Fetal Surveillance vs. Labor Induction

Post and Preterm Dangers

Today's due date predictions are much more accurate than in decades past. Physicians are very careful, however, to monitor the condition of the mother and the fetus throughout the pregnancy for healthy development and any possible problems. Both premature and postterm infants can encounter serious dangers, so striving for the proper delivery window is important.

If babies are premature through natural or medically assisted birth (such as when emergencies arise and the baby must be delivered immediately), they face the potential for various health issues, mainly determined by the number of weeks of gestation prior to the point of deliver. Dangers include underdeveloped lungs, organs, and immune systems, and very low birth weight.

Due to these serious risks, doctors are very careful of proposing labor induction until they are certain the fetus is adequately developed. There are also dangers associated with postterm pregnancies, including higher meconium aspiration (baby's first bowel movement taints the amniotic fluid), fetal distress, and newborn complications such as seizures. Since approximately ten percent of women deal with pregnancies that last beyond their expected due date, it is common for physicians to prepare for the possibility of prolonged pregnancy.

The Decision for Fetal Surveillance vs. Labor Induction

Labor induction is typically not discussed until a woman is significantly past her expected due date - typically one to three weeks postterm. At this point, if there are few imminent signs of labor beginning naturally, the physician will discuss a decision for fetal surveillance vs. labor induction with the mother.

About Fetal Surveillance

The decision for postponing induced labor might be made if the woman feels uncomfortable with induction and there is no immediate threat to the baby, if the physician is concerned about the infant's development, or if there is any evidence labor may begin naturally and both physician and mother feel comfortable with that course of action.

Fetal surveillance means that the fetus will be monitored using various types of medical procedures to check for full development and signal any warning signs of distress or problems. Fetal surveillance may be performed as specified by your physician, which might be once to twice per week or more until delivery. Monitoring may include:

• Assessing Fetal Movement ('kick counts')
• Nonstress Test (measures contractions and fetal heart rate)
• Ultrasounds to measure fetal breathing, movement, level of amniotic fluid
• Other tests as determined by your physician

Fetal surveillance is also common throughout the pregnancy for high-risk pregnancies or when the mother has or is at risk for certain medical conditions.

Labor Induction

If you've gone past your due date, your doctor may believe inducing labor to be the best option if the baby is fully developed and will be able to thrive. Physicians may be particularly concerned and suggest induction if the mother has diabetes, high blood pressure, or a serious infection.

Although some women attempt to induce labor naturally, it has been difficult to establish from a medical standpoint which, if any, natural methods of labor induction are accurate. Labor induced medically may be done by:

• Stripping the membranes
• Amnioty, or breaking your 'water'
• Prostaglandins (synthetic hormones are applied to cause the cervix to open)
• Pitocin (a synthetic hormone designed to bring on contractions)

Risks associated with induction include possibly stronger contractions (with pitocin), increased need for fetal monitoring, and perhaps increased risk of caesarean delivery. These factors may be overshadowed by the need to avoid more dangerous complications for mother and child. If there are dangers for the mother or fetus to continue the pregnancy at this point postterm, your physician may recommend this course of action.

Deciding between the risks and benefits of fetal surveillance vs. induction may seem overwhelming, but don't be afraid to talk to your doctor or practitioner about what is right for your situation. After all, no matter how it's reached, the ultimate goal of you, your family, and your health care team is a healthy mom and a healthy child.