Induction of Labor is a procedure of artificially stimulating the uterus to start labor. Over the past few decades, the use of this process to deliver babies are increasing, and more and more women around the world have undergone induction of labour, especially in developed countries. Induction of labor is not a risk-free and according to some women an uncomfortable procedure. It involves administering oxytocin or prostaglandins to the pregnant woman or by manually rupturing the amniotic membranes. Reasons why doctors perform induction of labor are:
- You’re approaching two weeks beyond your due date, and labor hasn’t started naturally.
- Your water has broken, but labor hasn’t begun.
- You have an infection in your uterus.
- The estimated weight of your baby is less than 10 percent of what is expected for the gestational age.
- There’s not enough amniotic fluid surrounding the baby.
- You have diabetes that develops during pregnancy.
- You have a pregnancy complication characterized by high blood pressure and signs of damage to another organ system.
- Your placenta peels away from the inner wall of the uterus before delivery — either partially or completely.
- You have a medical condition such as kidney disease or obesity.\
You can choose to have induced labor or your doctor will recommend it for any of the above reasons. There are a variety of options through which induction of labor can be done. The type of induction you will have depends upon the reasons due to the step of using this process is taken. The process varies for everyone since it depends upon their different circumstances. In some cases, a combination of methods is used to the labor started. Your doctor will explain all the details about different methods once it is decided whether to have an induced labor or not.
There are many and different ways to induce labor. Your doctor and midwife will first evaluate several factors, including your health, your baby’s health, your baby’s gestational age, weight and size, your baby’s position in the uterus, and the status of your cervix.
Sweeping the membranes
The midwife or doctor makes circular motions with their finger across the cervix during a vaginal exam. This activity is supposed to release a prostaglandin hormone. For this treatment, you don’t need to be admitted to the hospital and it is often performed in the doctor’s room It can be enough to start the labor, so you don’t need any other methods.
Risks: It’s a simple and easy method, but it doesn’t always work. It may be a little inconvenient, but it does not hurt.
To start your contractions, a synthetic form of the hormone oxytocin is supplied to you through a drip in your arm The amount of oxytocin is adjusted when the contractions start and you keep having daily contractions until the baby is born. These can take a couple of hours to complete.The contractions can sometimes can be too hard, which can affect the heart rate of the baby By decelerating the drip or offering you another drug, this can be managed.
Risks: Oxytocin can make contractions more intense, more frequent and more difficult to bear than in normal labor. You will need pain relief more likely, and the baby will be monitored continuously. Because of the drip in your arm your mobility will not be much and you’ll also have a fetal monitor around your abdomen to monitor your baby
Breaking your waters using ARM
Artificial membrane rupture (ARM) is used when the waters are not naturally breaking A thin hook-like tool is inserted through your vagina by your doctor or midwife to make a hole in the membrane sac that contains the amniotic fluid. This is done only if the cervix is partially dilated and thinned and the baby’s head is deep in the pelvis.This will increase the pressure of your baby’s head on the cervix , which may be necessary to start labor.
Risks: ARM may be a little uncomfortable, but not painful. There is an increased risk of having a prolapse of the umbilical cord, bleeding or infection.
Prostaglandin is often the primary method of labor induction as it is the nearest to natural labor. To soften your cervix and prepare your body for labor, a synthetic form of the hormone prostaglandin is inserted into your vagina. It may be in the form of a gel that can be delivered in several doses (usually every 6 to 8 hours) or a pessary and tape (similar to a tampon) that releases the hormone gradually for 12 to 24 hours. After the prostaglandin is injected, you will need to lie down and stay in hospital. You may also need ARM if you have not broken the waters or oxytocin to the start the contractions.
Risks: After prostaglandin, some women find their vagina swollen, or may suffer nausea, vomiting, or diarrhoea. Such side effects are uncommon. Tell your doctor straight away if you start to experience painful, regular contractions 5 minutes apart for your first baby, or 10 mins apart for subsequent babies or if you start bleeding, or if your baby is moving less, since this could be a sign that something is wrong.
Cervical ripening balloon catheter
A cervical ripening balloon catheter is a small tube with a balloon at the end which is inserted into your cervix. The balloon is inflated with saline, which usually puts enough pressure on your cervix for it to open. It stays in place for up to 15 hours, and then you’ll be examined again.
Risks: The risks for this method is same as prostaglandin.
Keep in mind that a combination of these approaches may also be used by your healthcare provider to induce labor.How long it takes for the labor to start depends on how ready your cervix is when your induction begins, the methods of induction used and how your body responds to them. If it takes time for your cervix to develop, it may take days before labor begins. If you just need a little push, in a matter of hours you could be holding your baby in your arms.
In most cases, the induction of labor results in a successful vaginal birth. If it fails, you may need to seek another induction or have a C-section. If you have a positive post-induction vaginal delivery, there may be no complications for future pregnancies. If the induction leads to a C-section, the health care provider will help you decide whether to seek a vaginal delivery with a subsequent pregnancy or to schedule a repeat C-section.