Inductions are becoming increasingly common for varying reasons. There are no studies to prove that routine induction regardless of gestational age improves perinatal outcome. The average length of gestation for primiparas (first pregnancy) is 274 days and multiparas (second and beyond pregnancy) 269 days from ovulation so that translates to 41 weeks 1 day for first time moms and 40 weeks 3 days for subsequent babies. Research evidence shows that induction for "suspected big baby" results in higher c-section and operative vaginal delivery rates than waiting for the birthing time to start on its own, and there is no evidence that larger babies pose a bigger risk of problems during birth. Furthermore, there is currently no way to assess how big a baby will actually be at birth, and ultrasound is often erroneous by several pounds.
Benefits: When medically indicated an induction can improve the perinatal outcome. Medically indicated reasons would not include you being past 40 weeks or a suspected large baby but rather a physical problem with you or the baby, a BPP (Biophysical profile) indicating a possible problem, or a Stress or Non-Stress Test indicating a possible problem. Keep in mind that these tests are meant for a prolonged pregnancy and they have a high false positive rate. This is not a cut and dry subject; there are many variables, and for this reason it is very important to have a care provider you trust and be as educated as possible.
Risks: It may not work, and your chance of getting a Cesarean Section are higher than if you would have gone into your birthing time spontaneously.
Alternatives: There are many natural ways of inducing birthing waves such as using hypnosis, nipple stimulation, intercourse, herbs, enemas, castor oil, etc.
Amniotomy is the artificial rupture of the membranes with an amniohook (AROM). An Amniotomy can be done to either induce birthing surges or at some point during the birthing time.
Benefits: If it is done later in the birthing time it can get a stalled one started again.
Risks: There are quite a few risks involved with Amniotomy. The amniotic fluid provides a cushion for both you and the baby, therefore making the pressure surge more comfortable, and the baby's head protected from compression. The baby can get stuck in an unfavorable position because he/she can not maneuver as easily with the amniotic fluid gone. There is an increased likelihood of umbilical cord compression or cord prolapse, where the umbilical cord gets flushed out with the water when it breaks and gets kinked like a hose. Due to the sterile field of the amniotic sac being broken you also have a higher risk of developing an infection. From the time you have an Amniotomy you are on the "clock" so to speak. A lot of care providers require birth within 24 hours regardless of method. Also you may be restricted to bed and you will be restricted from showering and/or bathing.
Alternatives: It depends on what your care provider wants to accomplish with AROM. If they suggest AROM to speed the birthing time up or get a stalled one going again and your baby is showing no signs of distress, you can simply give your body time to do what it was made to do, or use natural birthing stimulation techniques. If they suggest AROM to induce birthing surges you can use Evening Primrose Oil, nipple stimulation or other ideas. There are many. Read more about amniotomy.
Pitocin is commonly used to induce birthing surges or increase the strength and/or duration of them. There are some problems associated with the use of Pitocin: