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To induce labour or not to

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If a pregnant woman is advised by a doctor to consider induced labour, she should seek a second opinion, especially if her gut feeling tells her otherwise.

Dr Stephen Mutiso, a gynaecologist at Kenyatta National Hospital, says it is important that a patient consents to her doctor’s recommendations or find out from other professionals if it is right or safe to proceed with any procedure. According to him, a pregnancy of between 38 to 41 weeks (+ 6 days) is considered full term. But even before 38 weeks of gestation, doctors can induce labour, depending on their assessment.

“If a woman is experiencing high blood pressure, pre-eclampsia, or any other pregnancy related complications that could endanger the baby or mother, a doctor should promptly advise that labour be induced to avoid further exposing the baby to harm,” Dr Mutiso says.

“There are instances where a woman may not be in distress, but the doctor still recommends induced labour. Such instances include when a woman’s cervix has dilated to 4cm or even more. In such a case, her cervix is opening and inducing labour is prudent. If such action is not taken and she goes into labour outside a hospital environment, the baby may die, especially if the umbilical cord emerges first,” explains Dr Mutiso.

Labour can be induced by administering medicine to stimulate contractions or an injection to soften the cervical opening.

If delivery does not occur long after labour has been induced, then, according to Dr Mutiso, the medicine would be considered as having failed and an emergency caesarean section resorted to as the next course of action.

However, if the woman is already in progressive labour – the baby’s head can be seen – the doctor should perform episiotomy (a cut to enlarge vaginal opening) to ease the baby’s birth.

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This notwithstanding, Dr Mutiso maintains that patients cannot (and should not) be forced to undergo induced labour without their consent.

New pregnancy guidelines ratified last year by the American College of Obstetriciansand Gynaecologists (ACOG) have opened debate on whether 38 weeks of gestation is really full term.

In an article first published by UK’s Daily Mail in October 2013, it emerged that doctors in America established new timelines on what is considered  ‘healthy pregnancy.’

The doctors said a full-term pregnancy is between 39 weeks and 40 weeks and six days. An ‘early term’ or premature baby is one born between 37 weeks and 38 weeks and six days. A late term pregnancy is anything between 41 and 42 weeks; at which time the baby is ‘post term’ or long overdue. Studies indicate that babies born at 37 weeks are more at risk of complications, such as breathing problems, than those born at 39 weeks.

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