An increase in the number of elective inductions -- those that are not medically necessary -- also contributes to the growing rate.
Amy Kelly, of Westlake, Ohio, had her second and third pregnancies induced because she was concerned about the 35-minute drive to the hospital through downtown Cleveland (her first labor had taken only seven hours). She also needed to arrange care for her older children. "Inducing was safest, so that the babies weren't born on the highway," says Kelly. "It also gave me the peace of mind that my other children were taken care of."
A scheduled induction can also guarantee that your doctor will be present for the birth. Healthcare providers can plan deliveries for daylight hours and avoid midnight runs to the hospital.
According to Sabine Droste, MD, an associate professor of maternal/fetal medicine at the University of Wisconsin at Madison, many elective inductions are done to keep patients happy: "By the time they reach 37 or 38 weeks, a lot of patients are frankly sick of being pregnant."
Just ask Courtney Kyle of Jacksonville, Florida. She had been having regular contractions for more than a month when she saw her doctor four days prior to her due date. She was hot, uncomfortable, and tired of pregnancy. "My doctor knew it was driving me crazy and offered the option of inducing me on Friday when he was on call," says Kyle. "What helped me make the decision was knowing when I would have my baby and that my doctor would be the one who would take care of me."
During the labor, the baby's heart rate dropped, and Kyle ended up with an emergency c-section. Still, she was happy with her decision: "It was not my dream birth, but at least I had my own doctor."
The increased odds of a cesarean is among the risks of inducing. "An induced labor is by nature less effective than a spontaneous labor," says Dr. Droste, "and more likely to result in a cesarean delivery."
But while elective inductions are controversial, some ob-gyns support the practice. "A significant number of obstetricians argue that if you've had a baby before and are 3 to 4 centimeters dilated, an induction is reasonable. As long as patients understand clearly the risks and benefits, I wouldn't say it's a terrible thing to do," says Dr. Lockwood.
Elective inductions can also be inspired by exceptional circumstances. Recently, women have been induced at term before their husbands left for military service in Iraq.