"I'm getting pretty uncomfortable but I really don't want to be induced because I heard it makes things harder" OB response, "1)The nice thing about inductions is you can not only plan your baby's birth into your schedule without the risk of surprise or something going wrong before you make it to the hospital in labor but you also get to assure I'll be the doctor delivering you. (He also reminds her that she won't have to push out as big of a baby either) and 2) We are only giving you the hormone your body makes itself, so it's not going to be any 'harder'. Labor is hard. We have epidurals for that." Mom is surprised how much the answer eases her mind despite everything she's been reading - and feeling much more in control now, says, "As long as it doesn't increase my risk for having a csection, because I definitely don't want that... when is the soonest we can do it?" Doc responds, "The ones coming in with Birth Plans increase their chance of cesarean. (chuckles) You'll be fine. Let's do next Wednesday, you'll be 39 wks and a few days - policy changes - I have to wait until at least 38 wks now no matter how uncomfortable you are."

The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin No. 107 addresses counseling for induction of labor and specifically addresses elective induction in nulliparous women with unfavorable cervices as to the 2-fold increase in risk of cesarean delivery, length of labor, and the need for a readily available physician capable of performing a cesarean delivery. ACOG also offers a Patient Safety Checklist for induction of labor that includes documentation that risks and benefits were discussed with the patient.