Can a Doctor Force You to be Induced?
If you are like most expectant parents, you’ve been eagerly anticipating the arrival of your baby ever since you became pregnant. As you’ve counted down the weeks, you have grown increasingly excited to meet your baby and experience what it feels like to go into labor. But then you get some unexpected news at one of your check-ups: your doctor wants to induce your labor.
Wait, what? This is probably not the vision of your baby’s birth that you had hoped for all these months.
Depending on how your pregnancy has been going, this news may or may not have come as a shock. Perhaps you’ve been diagnosed with a pre-existing condition earlier on in your pregnancy—such as Gestational Diabetes (GD) or Preeclampsia—so you were already prepared for this outcome.
But if you’ve reached the final weeks of your pregnancy and all has been normal up to this point without complications, this news might be an unwelcome surprise.
So you may be wondering whether an induction is unavoidable, despite your preferences? Can your doctor force you to be induced even if you don’t want to be? To answer that question, we need to first understand what your doctor’s reasons are for recommending induction.
A Pre-Existing Condition
Let’s begin with preexisting conditions. There are several reasons that doctors recommend induction, including GD, preeclampsia, low amniotic fluid levels, Intrauterine Growth Restriction (IUGR), and premature rupture of membranes to name a few. In these instances, the risks of complications for you, your baby, or both of you increase if the pregnancy reaches full term. In order to mitigate that risk, induction is routinely scheduled anywhere between 37 and 39 weeks.
As a sovereign individual, you always have the right to accept or decline any medical treatment that is offered to you. Therefore, the general answer is no, a doctor can never force you to be induced. However, when preexisting conditions of this kind exist, it would likely be ill-advised to oppose your doctor’s recommendations.
Generally speaking, the benefits of following your doctor’s advice to induce labor outweigh the risks when medical conditions such as these arise. It may not be the news you were hoping for, but there are things you can do to prepare for the induction that will ensure it’s the best experience possible.
A Suspected Big Baby
One of the other most common reasons your care provider may recommend an induction is when your baby is measuring large. They may be concerned about shoulder dystocia at delivery if the baby reaches full-term or surpasses their estimated due date. The same recommendation might be made when you’re carrying multiples.
In comparison to a medical condition that can be diagnosed and measured with a certain level of accuracy, estimating your baby’s weight is an art, not a science. A typical ultrasound in the final weeks of pregnancy can be either 15% higher or lower than your baby’s actual weight. For example, a baby estimated to weigh 9 pounds may end up as small as 7 pounds 7 ounces, or as large as 10 pounds, 3 ounces.
With this amount of variation, it is unfortunate that many care providers rely on this data to dictate their decision for induction. If the sole reason your doctor is pushing for an induction is based upon this piece of data, you may want to conduct further research on this subject or, perhaps, switch care providers.
Going Over Due
An induction may also be recommended by your care provider in order to decrease the chances of a cesarean section. They may cite the ARRIVE study to justify this recommendation. In other instances, they might recommend induction when you surpass 41 or 42 weeks of gestation. The justification is once again that of reduced risk of negative outcomes for you, the baby, or both.
Similar to guessing the baby’s weight, due dates are also more art than science. Making medical decisions based upon a date that is merely an estimate can lead to unnecessary inductions.
If you and your baby have been healthy throughout pregnancy and your doctor wants to induce labor once you hit the 41-week mark, this may be another occasion where you may want to do your homework or consider switching care providers, before agreeing to this procedure.
Birth doesn’t live in a world of absolutes. There are a multitude of factors that are unique to you and your baby. Care providers often make their decisions based on the aggregate risk vs. taking into consideration the unique circumstances of you and your baby.
It is up to you to decide if you agree with your care provider that your situation warrants an induction. While the short answer is you never have to do anything that your doctor recommends—including induction—on the other hand, there’s a reason you have sought their care.
It’s a matter of understanding the evidence-based information regarding reasons for induction and making your own educated decision based on the information you have received from your doctor.
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