You mentioned that you're going to be induced at 39 weeks for a medical reason, and this is your first baby. You have some concerns about whether or not this induction will increase your chances of C-section. Generally speaking, in the days to weeks leading up to delivery, if a woman goes into labor spontaneously, her body starts to do some prep work. So your body releases hormones called prostaglandins that act on the cervix and actually ripen it just like a fruit ripens. It softens in consistency, it moves forward in your pelvis, it begins to thin out, and then once your brain starts to release oxytocin, which is the hormone that makes your uterus contract, it will act on the cervix when you're having regular and intense contractions, and cause it to dilate.
First-time moms are in labor for, on average, 12 to 18 hours, and this is from the point your cervix starts actively changing from hour to hour. That doesn't include the prep work, it doesn't include irregular contractions you might have leading up to the contractions that are actually dilating your cervix. So really, for most moms, the first baby is just a long haul anyway. And at the end of it all, when you're 10 centimeters, you have to push for 1 to 2 hours. So it can be a long, grueling process, especially for first-time moms.
Basically, when you're induced, we have to mimic what your body would have been doing spontaneously, and just squish it into a day or two. So if your body hasn't already done that ripening, if you're cervix is far back in your pelvis, it's thick, it's hard in consistency and not dilated much, then we have to administer some ripening agents that will act on your cervix and ripen it, as I discussed before. And then after giving those ripening agents, they'll likely have to start pitocin, also known as oxytocin, which is the hormone that your brain would have released if you went into labor spontaneously, to give you contractions. Basically, we just make them start for you, and this is given through the IV. And again, regular and intense contractions will cause your cervix to dilate, and then you'll be in labor.
Now how does this all relate to your chances of C-section being higher or not? Our thought, for a long time, has been that if you induce a mom for fun at 39 weeks (but you mentioned you're being induced for medical reasons, so it's absolutely necessary - whether you end up with a vaginal delivery or a C-section, it needs to happen), our thought has been if you try to force a mom's body to do something that it's not ready to do on her first baby, then she may be less likely to progress, and a C-seciton might be slightly more likely. With that said, C-section rates are not astronomically high. There are plenty of women who still deliver vaginally that are induced.
And there have actually been studies done in other countries that have shown that C-section rates are lower at 39 weeks than they are at 41 weeks, which is a woman's ultimate due date. We won't let you go past that point, because the placenta has an expiration date. It stops feeding your baby like it should after about 40 weeks, and for sure after 41 weeks, and so at that point, they need to come out. And the reason why C-section rates are lower at 39 weeks than they are at 41 is because the placenta is healthier. We can be more patient, because your baby is better able to tolerate labor and contractions. So we can give you more time to let your body dilate than we might be able to when you're 41 weeks and the baby is experiencing lots of stress during labor because the placenta is old and not perfusing as well.
So overall, is your chance of C-section higher? It might be slightly, but if so, probably not much. I recommend talking with your doctor about the specifics of your situation, and based on their knowledge of your circumstances, they'll be able to give you the best information about what to expect. Good luck with everything, and congratulations ahead of time! And if you have any other questions for me in the future, feel free to ask them on our Facebook page at / intermountainmoms , and recommend us to your friends and family too.