How to Avoid an Induction of Labor

pregnant woman in hospital bed

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The induction of labor, or starting labor artificially, is fairly common. Rates of induction have been steadily climbing as more and more social or elective inductions (inductions for non-medical reasons) are done. Social inductions may happen for the convenience of the doctor, midwife, or family; for changing due dates; or for other reasons. But the truth is that induction of labor increases complication rates, including the use of cesarean section. (However, a 2018 study of elective inductions in low-risk women found they resulted in fewer C-sections than spontaneous labor.)

The American College of Obstetricians and Gynecologists (ACOG) lists three primary reasons to induce labor:

  1. Maternal illness (e.g., high blood pressure, gestational diabetes, uterine infection, etc.)
  2. Fetal illness
  3. 42 completed weeks of gestation

In addition to these recommendations, providers might suggest an induction if amniotic fluid levels are low, or if your water has broken without being followed by contractions within 24 hours. The ACOG also says that inductions without medical indication should not happen prior to 39 weeks gestation. There are simply too many risks to the baby prior to that timing.

When medically necessary, induction can be a lifesaving procedure and one that allows for the opportunity to attempt a vaginal birth.

Pregnant women should not feel guilt or shame about needing an induction, but you may still want to avoid an induction when it's not medically necessary. Here's what some real moms have to say about how they did that.

Communicate With Your Doctor

Throughout your pregnancy, it's important to build a relationship with your health care provider. This makes it easier to communicate your feelings about induction and your desired birth plan. When you have a good relationship with a doctor who understands and respects your desires, you will feel more comfortable making tough decisions, like whether to induce. You’ll trust that if your doctor is making that recommendation, they are doing so with yours and your baby's best interests in mind.

"I think having a good relationship with your obstetrician is crucial. With my second child, my OB's partner was on call when my labs came back for preeclampsia. My blood pressure was trending up, and there was protein in my urine. The partner called me and wanted to induce the next morning. I was upset, and I had a long talk with him telling him I wanted a VBAC and inducing would reduce my chances of being successful. He kept insisting, then we argued about the magnesium. I didn't want it, he did. He wanted me to come in at seven the next morning."

"Around 9:00 p.m., I insisted on having intercourse with my husband. Labor started at midnight, and I delivered at 4:00 a.m., vaginally, without magnesium. Later I spoke with my OB, and he said he would not have induced me, nor would he have used magnesium. I am a physician as well so I understand that so much of medicine is an art, and you do things based on your past experiences and overall knowledge and comfort level. Everyone practices differently, so it's important to be on the same page as your provider."
Heide, mother and physician

"I avoided induction by being very well informed and making sure I kept up the lines of communication with my doctor. I had had an induction for medical reasons with my first, and I told my doctor from the outset with my second that I did not want another induction unless it was medically necessary."

"My first induction was from low amniotic fluid in the 39th week. So, this time around, I drank 90 ounces of water a day instead of the 70 I drank with my first. My doctor said that would help make sure fluid levels stayed normal, which they did. Mainly, though, when I went past my due date, I made sure my doctor knew that I still didn't want an induction. He's been known to induce on the due date if the mother so desires, and I wanted to let him know that I did not so desire. He was very supportive, and I finally delivered at 40 weeks and five days."
Amanda, mother of two

Decline Unnecessary Ultrasounds

Sometimes third-trimester ultrasounds are used to estimate a baby's size and potential birth weight. These estimates may then factor into a provider's suggestion to induce labor or even plan a C-section delivery. If a baby seems small, the provider may be concerned about intrauterine growth restriction. If a baby seems large, the issue is the potential for shoulder dystocia during delivery. But since these weight estimates are just that—estimates, which research has shown can vary in accuracy —they could lead to an unneeded induction.

"I think one of the best ways to avoid induction is to avoid unnecessary ultrasounds in the final months. My last pregnancy I had to have an ultrasound two times a week for the last three months. Having small babies as I do, I just knew the doctors would want an induction. They did. I seriously contemplated not showing up for the induction. It's hard not to because you do want to have the baby as soon as possible. Doctors seem to get it into their heads that the (ultrasound) measurements in the last trimester are accurate when they are known to have a variable of one to two pounds."
Dawn, mother of three

Check Caregivers' Induction Rates

As you are meeting potential health care providers, ask questions, including their thoughts on the induction of labor and how common it is among their patients. Look for a provider who has a history of supporting births with fewer interventions, a practice that employs certified nurse-midwives (CNMs), and/or providers with a history of working well with other birth professionals such as doulas.

"I think the first step is choosing a caregiver that has an extremely low induction rate. If it isn't normal for them, they won't consider it normal for you, and the odds of it only being discussed for a sound medical reason are much better."
Diane, mother of two

A Word From Verywell

Being a well-informed advocate for yourself and your baby is important during pregnancy. It is your first taste of what your job as a parent will often include. But as with parenthood, flexibility is also crucial. Be prepared, because your delivery may not unfold exactly as laid out in the birth plan (they rarely do).

7 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Grivell RM, Reilly AJ, Oakey H, Chan A, Dodd JM. Maternal and neonatal outcomes following induction of labor: a cohort studyActa Obstet Gynecol Scand. 2012;91(2):198–203. doi:10.1111/j.1600-0412.2011.01298.x

  2. Grobman WA, Rice MM, Reddy UM, et al. Labor induction versus expectant management in low-risk nulliparous womenN Engl J Med. 2018;379(6):513–523. doi:10.1056/NEJMoa1800566

  3. American College of Obstetricians and Gynecologists. Induction of labor at 39 weeks.

  4. American College of Obstetricians and Gynecologists. Avoidance of nonmedically indicated early-term deliveries and associated neonatal morbidities.

  5. Cosmi E, Fanelli T, Visentin S, Trevisanuto D, Zanardo V. Consequences in infants that were intrauterine growth restrictedJ Pregnancy. 2011;2011:364381. doi:10.1155/2011/364381

  6. Menticoglou S. Shoulder dystocia: incidence, mechanisms, and management strategiesInt J Womens Health. 2018;10:723–732. doi:10.2147/IJWH.S175088

  7. Bajracharya J, Shrestha NS, Karki C. Accuracy of prediction of birth weight by fetal ultrasoundKathmandu Univ Med J (KUMJ). 2012;10(38):74–76.

Additional Reading

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.