Pregnancy Info

Induction is a way of starting labor artificially by rupturing the membranes and giving oxytocin or prostaglandins to stimulate uterine contractions. The same techniques are used to accelerate labor if your contractions are weak and progress is slow. If your induction is not done for the medical reasons or as an emergency, you’ll have an elective induction. An appointment will be made for you to go into the hospital at a certain time. Your partner will be able to be with you all the time. If you’re in any doubt about why your doctor - is suggesting induction of labor; ask for a detailed explanation-this should cover all of the alternatives. In the end, of course, the decision is up to you.

The History Of Induction

When induction was first available, it was often used for hospital or social convenience or so births could be arranged to happen during working hours. Such reasons are no longer acceptable.

When induction first became fashionable, doctors didn’t have all the technological backup that we have today for checking fetal maturity, such as ultrasound and amniocentesis, and some babies were born too early and had respiratory problems. The rate of cesarean section also rose. Nowadays, fewer than one in five labors are induced.

Only five percent of babies actually come on their due date, and it can be hard for some doctors-and mothers-to remain calm when that magic date passes. They may worry that the placenta is becoming inadequate and that the baby is outgrowing its environment.

Don’t worry if you have to be induced. Induction is fine, provided it’s done strictly for medical reasons and either for your well-being or the baby’s. And please don’t feel angry with yourself if your birth doesn’t turn out just the way that you’d planned.

How It’s Done

Most obstetric units will normally use a combination of three different methods to induce labor.

Prostaglandin suppositories One method of induction uses prostaglandin suppositories, which soften the cervix and start it dilating. They can be inserted at any time of day, although most units put them in at night, and they usually take full effect in six hours. This is a good method of induction since you are free to move around the labor room.

Artificial rupture of the membranes (ARM) This is also known as amniotomy and involves the use of an instrument not unlike a crochet hook. It is inserted through the cervix (when it is dilated) into the uterus to make a small opening in the membrane so that the water escapes. Amniotomy can be performed with or without contractions, but if there are no contractions, you’ll need to have an oxytocin drip. If you have a drip, doctors usually advise fetal monitoring so they can check the effect of the induced contractions on the fetus. Labor usually reaches full intensity quickly after ARM because the baby’s head is no longer cushioned and presses down hard against the cervix, encouraging the uterus to contract and the cervix to dilate. If left alone, the water doesn’t usually break until late in the first stage.

Amniotomy is not just a method of induction. It will be performed if an electrode needs to be attached to the baby’s scalp to monitor its heartbeat. It will also be performed if the baby’s heart rate goes down because of distress. In this case, traces of meconium, the baby’s first bowel movement, may be seen in the amniotic fluid.

Oxytocin-induced labor Oxytocin is the natural hormone from the posterior pituitary gland in the brain that stimulates labor. The synthetic form is used for inducing labor.

Oxytocin used to be administered in tablet form, but it’s now only given through a drip, which is easier to regulate. Ask for the drip to be inserted in your left arm if you are right-handed, and check that you can have a long tube connecting you to the drip. You’ll then have more room to move around, even if this is just on the bed; some drip stands are on wheels so that you can still move around the room and change position if you wish, which will help you control the more intense labor pains. The oxytocin drip can be turned down if you go into strong labor quickly and the cervix becomes half dilated. The needle won’t be removed from your arm until after the baby is born because the uterine contractions help to expel the placenta.

Contractions brought on by an oxytocin drip are often stronger, longer, and more painful than normal contractions, with shorter breaks between them, so there’s an increased need for painkilling drugs. As the blood supply to the uterus is temporarily shut off during each strong contraction, it’s thought that this may be detrimental to the fetus. Most obstetricians believe that only a small percentage of deliveries need an oxytocin-induced labor.

Expectations Of Induced Labor

If properly handled, induced labor needn’t be more painful or difficult than natural labor and, using oxytocin, your doctor or midwife should be able to get you to the stage where you’ll have a normal labor. You can still do all your breathing exercises and push the baby out at your own pace if you prefer to have a natural childbirth. If the induced labor does become too painful, you can ask for an epidural or other pain relief.

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