With a relentless focus on excellence in healthcare, Pullman Regional Hospital presents The Health Podcast.

Deborah Howell (Host): Well, we've all heard about induced labor, but what actually happens during the process and what potential risks are associated with? To learn more about inducing labor, we'll talk to someone who knows all about it. Today, we'd like to welcome Dr. Theresa Myers, a certified OB-GYN at Moscow Pullman OBGYN. Dr. Myers, welcome.

Dr Theresa Myers: Thank you. Glad to talk to you.

Host: So, let's begin at the beginning. What does being induced into labor mean?

Dr Theresa Myers: Induction is our process of trying to kickstart labor. So, getting contractions started to end in cervical dilation and delivery of a baby.

Host: And what happens during induction?

Dr Theresa Myers: We use various methods to try and help prime the cervix for labor if you haven't already started dilating slightly yourself. And then, generally, we use oxytocin or synthetic Pitocin to start contractions. And then, we sometimes break a bag of water. Other than that, it progresses pretty much like normal labor.

Host: Okay. And typically, how long after being induced does a woman give birth?

Dr Theresa Myers: That is extremely variable. It can be a while for induction to progress through like latent phases of labor when you're having contractions but not much dilation of the cervix. And so, anywhere from a few hours to a few days would be both normal and safe.

Host: So, when does the conversation about induction occur?

Dr Theresa Myers: That depends. We induce for a wide variety of reasons. If you're coming into pregnancy with a known medical condition or complication, then that conversation can start as early as the beginning of prenatal care. Otherwise, as complications develop generally in the second half or toward the end of pregnancy, then we can start having conversations about when is going to be the safest time for the delivery of this baby.

Host: Okay. And what factors might come up to prompt the option to be induced?

Dr Theresa Myers: Induction is based on our calculation of the risks of pregnancy versus the risk of birth. So generally, the risk of birth is the risk to the baby especially if we're considering an early induction. And the risk of pregnancy is the risk that whatever is complicating the pregnancy could get worse and harm either mom or baby or both. All of that is an inexact science, obviously, but we're looking at things like bleeding, blood pressure problems, anything that tells us that baby's not doing well or not growing well, then it's possible that continuing to remain pregnant could be more dangerous than giving birth.

Host: Okay. Got it. I think you've answered this in full. But just in case, I'll give you another chance if you want to add anything. Are there any risks associated with being induced?

Dr Theresa Myers: I think the biggest thing is just the mental game, it can be extremely long and patients can find that very challenging, especially mentally and emotionally. Especially if we're attempting an early birth for everyone's safety, then we do have a higher risk of C section, but that's more with our early 30-week inductions. Our term inductions don't have that trouble. And then, any birth, any labor is always a high stress process for both mom and baby physiologically. So of course, we have risks of bleeding, risks of baby not tolerating labor. Those appear to be equivalent for spontaneous labor or induced labor. It's just labor is a stressful event.

Host: With great rewards.

Dr Theresa Myers: Yes.

Host: So, are inductions ever elective? And if so, what factors are considered?

Dr Theresa Myers: Yes. Actually, there was a massive study a few years ago that showed that elective inductions can be safe and effective ways of giving birth, starting at 39 weeks. So, we tend to offer optional induction after 39 weeks, depending on patient's preferences.

Host: All right. Now, for the mom, is recovering from an induction any different from a normal birth?

Dr Theresa Myers: No, it shouldn't be.

Host: And what about for the baby?

Dr Theresa Myers: No. When we induce for early term or preterm infants, those infants are going to be born early. And therefore, they can have complications from an early birth, but that's why the initial conversation about induction is about the risk of continuing the pregnancy versus delivering now. And so, if babies are having complications of early birth, it's because the risk-benefit thought was that pregnancy would be even more dangerous for them.

Host: And, you know, we've all seen movies where the mom says, you know, "I want my baby to be born on my birthday. So, can you induce me?" What's your response to that?

Dr Theresa Myers: After 39 weeks, elective induction can basically be attempted for any reason. Common ones we see are child care for other children or people who live far from the hospital who don't want to risk going into labor in Moses Lake and having to drive all the way here. But of course, induction several hours to several days is very hard to induce for a specific birthday.

Host: I see. Okay. All right. Have you ever nailed it?

Dr Theresa Myers: Of course. Every once in a while, you get lucky.

Host: I love it. I have so many more questions, but I think we've covered all the basics. Is there anything else you'd like to add?

Dr Theresa Myers: I think induction is a thing that people can find very intimidating. There's a lot of information on the internet that can both be very encouraging and very scary. But there should always be a conversation with your provider about what are the risks for your specific pregnancy and your baby and it can be a reasonable option.

Host: It sounds wonderful. Well, Dr. Myers, we really appreciate having you on the show. Thank you so much for being here with us.

Dr Theresa Myers: Absolutely. I appreciate the opportunity for the conversation.

Host: And you can learn more about the childbirth experience at Pullman Regional Hospital by visiting pullmanregional.org/birthplace. I'm your host, Deborah Howell. And this has been The Health Podcast from Pullman Regional. Thanks for listening and have yourself a great day.