Inducing labor: Why are you being induced?
Normally, every pregnant woman should go into labor anytime between 37 and 42 weeks of pregnancy because it is during that period that the cervix softens and begins to open up causing contractions before your water “breaks”. When this process doesn’t happen at the anticipated time which is usually called the Expected delivery date (EDD), it is common for many pregnant women to start to get worried and anxious especially as the days continue to go further from the EDD.
Going through a waiting period for your baby to be born can be such a grueling process especially for first-time mothers who may not be able to cope with an extended period of pain, tiredness, and different symptoms while being pregnant and can’t wait to get done with the whole process already.
In quite a lot of cases, pregnant women who experience late pregnancy decide to go with inducing labor to have childbirth. In the UK for example, 1 in 5 women in labor every year are induced while in Australia, about 1 in every 3 women go through induced labor.
The choice of whether to have induced labor or not is yours but before you make that decision, here’s a concise guide about inducing labor.
What does it mean to induce labor?
Inducing labor refers to the use of artificial methods and procedures by a doctor or midwife to try and help a pregnant woman go into labor. Usually, this procedure is done to stimulate uterine contractions during pregnancy for the woman to go into labor and have childbirth instead of waiting for labor to start naturally.
It is in most cases best for labor to happen on its own but sometimes, it is required that a woman induces labor and with a recent study indicating that induced birth at 39 weeks may seemingly have a better outcome than waiting for labor naturally, more women are certainly becoming more open to the idea with the American College of Obstetricians and Gynecologists (ACOG) reporting that about 20% to 40% of labors are now being induced.
How does inducing labor work?
The decision on whether to induce labor cannot be taken in a hurry and has to be thoroughly thought about after understanding the procedure and possible risks involved. So how does it work?
Cervical ripening
A very important process for childbirth is the softening or opening of the cervix and in cases of induced labor, your doctor would need to artificially ripen your cervix if there is no sign of that happening to allow your baby to leave the uterus into the birth canal.
This is usually done by applying prostaglandins either as a drug or a vaginal suppository to your cervix. This should be enough to get your contractions started and your cervix would be monitored and checked after a couple of hours to ascertain that the cervix is ripening.
In the case where you have undergone a cesarean section or any other uterine surgery previously, it is not advisable to use prostaglandin to prevent rupturing of the uterus.
Membrane stripping
If your contractions have not begun but your cervix has been softened, your doctor (with gloves on) would insert a finger into your vagina through the cervix in a back-and-forth movement to separate the thin membrane that connects the amniotic sac; where the baby and the amniotic fluid is to the wall of the uterus. This causes the release of prostaglandin in the uterus which would trigger your contractions.
Rupturing the membrane
The release of prostaglandin should lead to your water breaking but if that doesn’t happen then your doctor can start your contractions by breaking the amniotic sac that surrounds the baby using a long crochet-like hook that has a sharp tip. This is referred to as an artificial rupturing of the membrane and labor should begin in a matter of hours.
Pitocin
Pitocin is a synthetic form of oxytocin that is usually given through IV if neither of the methods mentioned above brings regular contractions after some time, usually hours. Your contractions would be stronger and more regular than if it was naturally induced.
Inducing labor naturally
There are a few natural methods which although have not been verified medically have been said to be able to help induce labor. Some of these methods although may seem harmless have some side effects and that is why your doctor must be aware of any method you may decide to go with.
Exercise
Physical work would generally get your heart rate increased and exercise is a great way to get that to happen. While light exercise is safe for pregnant women, there is a medical experiment that proves that it can induce labor.
Acupuncture
This method has been around for years but even with medical trials, it still has no clear proof on how it induces labor. Many people still believe in its validity though with parts of Asia believing that it can be used to jumpstart the labor process by balancing your “chi”.
Castor oil
Castor oil is believed to stimulate prostaglandin release and is one of the very popular natural methods. Drinking it in small amounts has been said to be very productive in inducing labor although it causes diarrhea and dehydration.
Sex
Although sex can cause a release of oxytocin in the cervix which can trigger your contraction, it is not always advisable to have sex after your water has broken to avoid the risk of infection. Also, men secrete prostaglandin hormones in their semen and this can help ripen the cervix but no proof can start labor.
Nipple stimulation
Stimulation of your nipples causes the stimulation of oxytocin which can cause uterine contractions and helps the uterus to return to its original size post-delivery. Although it may cause contractions, it may also lead to prolonged and severe contractions that may be harmful to the mother.
Eating of date fruit
Some research has tended to the fact that eating 6 date fruits over 4 weeks before childbirth helps to ripen the cervix but for persons with gestational diabetes, it is not recommended.
Red Raspberry Leaf
The myth about the use of raspberry leaf in inducing labor is still unproven but it’s still common among women with some believing that it helps to shorten labor.
Reasons for inducing labor
We all want a perfect pregnancy process where everything goes smoothly according to plan but sometimes, there are some cases in which inducing labor may be the best option for you. Your doctor may recommend that you undergo this due to the following reasons:
You are overdue: if you are approaching two weeks after your expected due delivery date and you haven’t started your labor
- If you have a uterine infection (chorioamnionitis)
- Poor growth of your baby: when your baby has stopped growing at the expected rate
- Gestational Diabetes: if you develop diabetes during your pregnancy period
- Preeclampsia: if you have high blood pressure, it can lead to complications during childbirth
- Oligohydramnios: In a situation where there is not enough amniotic fluid surrounding the baby
- If there is a problem with your placenta: if your placenta separates partially or completely from the inner walls of your uterus
- Early breaking of your water: If your water breaks more than 24 hours before your contractions begin
- If you live far away from your hospital and have a history of delivering quickly (short labor) there is a concern that you may not be at the hospital in time for delivery and elective induction may be a necessary option.
Inducing labor risks
Some serious risks can arise in induced labor and that is why it is important to speak with your doctor, understand, and adequately weigh the options before deciding to go ahead.
Failed induction
Inducing labor is generally successful most of the time but there are some instances in which the process fails and this will lead to the woman needing a cesarean section to deliver the child. This sometimes happens if the cervix is ripe and as such the body is not ready.
Premature birth
Sometimes, inducing labor can cause your baby to be born preterm especially if you got the expected delivery date (EDD) wrong and this can lead to your baby having breathing, feeding problems, or even jaundice.
Fetal heart rate complications
The use of prostaglandin or oxytocin can cause excessive contractions which can affect the oxygen supply to your baby which would affect their heart rate.
Rupture of the uterine
If you have had a cesarean section previously, there is a high risk of uterine rupture when inducing labor.
Greater chance of infection
Rupturing of the membranes for a long time before contraction starts can lead to infection for the mother and the child. Another method of inducing labor will be required.
Excessive bleeding after delivery
There is also the risk of serious bleeding after childbirth in the case where your uterine muscles don’t connect properly after delivery.
Inducing labor prevention
Inducing labor is an artificial method to help a pregnant woman go into labor and have contractions. Preventing this would mean allowing your body to take the normal and natural process of pregnancy to childbirth. Not every woman’s body can undergo the process and not every woman should undergo the process except your doctor or midwife recommends that you undergo it after explaining the process to you. In the exception of cases where the health of the mother or child is at stake, inducing labor should be prevented.
Always ensure your doctor uses the Bishop score system to confirm factors such as how soft, thin, or dilated your cervix is and the fetal station of your baby to prevent inducing labor if not necessary. A low score usually indicates a low chance of a successful induction while a high score means a high chance of success.
Inducing labor FAQs
Is inducing labor always uncomfortable and painful?
Inducing labor is not the most pleasant process but is not always uncomfortable. The method carried out by your doctor determines to a great extent how the process would feel for you. The use of Pitocin usually brings stronger contractions and could be very unpleasant. You will more likely need an epidural when undergoing induced labor. Membrane stripping is equally slightly uncomfortable especially when the amniotic sac gets ruptured.
What is an epidural?
An epidural refers to a procedure where your nerve signals are blocked using a local anesthetic which is administered using a catheter that is run through a needle into the epidural space situated around the spinal cord. It is a type of pain relief that is used for women in labor or undergoing a cesarean section and is administered by an anesthetist.
Can herbal supplements trigger labor?
Herbal supplements have not been medically proven to trigger labor and it is not advisable to use any herbal supplements to induce labor. Always ensure that your doctor or midwife is aware before you try any method or herbal supplement to avoid causing harm to the baby and the mother.
Is elective induction always available?
Elective induction is not necessary for every scenario and although you can always request it, it is best to request it if your condition requires it. Conditions that may require elective induction include; if you live at a long distance from a nearby hospital, you have a history of short labor, you have high blood pressure.
Conclusion
It can understandably get frustrating having to wait for so long before you go into labor considering the pain and aches that will have built up over the weeks of the pregnancy but waiting is always the most preferred option except your health or that of your baby is in jeopardy. If not, then naturally induced labor saves the risk of complications that can arise from an artificial induction.
Remember to completely understand the process, pros, and cons with your doctor before making a finaldecision. Don’t be in a haste or feel pressured to make the decision on whether to induce labor or not. If you need to take some days to mull over the decision then take some days to think about it. Your final
decision should be communicated to your doctor and the method you want to go through. After waiting for such a long period, having to wait a while longer is a small sacrifice to pay compared to the risks that can be accrued from making a rushed and bad decision.