Approximately one third of women have an induction of labour. An induction of labour involves your Doctor or Midwife encouraging the process of labour to start artificially before your body starts labour naturally.
***Key Points***
During your pregnancy appointments your midwife or doctor will be monitoring you and your baby to make sure you are well and your baby is well and growing as expected.
If there is something that indicates concerns for you or your baby, they may suggest induction of labour.
That may involve the insertion of a hormone or catheter into your cervix, breaking your waters, or starting a hormone drip – it is usually a combination of these interventions.
There are risks with these procedures, make sure you are informed and ask lots of questions before you make your decision.
***Key Points***
***Reasons an induction may be suggested***
If your doctor is recommending induction of labour ask questions to ensure you understand why they they are suggesting it.
It might be because they consider you to be ‘overdue’ or past 41 weeks of pregnancy, or you have high blood pressure or other illness or concerns about you. There might be concerns about your baby or that the placenta is not functioning as expected or if your baby is not moving normally for your baby. If your waters have broken but contractions have not started this may also be a reason for an induction of labour.
The most common reasons for an induction of labour are:
- Pregnancy has gone on longer than 41 weeks without signs of spontaneous labour
- Waters have broken bu labour has not started naturally
- Baby is not well, not moving normally or growing well
- Mother is unwell or has specific medical conditions.
Some women may not want to be induced because they have reached 41 weeks of pregnancy, especially if there are no signs that the baby is unwell, speak to your Midwife and Obstetrician about your choice.
These may include
- Monitoring you baby via a CTG to check the baby’s heart beat
- An ultrasound to check that the blood flow to and from the placenta is functioning properly, providing oxygen to the baby and taking waste products away and to check the amniotic fluid levels are within the normal range.
If no abnormalities are found, you can discuss with your doctor the option to delay the induction for a few days.
***Reasons an induction may be suggested***
***How is labour induced?***
Usually the first thing the doctor will do is to do a vaginal examination to check your cervix, they are trying to feel whether it is opening, if it is firm or soft or thinning out. Depending on the findings most women will need a combination of these steps to induce labour.
- A prostaglandin
- A balloon catheter
- Artificially breaking your waters
- A synthetic oxytocin drip
***How is labour induced?***
***The experience for you***
The method of induction will depend on how ready your cervix is for labour to begin.
A prostoglandin is a gel or tablet that is inserted into your vagina to soften the cervix. You will usually need to lie down for around 30 minutes and the have your baby’s heart rate monitored and most likely stay in hospital now until labour begins. You may feel
- Mild cramping sensations
- vaginal soreness
- a small number of women feel nauseas or experience diarrhoea or vomiting
- Very occasionally the prostaglandin gel may stimulate the uterus to contract strongly too quickly. This can be treated with further medication to assist the uterus to relax
A balloon catheter is an alternative option to help prepare the cervix for labour. This involves a thin rubber tube called a catheter with a balloon on the end being inserted into your cervix. the balloon is inflated with a small amount of water and applies gentle pressure to your cervix.
The next step during an induction of labour is to
Break your waters, this is usually done with you lying down, the Midwife or Doctor will place a small instrument inside your vagina and through the cervix, to break the bag of water surrounding your baby. This may be uncomfortable during the examination. You will usually experience a gush or trickle of fluid once the bag of forewater has been punctured.
After that is done the Midwife will start an intravenous drip with a hormone called syntocinon. This will start your uterus contracting. A pump will control the amount of medication you are given. They start on a low dose, then increase the amount of medication every 30 minutes until you are experiencing a pattern of contractions that are about three or four in a ten-minute period lasting about one minute, making sure there is enough rest in between each contraction. They will need to monitor your baby’s heart-rate continuously with a CTG (cardiotocograph) throughout your labour when you are being induced. That means you may not be able to move around as much as you would like as you will have a IV drip and are attached to a CTG machine.
When you have the syntocinon drip, they will also start some plain intravenous fluids. The midwife will closely monitor the intravenous fluid and medication, as well as your baby’s heart-rate and your observations [such as pulse, blood pressure and contraction pattern] will be regularly observed. The doctor or midwife caring for you may also want to perform a vaginal examination every four hours or so to check to see that your cervix is opening.
Because your body is not naturally going into labour, it can be more painful than natural labour and some women ask for pain relief more quickly than if they weren’t being induced. If you have an epidural, it might stop you from feeling the sensations of your body and you might need some help to get the baby out. The doctor may need to use forceps or a vacuum. If you have an epidural you will most likely be confined to the bed, however you can still change positions using the functions of the bed to support you. Your midwife should be able to help with position changes.
***The experience for you***
***The risks of an induction of labour***
For some women, an induction does not result in labour starting and you need to have a caesarean.
You are at a higher risk of your uterus being over stimulated from the synthetic hormones used during an induction. There are risks to the baby including a lack of oxygen due to the strength and frequency of the contractions. Talk to your care provider for risks specific to you and your baby. It is always important to balance the risks and benefits of an induction of labour and make a decision in collaboration with your doctor or midwife
***The risks of an induction of labour***
References
Pregnancy Birth Baby – induced labour
Pregnancy Birth Baby – induced labour what are your options?
