With Christmas coming up fast, there's the usual chatter in pregnancy worker circles about all the inductions that will be scheduled before the festivities kick in. Doctors seem to be booking inductions at 38, 39 or 40 weeks weeks, citing reasons like getting the best Christmas present, that staffing levels are lower so you won’t get as much support or even their own holiday plans if seeing someone privately. But really, are they good enough reasons to start a medical procedure that has many well documented risks?

The facts are that Ireland’s induction rate is climbing, even outside of the holidays with 35.1% of all labours induced in 2021. This was even higher for first time parents, 44% of them were induced. The national reports don’t give a month by month breakdown but the hospital ones do.  Christmas and holidays might bring joy, but they aren’t solid reasons for induction. Yet, if we look at the busiest hospital in the country, the Rotunda. Their November 2022 inductions stats were

November 2022 Inductions

Overall: 38.1%

FTM: 48.7%

Shocking stats in themselves but now lets look at December 2022

December 2022 Inductions

Overall: 42%

FTM: 56%

Like WTAF!?

The World Health Organization says a normal pregnancy lasts between 37 and 42 weeks, emphasizing the differences between pregnancies. But these days, inductions, especially around Christmas, seem more about convenience than necessity, which raises concerns, especially for those pregnancies without any additional risk factors. What’s wrong with just letting babies come when they’re ready?

In it’s latest guidance the WHO recommends that “Routine induction of labour, for women with uncomplicated pregnancies, at less than 41 weeks is not recommended”.

This is because of the risks associated with induction including:

• “Failed induction” - An induction might be considered failed if the methods used don't result in a vaginal birth after 24 or more hours. In such cases, a C-section might be recommended.
• Fetal Distress - The medications used to induce labor — synthetic oxytocin and/or prostaglandins — can cause the uterus to contract too much, and too strongly, which can lessen the baby's oxygen supply and lower the baby's heart rate sending them into distress which can mean s caesarean birth might be necessary to save them.
• Infection - some methods of labour induction, such as rupturing the membranes (breaking the waters), might increase the risk of infection for both mother and baby. The longer the time between membrane rupture and birth, the higher the risk of an infection.
• Uterine rupture - This is a rare but serious complication in which the uterus tears due to the extreme contractions caused by induction.

It can be tempting to want to meet your baby sooner rather than later and the last weeks of pregnancy can be demanding, but they're also a time to relax and enjoy. Managing stress, staying emotionally balanced, and looking forward to the birth can have a big impact on having a positive birth experience and on your postpartum health.

Healthcare providers, despite being human and wanting holiday celebrations, have a responsibility to ensure medical decisions are based on evidence, not convenience. The flaws in our maternity system and potential biases mean it’s necessary for parents to be able to advocate for themselves and have informed discussions before making any decisions.

When researching for this blog I asked some parents to share their stories with me and I want to say thank you to everyone who did. You can read them now below.

“I was offered an induction at 42 weeks, my doctor always said let’s wait and see, hopefully a spontaneous labour will result. In the end I opted for induction as I became so uncomfortable! The doctor did suggest that maybe after 42 weeks it would be time to consider.  What really made the experience less than ideal was that the hospital was sooooo busy because of the amount of inductions booked; it was the 17th of December. From talking to many mothers to be there, they were all around 39 weeks or so and wanted to have an induction so to avoid being away from their other children over Christmas.. the labour wards were FULL. The midwives stretched beyond limits, and post natal wards were full. I end up on a gynae ward with women who had just had hysterectomies; I felt awful. I have since had a spontaneous labour, and I can honestly say the experience in incomparable. This time round felt so much easier, my baby and body decided when ready and recovery had been more gentle. I knew the information on induction; informed of risks etc. however, I would urge anyone to deeply consider opting for an induction (unless medically indicted), it’s a huge decision. I wasn’t pushed into it, but I’ve heard it is so, so common to be pushed for it, which is so wrong and makes me mad. Especially now that I have the two experiences to compare!” - R



“My due date was 15th December 2021 with my first little girl, (due my second next feb), also an IVF pregnancy. A few days after my due date I had an anxious night and felt like baby wasn't moving as much. I went in for CTG trace and my consultant did a sweep with my permission, all was fine with baby and movements were fine. she then talked about placenta failing post due date etc. At 7 days post due date, she booked me in for induction, pessary, at this point I was so nervous that something would happen to my baby despite all my reading about dates and placenta etc. I know if it hadn't been Christmas week that she would have allowed me more time. My 10 days over would have been Christmas day and my consultant wasn't on duty over Christmas weekend. I went ahead with induction at 7 days post dates and baby was born the night of 8 days over. All was fine and I managed a natural delivery with some vacuum. It was not the labour I wanted or planned for and Christmas definitely had an impact.” - C

“My first was 12 days over...from 37 weeks on a weekly basis I was being told he was huge and wouldn't lend well to a vaginal birth. He was grand and 8 lbs. Second...same story. Absolutely massive baby...9lbs. 3rd...same story...another massive baby. I told them I had heard that story twice. Absolutely no pain relief on her, not even gas and air and she flew into the world. 8lbs. I get really angry when I think about how someone with less education and less support might feel pressure to comply. My husband is a doctor and while not in the area of obstetrics he was a great help and his support was huge. He never understood the push to get them out and used say they'll come when they're cooked” - M