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Childbirth by Appointment

It started as a little joke. Sherry Martin of Tennessee was almost at the end of her fourth pregnancy  -- and the end of the year  -- when she made a lighthearted comment to her obstetrician. "I told him my husband said he might not get paid if he didn't get the baby here before New Year's so we could get a tax deduction," says Martin (whose name has been changed). That's not a problem, her doctor told her. He suggested that he could induce labor on her due date  -- December 31  -- and be perfectly justified in doing so, since her third child had been nine and a half pounds and he wanted to avoid another big baby. "At the hospital, doctors have to give a medical reason to induce," says Martin, "so my reason was that I tend to have big babies."

When the day came, Martin, who'd never been induced before, hesitated. "I thought, 'This is crazy. Why am I doing this?' But I was tired of being pregnant, and it was such a good time, with the kids out of school on Christmas break. You can definitely control things much better when you do an induction."

Martin went to the hospital and was hooked up to an IV of Pitocin, a drug that's often used to bring on labor. Six hours later, she delivered a healthy seven-pound girl. She says she never worried that anything would go wrong with the delivery because she was never told of any potential dangers, such as an increased chance of fetal distress, c-section, and, though rare, uterine rupture, which can be fatal to the baby or mother. "I might not have done it if I'd known the risks," she says now.

Martin is part of a growing number of women who are having inductions, some for medical reasons, some not. The rate of induced births has increased from 18 percent of all deliveries in 1997 to 22% in 2006, according to the National Center for Health Statistics  -- but there's also a trend toward outright promotion of elective inductions, those done mainly for the doctors', or parents', convenience.