Being Induced at 39 Weeks

Pregnancy is a unique experience both joyful and miserable. While the fact that you're about to having a baby can bring great joy, that doesn't help to counteract all the pregnancy symptoms such as morning sickness, swelling, aches and pains, etc. And as your pregnancy comes to the 39 weeks, that hugeness and all the difficulties in carrying out daily activities may lead you to consider an induction. Just a quick decision, then you'll get rid of all these and have an excellent baby! But is it really so?

Should You Get Induced at 39 Weeks?

It depends. Opinions vary when it comes to induction at 39 weeks. But generally speaking, if there is nothing wrong with your pregnancy or your baby, and everything is straightforward, then it is not necessary to get an induction. However, there're occasions when induction is a safer option if there's risk with you or your baby's health. These include:

  • You're 2 weeks overdue and there is no sign of labor
  • Broken water with no contractions
  • An uterus infection occurs
  • Your baby is not developing as he/she should be
  • Oligohydramnios, a condition characterized by insufficient amniotic fluid
  • Placental abruption
  • You have medical conditions such as diabetes or high blood pressure

Here's what moms got to tell you on this:

I am now just a couple of weeks to 39 weeks pregnant. And people around me kept telling me not to induce unless complications occur. They say that being induced at 39 weeks will cause pressure to the baby and serious issues may result. So better wait till your baby is ready or unless otherwise suggested by your doctor. Just think about this, you've been this far, why not wait for a few more weeks? It just doesn't worth the risks.

I was induced at 39 weeks pregnant when I was 3cm and 75%. The whole process took about 3 hours and I got my beautiful baby girl! As for whether you should get it, I would say, listen to what you doctor says as everyone is different and only your doctor knows which is the best. 

Does It Always Work?

According to some of the anecdotal accounts of induction at 39 weeks of pregnancy, some women have reported successful induction with intravenous infusion of oxytocin. Yet others have stated failure of induction of labor, especially during the 1st time pregnancy, leading to instrumental delivery.  

Most of the women report that cervix is not engaged enough at 39 weeks which makes the induction process difficult with frequent abandoning of the procedure and waiting for spontaneous induction. In some cases where labor was imminent or the woman had any high-risk medical condition, there have been accounts of stopping the induction process and going straight for emergency caesarian section.

The success of induction depends significantly on whether the body of the mother is ready for delivering. This is assessed by a system known as “Bishop Score” which entails measuring the extent to which the cervix is open and thinning of the cervix. Factors like whether the membranes are intact or ruptured, whether the mother is suffering from high risk conditions like gestational diabetes or preeclampsia, etc. are also taken into account. Together, they determine the success rate of the procedure.

Is It Dangerous for the Baby?

Being induced at 39 weeks can pose some risks to the baby as the development of vital organs including brain, lungs and liver continues till the very end of pregnancy. Between the 35th and 39th week of gestation, only one-third of the human brain is known to develop. The brain development optimizes after the 39th week. Labor induction before 39th week, therefore, enhances the likelihood of congenital brain disorders.

During the last weeks of pregnancy, layers of fat are added beneath the skin to enhance its insulating action. Lungs and liver also continue to mature till the very end of pregnancy. If labor is induced too early, the baby is exposed to the risks of:

  • Fetal respiratory distress syndrome (RDS)
  • Inability to stay warm
  • Feeding problems
  • Jaundice (due to inability of liver to function optimally)
  • Learning and behavioral disorders
  • Neonatal infections 

How Is It Done?

The method of induction depends on the condition of the cervix. The cervix should be dilated and soft enough before induction. If the cervix is still not "ripe" for induction, mechanical or medicinal procedures are used to prime the cervix for induction. Here are some of the methods used for labor induction at 39 weeks of pregnancy.

1.      Prostaglandins

If the cervix is not optimally dilated and softened for induction, the goals are achieved by administration of prostaglandins. Prostaglandins act on the vagina and cause the cervix to open and become soft. Sometimes, prostaglandins may be all that is needed for being induced at 39 weeks.

2.      Pitocin

If prostaglandins are not enough to start contractions, Pitocin, which is a  man-made oxytocin, may be given. However, this should only be used when your cervix is already open for labor.

3.      Membrane Stripping/Sweeping

Another of the mechanical procedures is membrane sweep method which is used when the cervix is already dilated to some extent. The obstetrician inserts a finger and sweeps the amniotic sac to separate it from the uterine wall. This action stimulates the release of prostaglandins and can induce contractions.

4.      Rupturing the Membranes

 If the cervix is already ripe but the membranes are still intact, labor can be induced by introducing a hooked instrument and manually rupturing the membranes. This procedure is also known as "amniotomy" and can stimulate the labor contractions.

How Long Does It Take?

The length of induction is longer than normal labor. Depending on the condition of the cervix and the time of rupture of membranes, labor induction may take anywhere between a few hours and 2-3 days. If the cervix needs time to dilate and soften, being induced at 39 weeks can take about 2-3 days.

Since the contractions are brought on suddenly at times, the intensity and length of contractions is more as compared to normal labor. The amount of pain and discomfort associated with any of the induction methods is the same as natural labor. Though, the use of pain medications can help relieve the pain.

Is There Anything Else I Should Be Aware Of?

Here are some of the considerations to be kept in mind.

  • Inductions are quite unpredictable and every pregnancy and labor is different from one another.
  • You won't be allowed to eat much during the induction process.
  • There is a slight chance of failure associated with every induction and Caesarian section may be required in such cases.
  • Induction of labor should be opted for only in case of medical indications.
  • Induction at 39 weeks carries the risks of uterine rupture and heavy bleeding (known as postpartum hemorrhage, PPH)
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