When Plans Change. Advocating When Faced With an Induction
As a Doula, I have seen many versions of this situation play out. You’re heading into a routine appointment at the end of your pregnancy. Up until now, everything has been smooth and uneventful. Then suddenly, your provider starts saying things like:
“Your blood pressure is high.”
“Your fluid levels are low.”
“Baby is measuring too large… or too small.”
This can be an incredibly jarring moment, especially if you were planning to wait for spontaneous labor. When unexpected concerns come up, it’s easy to feel rushed, or pressured into making a decision on the spot. But a recommendation for induction is not an emergency by default, and you deserve the time and information needed to make an informed choice.
Advocacy doesn’t mean refusing care. It means understanding why something is being recommended and whether it’s the best option for you and your baby.
Using the B.R.A.I.N. Framework
A helpful tool for decision-making is B.R.A.I.N.:
Benefits – What are the benefits of induction right now?
Risks – What are the risks of induction and of waiting?
Alternatives – Are there other options?
Intuition – What feels right to you?
Nothing – What happens if we do nothing for now?
Important Questions to Ask Your Provider
1. Is this a medically indicated induction?
Not all inductions are urgent or medically necessary. Some are precautionary, some are based on trends, and others are due to hospital policies rather than your individual situation.
2. What is the diagnostic criteria, and do I meet it?
Ask for clarity. For example:
What blood pressure readings qualify as hypertension or preeclampsia?
How is low amniotic fluid diagnosed?
What margin of error exists with growth ultrasounds?
Understanding the criteria helps you determine whether this recommendation is based on a single data point or a clear medical diagnosis.
3. What are the risks of induction vs. waiting for labor to begin on its own?
Every choice carries risks and benefits. Ask your provider to walk you through:
Short- and long-term risks of induction
Risks of expectant management (waiting)
How your individual health history factors into the decision
4. How urgent is this decision?
Is this something that needs to happen today, or can you monitor and reassess in 24–72 hours? Time can change the conversation dramatically.
5. What are my options if I decline or delay induction?
This might include additional monitoring, repeat testing, or non-pharmacologic approaches to encourage labor.
A Final Reminder
Birth plans changing can bring grief or disappointment and those feelings are valid. Asking questions does not make you “difficult.” It makes you informed. You are allowed to pause, ask for clarity, request evidence, and involve your support team.
Whether you choose induction or expectant management, the goal is the same: a decision made with confidence, consent, and support.
You deserve care that feels collaborative, not rushed!
