Induction is a process that is considered when:
- Pregnancies have gone longer than 41 weeks.
- Waters have broken but contractions have not started naturally.
- Baby is not well.
- Mother has specific health issues such as infection in the uterus, too little amniotic fluid, gestational diabetes, high blood pressure, issues with placenta.
Today we’ll be talking about the process of induction. It is always your choice, it’s always a good idea to discuss with your midwives and doctors what the benefits and risks are associated with inducing labour vs labour beginning naturally. There are many variables and different circumstances that lead to labour that really is a discussion that needs to take place with your doctors and midwives in the moment. As with any procedure there will be risks and benefits. It is your decision about whether you think the benefits outweigh the risks in the particular situation you find yourself in.
So how is labour induced?
There are four different ways:
- Prostaglandins (gel)
- Balloon catheter
- Artificially breaking the waters
- Oxytocin
Via a vaginal exam your midwife will determine if your cervix needs “priming”. To prepare for labor. A prostaglandin gel is placed at the entrance of the cervix to help stimulate dilation. Once administered you will need to remain at the hospital until labour begins. These methods do not start labour but prepare your cervix for labour. It can take anywhere from 6-48 hours to be effective.
Once your cervix is primed you may need your membranes ruptured (waters broken). They take a small hook similar to a crochet hook and rupture the membranes. Just by rupturing the membranes doesn’t mean labour will start. Once ruptured the recommend starting an oxytocin drip soon after to begin contractions.
Oxytocin is your happy hormone; it helps to stimulate labour. It is the same hormone you produce naturally that helps you bond with baby after delivery. Delivered via an IV drip your midwife will increase the amount of oxytocin delivered to your system every 30mins until you are in labour. The length of time varies from person to person. This will continue until contractions start and labour begins. Unfortunately, you are limited with how much you can walk and move around once a drip has been started, and you are unable to have a water birth.
Induction is not for everyone, people who have had a previous caesarean, major uterus surgery, placenta that is blocking the cervix or if your baby is in a breech position are unable to have an induction. Induction also isn’t without risks. Risks associated are:
- Failed induction
- Low fetal heart rate
- Infection
- Uterine rupture
- Postpartum hemorrhage
As we mentioned, induction is a process that is best discussed with your obstetrician or midwife. Everyone gets to choose their own path and how they would prefer to deliver. Sometimes for the safety of mum and bub and reasons out of your control induction may need to be a part of your journey you weren’t expecting. It isn’t a process to fear and hopefully this has taken some anxiety about the process away.
Until next time.
References
https://www.thewomens.org.au/images/uploads/fact-sheets/Induction-of-labour-181018.pdf
https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/inducing-labor/art-20047557
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864341/