductive Health Hub


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Is breech presentation an indication for labour induction?
No; at least not in its unchanged form.
A breech presentation may be converted into a head-down presentation. Once this is achieved, some will consider inducing labour to prevent the fetus flipping back to breech, which is always a possibility, albeit a slim one. The manouvre is called external cephalic version (ECV).  Current practise is that, if a breech presentation cannot be successfully turned into head first, a caesarean section will be the advised mode of delivery


Does previous obstetric history have any bearing on deciding to induce labour?
It could. In tragic cases of previous unexplained stillbirth late in pregnancy, it may be decided to induce labour, probably at thirty-seven to thirty-eight weeks, when the chances of success are good and the baby is mature enough not to need any special care after birth.


Talking of chances of success, does it mean induction of labour can fail?
Yes. This happens occasionally. A rough guide to the chances of success is the gestational age. The more advanced the pregnancy, the better the chances of success. This, however, is not a black-and-white situation. Labour induction at 42 weeks of gestation has been known to fail.


What are the maternal indications for inducing labour?
If the mother has a medical condition that is deteriorating because of pregnancy or which needs treatment urgently but only after the end of pregnancy, labour may be induced. Such conditions include pre-eclampsia, kidney failure and cancer. Sometimes induction may be requested or offered because of maternal distress as a result of pain from pregnancy conditions such as symphysis pubis dysfunction or even severe debilitating back pain (discussed below).


Is pain an indication for induction of labour?
It can be. Of course, pain is subjective and it is difficult for the doctor to objectively judge what pain justifies intervention to bring the pregnancy to a premature conclusion. It is true, however, that sometimes pregnancy is associated with severe debilitating pain, usually in the pelvic region. This may justify induction of labour as a rescue measure.


Are there any indications  for labour induction that are neither fetal nor maternal?
Yes. In the tragic event of fetal demise late in pregnancy, labour will be induced.
Induction of labour may also be advised in a case where a lethal fetal condition has been diagnosed late in pregnancy. Such conditions that are incompatible with life outside the womb include anencephaly (where there is no brain), chromosomal disorders (e.g. Edward's Syndrome) and the absence of kidneys.

Most of these are diagnosed early in the second trimester and termination of pregnancy is offered. However, a few do inadvertently escape detection till late in pregnancy, where induction of labour will be offered.


People talk of "social indications" for induction of labour. What are these?
This term simply refers to a situation where induction is carried out in the absence of any obstetric or medical indication. In other words, it is labour induction requested by the parents for their convenience.

The most common social reasons include to allow a partner or another family member to be present at the birth, to avoid certain dates and occasionally to allow the baby's arrival before Christmas or the New Year!