The When & How of Labor Induction
Why Does the Doctor Decide to Induce?
The last few weeks of pregnancy can feel like years, especially if you've hit your due date and haven't felt any serious twinges outside of Braxton-Hicks contractions. Then, your due date comes and goes and you're convinced you will look like this for the rest of your life. You feel cumbersome and it is difficult to move around. You really would like to have the baby already.
For some women, that is enough reason to ask for induction. However, your doctor won't induce unless there is a serious reason to do so. Some of those reasons include:
· You are nearly two weeks past your due date. Waiting longer than two weeks past the date the baby is due can put both you and your baby at risk, according to the experts. The placenta may become less effective at nourishing the baby and this alone could result in a stillbirth or serious problems for your newborn. Besides, if your baby gets too big your labor will be longer and more difficult, and if you delivery vaginally, it could create an increased risk of injury to you and your baby. Then, you'll need a c-section.
· Your water breaks and labor hasn't started. This situation increases the risk of infection to the baby and to your uterus. Having said that, if the baby is still very premature, the doctor may opt to hold off induction.
· If your placenta is no longer nourishing the baby, you have too little amniotic fluid or the baby is not growing or thriving, then the doctor will likely want to induce labor.
· Your own health is compromised due to illness, such as diabetes, or you have developed preeclampsia which is dangerous to both you and the baby.
· If you've had a stillbirth before, the doctor will not want to take chances with the next birth.
How Is Induction Performed?
There are several ways to induce labor that are very effective and are usually done in the hospital, mainly because the doctor will want to monitor the baby's stress levels during the process. Below are some of the ways labor is induced.
· Using prostaglandins to ripen the cervix so it will soften and thin out. Sometimes this is enough to stimulate contractions.
· Stripping or sweeping the membranes is often done in the doctor's office and then you are sent home to wait for labor to start.
· Rupturing the membranes is done when you are dilated at least a few centimeters and labor isn't moving very fast. By causing a small rupture in the amniotic sac, often labor kicks in and things get underway.
· A Foley catheter is a small catheter with a deflated balloon on the end. The catheter is inserted into the vagina and the balloon is inflated with water. The pressure created against the cervix by the balloon can stimulate the release of prostaglandins that begin contractions.
· Pitocin is a synthetic oxytocin, the hormone that gets and keeps contractions going. Pitocin is administered through an IV and is regulated by the doctor to assist in getting labor to the place of delivering the baby.
Are There Risks to Me or My Baby?
Although induction is relatively safe, it does carry some risk as well, depending upon the method used and your condition.
· Oxytocin (Pitocin), prostaglandins and nipple stimulation (causes a release of oxytocin from the brain and may help start labor) can cause contractions that come on too quickly, too hard, and too long. This can put stress on the baby.
· Prostaglandins or oxytocin can also cause placental abruption or uterine rupture in a woman who has had previous uterine surgery. Misoprostol, a frequently used prostaglandin, is linked to a relatively high rate of rupture in women who try to deliver vaginally after having had a c-section.
· The baby will have to be monitored continually with electronic fetal monitoring during the course of the induced labor. That means you're stationary and will have to lie or sit in one place for a long time.
· Induction can take a very long time which can be incredibly stressful on you and your partner. Then, if the induction doesn't work, a c-section is necessary. In this scenario, the risk of complications for the baby is much higher.
It is important to remember that you probably won't be induced unless your doctor feels it is safer than letting you go until you begin labor on your own. For more information about induction, see our article here, on this site.