Labor induction, also known as inducing labor, is the stimulation of uterine contractions during pregnancy before delivery starts on its own to achieve a vaginal birth.
For different reasons, a healthcare provider may prescribe labor induction, mainly when there is a concern for a mother’s health or a baby’s health.
The tenderness and distension of the cervix are among the most significant factors in predicting the probability of good labor induction (cervical ripening).
The advantages of labor induction usually outweigh the hazards. Understanding why and how labor induction is performed if you are pregnant will help you plan.
Reason for Labor Induction
In an ideal world, you can go into labor right on cue at the 40-week mark. However, the process often does not go as smoothly as expected, and the baby runs late.
For you and your baby, some medical complications can make an extended pregnancy risky, including:
- Development concerns in the baby
- Too little amniotic fluid surrounding the infant
- Gestational diabetes
- Elevated Blood Pressure
- Preeclampsia
- A uterine infection
- Separation of placentals from the uterus
- Rh incompatibility
If your amniotic sac (water) splits, but you haven’t started having contractions, your doctor may have to induce labor. Contractions are signs that labor has begun and the cervix has begun to open up (dilate).
A lack of contractions could indicate that your body, as it should, is not preparing for delivery. You might choose to induce labor if you live far from a hospital or you have a history of delivering fast.
After 42 weeks, inducing labor could be medically appropriate. The placenta can no longer give sufficient oxygen and nutrients to your baby at this stage.
One rationale for inducing labor is preeclampsia. During pregnancy, if you have blood pressure, delivering your baby early could minimize dangerous complications.
Risks
Labor induction carries different dangers, including:
- Unsuccessful induction: Approximately 75 percent of induced first-time mothers would have an excellent vaginal delivery. This means that a C-section may be required for about 25 percent of these women, who often start with an unripened cervix. Your healthcare professional will discuss the possibility of a C-section requirement with you.
- Low heart rate: Oxytocin or prostaglandin, the drugs used to induce labor, can cause irregular or prolonged contractions, which can reduce the supply of oxygen to your baby and lower the heart rate of your baby.
- Infection: Some labor induction techniques, such as rupturing the membranes, may increase the risk of infection for both mother and child. A prolonged rupture of the membrane raises the risk of disease.
- Uterine breakage: This is an uncommon but severe complication in which, from a previous C-section or major uterine operation, the uterus breaks open along the scar line. In sporadic cases, women who have never had prior uterine surgery can also experience a uterine rupture.
- Post-delivery bleeding: Labor induction raises the likelihood that after you give birth, the uterine muscles will not contract correctly (uterine atony). This may lead to significant bleeding after childbirth.
Labor induction is not ideal for everyone. It could not be an option if:
- You had a previous C-section with a traditional incision or major uterine operation
- Your cervix is blocked by the placenta (placenta previa)
- Your baby lies first (breech) or sideways buttocks (transverse lie)
- You have an active herpes infection of the genitals
- Before birth, the umbilical cord falls through your vagina (umbilical cord prolapse)
Your healthcare provider will avoid such drugs to minimize uterine rupture risk if you have had a previous C-section and have induced labor.
How to Induce Labor?
If your baby is behind schedule, there are some ways to speed up the process. Seeing your physician is the safest and most effective way.
Medicines or treatment methods can quickly bring labor to life. The other choice is attempting to induce labor on your own.
Chat with your doctor or midwife before you try something. Be sure that the procedure you are trying is safe and that your pregnancy is at the right moment to trigger it.
Certain foods have been touted to bring on contractions. A common labor inducer is one form of fruity tea in particular.
Medicine to Induce Labor
Two forms of drugs can trigger labor Induction. Drugs called prostaglandins soften the cervix to prepare it for delivery or “ripen” it.
These medications may be taken through the mouth or injected into your vagina as a suppository.
The next kind of treatment kick-starts contractions, and the most prevalent drug is Pitocin. You can get it via an IV. Your cervix needs to be ready for childbirth, or it won’t work with the medications.
Labor Induction Methods
The best way to get your labor started is not only with drugs. Two other choices are membrane stripping and splitting your water. These can be administered at your doctor’s office.
The amniotic sac is active in stripping the membranes. Your doctor will use his fingers to push the amniotic sac away from the cervix.
The doctor breaks open the amniotic sac with a little plastic hook to break up the water. In preparation for birth, your baby will then make its way towards the top of your cervix.
Typically, membrane stripping is considered safe. However, experts differ about whether this procedure is worth performing.
Natural Ways to Induce Labor
It would help if you tried inducing labor on your own for a more “natural” solution without medical intervention.
Studies have not checked whether these approaches work, so consult your doctor or midwife before trying any of them. Strolling is among the simplest and best ways for women to induce independent labor.
The gravity of your movements will enable the baby to slip into place. Although a walk may not speed up your delivery date, it’s generally good for you.
You can also have sex if you feel up to it. Semen contains hormones called prostaglandins, which contract the muscles of your uterus.
Your uterus would also be stimulated by having an orgasm yourself, a win-win. Acupuncture can also be attempted, and it functions as well as membrane stripping, and a doctor’s office visit could save you.
Exercises for Labor Induction
There is no proof becoming more active can induce physical labor. Nonetheless, exercise is good for your health and pregnancy. It decreases the risk of gestational diabetes and a C-section.
For most women, exercising during pregnancy is healthy. Even consulting your doctor before lacing up your shoes is smart. However, some conditions can mean that you should avoid exercise during pregnancy.
Pineapple to Induce Labor
Bromelain is an enzyme that breaks down proteins. It is found deep within the heart of a pineapple, making it a key ingredient in many meat tenderizers.
The idea behind the use of bromelain for labor induction is that tissue in your cervix will break down. The cervix gradually softens and ripens to prepare for childbirth.
Nevertheless, there’s no empirical proof that this hypothesis is valid. Bromelain might work well on meat, but it isn’t very active in the human body. Plus, pineapple could make heartburn worse in pregnancy.
Acupressure to Induce Labor
This procedure activates several points in the body’s energy pathway, such as acupuncture. The distinction lies in the application.
Acupressure activates these points using massage-like pressure instead of needles, and multiple pressure points across the body are believed to cause labor.
One lies just above your foot on the back of your shinbone, and another is in the middle of your palm.
Put pressure on one of these points for several seconds to perform acupressure on yourself. Then, massage the area. Acupressure may also make your labor less painful.
Induction at 39 Weeks
Although it’s typically better to let nature take its course if there’s an issue with your pregnancy or your infant, inducing labor might be a good idea. An induction could help you prevent a C-section if you’re well.
2018 researchers showed that women induced at 39 weeks are far less likely to need a C-section in their first pregnancy than those who waited. Complication rates between the two classes did not vary.
Check with your doctor if it feels right to induce at 39-week if:
- It’s your first pregnancy
- You are carrying just one infant
- You and your child are healthy
C-sections, inducing complications such as bleeding and infection, may be dangerous. While they may be appropriate in some situations, these surgical deliveries may cause further complications with potential pregnancies.
Labor Induction Process
The labor would be triggered in a hospital or a birthing center. The process can vary based on which procedure the doctor uses to induce labor. Physicians often use a mixture of approaches.
Depending on the strategies your doctor tries, it can take anywhere from some hours to several days for your labor to begin. Induction can lead to a vaginal delivery most of the time.
You may need to try again or have a C-section if it does not work.
What to Expect During Labor Induction?
What you should expect depends on the induction method:
- Prostaglandins arrive as a suppository that goes through your vagina. The drug could induce labor after a few hours.
- You can get Pitocin via an IV. This chemical causes contractions and helps speed the process of labor.
- The doctor will put a plastic hook inside your vagina to open up the sac during the amniotic sac’s rupture. As the sac splits, you can feel a warm rush of water. Your body’s prostaglandin production rises when water breaks, triggering your contractions.
The hospital staff will control your contractions to see how your labor goes. The pulse of your baby is tracked as well.
Side Effects of Labor Induction
The medications and procedures used to induce labor in both you and your baby can cause side effects. Pitocin and other drugs that ripen your cervix can worsen your contractions, making them come closer and closer together.
More frequent contractions can be more painful for you, and quicker contractions can also impact your infant’s heart rate.
If your contractions come too soon, your doctor might stop giving you the medication. Puncturing the amniotic sac in front of your baby can cause the umbilical cord to slip out of your vagina.
This is known as prolapsing. Pressure on the cord can restrict the supply of oxygen and nutrients to your infant.
After rupturing your amniotic sac, labor needs to begin between 6 to 12 hours. Not going into labor within that period raises both you and your baby’s chance of infection.
Bishop Score for Induction
The Bishop score is a method used by your doctor to determine how fast you’re going to deliver and whether to induce labor.
It is named after the obstetrician Edward Bishop, who invented the system in 1964. Your doctor will determine the score based on the physical examination and ultrasound results.
The score is based on variables such as:
- How much farther your cervix has opened (dilated)?
- How stiff is your cervix(effacement)?
- The softness of your cervix
- Where is your baby’s head in the birth canal? (fetal station)
A score of 8 or higher means you’re close to beginning labor, which should work well for induction. With a lower ranking, the chances of good induction go down.
Induction Vs. Labor That Isn’t Induced
Induction uses drugs or medical techniques to begin labor. Natural labor happens on its own. The duration of delivery that takes place without medical attention varies.
A few women can deliver within some hours of their first contractions. Others have several days to wait until they’re able to deliver. When you naturally go into labor, the muscles of your uterus begin to contract first.
Your cervix widens (dilates) and softens to prepare for your infant’s birth. Your cramps get worse during active labor and come more often.
Your cervix widens from 6cm to 10 cm to accommodate your infant’s head. Your baby is born at the end of this point.
What Does Labor Induction Sound Like?
What labor induction feels like is based on how your doctor induces your labor. Membrane stripping is slightly awkward. Afterward, expect some cramping. When the doctor breaks your amniotic sac, you’ll feel a slight tug.
There’ll be a stream of warm fluid after that. The use of medication to induce labor induces contractions that are stronger and quicker.
When you’re induced, you’re more likely to need an epidural than if you begin labor without induction.
Advantages of Waiting
If your baby’s well-being is at risk, the safest option is to wait for labor to come independently.
The greatest advantage of waiting for childbirth to start spontaneously is that it decreases the risk of induced labor complications.
Labor induced before 39 weeks for a good cause may lead to more complications than benefits.
But if your doctor induces labor for medical purposes, it could improve both your health and your baby’s health.
Before you decide to have an induction, consider all the benefits against your doctor’s risks. Get a second opinion if your physician pushes you because of scheduling problems.
Reference;
- Everything You Need to Know About Labor Induction – Healthline
- Labor Induction – Mayoclinic
