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healthy pregnancy


Women who undergo cesarean when an induction doesn’t result in a vaginal birth are at risk for the complications and consequences of cesarean:


either your or your provider’s convenience. Examples might be scheduling induction when your mom is in town or when your provider is on call. Elective inductions bring short-term and life-


long risks for you and your baby. Experts agree that an elective induction should never occur before 39 weeks because your due date is just an estimate. Inducing before 39 weeks could put baby at risk for problems of being born early (premature). But even after 39 weeks, if your body isn’t ready


for labor, you still have an increased risk for a cesarean when labor is induced. Women who undergo induction lose the benefi ts of their body’s natural hormones preparing them and their baby for labor.


LEARN THE BISHOP’S SCORE


One way your healthcare provider can know how ready your body may be to labor is the Bishop’s Score. It’s the sum of 5 factors that show how “ripe” or “ready” your cervix is for labor.


1


Dilation How open is the cervix? (0-3 pts)


2


Effacement How much is the cervix thinned out on the edges? (0-3 pts)


3


Fetal station How low is baby’s head in the pelvis? (0-3 pts)


4


Position of the cervix How far back is the cervix? (0-2 pts)


5


Consistency How soft is the cervix? (0-2 pts)


T ese hormones start labor when both you and your baby are completely ready and help you have a labor that usually goes faster, with gentler contractions for your baby, than when labor is induced with synthetic hormones. When considering induction, remember: T is


is your body, your baby and your future. Making sure you know the reason for this recommendation means you can truly make a decision, and not just agree to what could be a life-changing choice.


CATHERINE RUHL, CNM, MS, is a certif ied nurse midwife, and Director of Women’s Health Programs at AWHONN in Washington, DC.


 Excessive bleeding (hemorrhage)


 Infection


 Delays starting breastfeeding after birth


 Longer recovery


 Problems with the placenta in future pregnancies, which increases with each pregnancy if a woman has repeat cesareans


 Life-threatening hemorrhage during future pregnancies if these placental problems occur


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0cm = 0 pts 1-2cm = 1 pt 3-4cm = 2 pts > 5cm = 3 pts


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Score of: 0–5


Not ready; a much higher chance of a failed induction and cesarean


38 health4mom.org


0-30% = 0 pts 31-50% = 1 pt 51-80% = 2 pts > 80% = 3 pts


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-3cm = 0 pts -2cm = 1 pt -1cm, 0cm = 2 pts +1cm, +2cm = 3 pts


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Posterior = 0 pts Middle = 1 pt Anterior = 2 pts


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Firm = 0 pts Average = 1pt Soft = 2 pts


Score of:


6–8


Borderline ready; increased risk for cesarean


Score of:


9–13 Ready


IMAGES © ISTOCKPHOTO


CESAREAN RISKS & CONSEQUENCES


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