Your feet are swollen. You feel huge and miserable. You’re well past your due date, but your bundle of joy shows no sign of exiting the place it has called home for the last nine months. At least someone is comfortable.
If your doctor hasn’t already suggested inducing labour, the thought has probably crossed your mind. You may be not-so-silently screaming “Get this baby out!” And nothing would be better than having your baby safely delivered and your figure back, right?
A full-term pregnancy is considered a gestation of 38 to 39 weeks. If your pregnancy has gone over the 41-42 week mark, there is a good chance you will be offered an induction of labour.
An estimated one in five women will have their labour started artificially. In some cases it is absolutely necessary, but there is some debate over when and how it should be done. Here are some questions to ask your doctor before getting into that operating room. You should be fully informed before making any decision that will affect the health of your baby.
7 Is It Safe to Induce Labour?
Labour induction involves the artificial start of the birth process through medical or non-medical interventions.It can be done very safely and in some cases is absolutely necessary. Women are often wary of having their labour induced because of complications that could arise and out of a fear of an increased risk of having a Caesarean section for first-time moms.
Doctors should weigh the pros and cons with you when deciding to safely induce labour artificially. And remember that the baby’s health and yours are always the main concern.
You want some pros and cons, don’t you?
When considering safety and grappling with decisions, most of us really just want to weigh pros and cons. In terms of labor induction, much of the pros and cons depend upon how far along you are and what is motivating your interest in induction. The obvious benefit of a planned delivery is alluring, but is that convenience enough to outweigh a potentially more painful delivery (you’ll see what I mean when you read about Pitocin further below)?
Of course, if there is a medical reason to induce -- such as baby no longer thriving in the womb -- baby’s safe delivery should outweigh any discomfort that may accompany induced labor.
Furthermore, there’s no reason to think of only pharmaceutical and medical treatments when considering induced labor. You might be more comfortable trying out a natural or “home” form of induction first. These, of course, also come with risks. Research what you’re considering and don’t overlook discussing with your doctor what might even seem like a minor step to inducing labor.
6 Why Is Labour Being Induced?
There is a difference between elective induction and emergency induction.Elected induction occurs when you and your doctor/midwife decide together that delivery should happen. More often than not, this is because you are 10 days past your due date and there is more risk to the fetus if you stay pregnant for too long. Also, your cervix may not be considered ripe enough for birth.
Elective surgery will likely not happen because you want your baby born on a specific day or you have grown tired of being uncomfortable during your pregnancy.Sorry gals, it just doesn’t work like that. Comfort level takes a back seat when it comes to health and safety. At this point in your pregnancy, your comfort probably doesn’t even remember what the front seat looks like!
When There Is an Emergency
Labour is likely to be induced when medical complications arise. Some of these emergency situations could be:
- Hypertension, preeclampsia
- Your baby is not thriving
- Heart disease
- Bleeding during pregnancy
- Gestational diabetes
- The amniotic sac has ruptured and the delivery has not happened within 24-48 hours
- A uterine infection, or you tested positive for the Group B Streptococcus Bacteria (GBS)
- Severe fetal growth restriction
These are all considered medical emergencies where labour induction is absolutely necessary.
5 What Medical Methods Are Used to Induce Labour?
There are many ways to induce labour. Here are some of the methods doctors commonly use in a hospital setting.
A tablet or gel containing a hormone-like substance called prostaglandin is inserted into the vagina in order to “ripen” the cervix and start contractions. A ripe cervix is softer and becomes more vascular, allowing it to stretch and dilate. As we know, it’ll have to do a lot of stretching to accommodate the size of a baby’s head. A lot of stretching.
Doctors will encourage you to take a walk while you wait for the prostaglandin to work. You may even be able to go home and wait it out there. This may be more comfortable than walking up and down the halls of the hospital.Side effects are minimal and include nausea, fever, and vaginal soreness. You’ll have to contact your doctor if you have not started contractions within six hours.
Another alternative is to take the prostaglandin in a pessary form. A pessary is a removable device placed into the vagina. With this method, you will have to inform your doctor if contractions do not start after 24 hours.
Artificial Rupture of Membranes (ARM)
If your cervix is dilated but your water hasn’t broken yet, this method will be used by your physician if they see the labour is not progressing. Your doctor will make a small break in the membranes surrounding your baby using a long, thin instrument that resembles a crochet hook. Yes, it’s as uncomfortable as it sounds. Good thing it’s quick.
If your amniotic sac is still going strong, your practitioner can get labour started by swiping her finger across the membranes that connect the amniotic sac. This causes the uterus to release natural prostaglandin, which helps the cervix ripen and contractions to begin.
4 Do I have the Right to Refuse Induction?
This is your body and you absolutely have the right to refuse induction in favour of natural labour. No one can force you to do something you are not comfortable with. But keep in mind your reasons for doing so. Is it fear? Is it lack of education about induction and why it is being suggested?
Arm yourself with the proper knowledge about your health and your baby’s health before making such a crucial decision. If you decide to let your pregnancy continue past 42 weeks, be sure to report to your medical facility for careful monitoring until nature takes its course. This may include an ultrasound or two.
Consider that your doctor probably suggested induction for a reason. You don’t have to comply with the suggestion, but remember to take it seriously when grappling with these decisions.
3 What Happens if You Don’t Go Into Labour?
Your labour has been induced. You’re over-the-moon excited to meet your little one, but nothing seems to be happening. Where are the contractions? Wasn’t this supposed to be painful? If some of the measures your doctor has taken, such as membrane stripping, rupturing the membrane, and prostaglandin fail, your doctor may recommend Pitocin.
What is Pitocin anyways?
This synthetic form of the drug oxytocin will be offered to help the labour progress if all other options fail. Oxytocin helps the uterus contract. This will be offered through an IV drip and is started at a low dose. It will be increased every 30 minutes, until contractions come every 2 to 3 minutes for a minute or more. The dose can also be increased.
The contractions Pitocin brings on are often more intense than natural ones. If you are considering an epidural, ask about getting it started so it’s in place when the drug fully kicks in.
Is it safe?
Some women have concerns over whether the use of Pitocin is safe. Studies show that if Pitocin is used properly, it is generally safe for babies. If used incorrectly, it can cause hyper-stimulation, which brings on a strong “mother” contraction.This can affect the fetal heart rate (fetal distress). In rare cases, this strong contraction can lead to a tearing of the uterus. Again, these are rare cases.
2 Is an Episiotomy More Likely?
An episiotomy is a small cut made in the tissue between the vagina and anus. This is done to widen the vagina’s opening so the baby can be delivered with more ease.The theory behind it is surgical tearing is better than natural tearing, which can take longer to heal and be more painful. On the flip side, you will require stitches afterwards with an episiotomy and it can make sitting quite uncomfortable in the days following your delivery. Ouch.
Women with labour inductions may be more likely to have assisted delivery, which includes an episiotomy. This is particularly true if Pitocin is used, because the contractions tend to come on faster and harder. If time allows, discuss this option with your doctor prior to giving birth.
1 Will My Induction Result in a C-Section?
Having a baby by Caesarean section is a not a subject to be taken lightly. It’s major abdominal surgery that comes with its own set of risks, including potential bladder and bowel injury and risk of excessive blood loss. Yet, having a C-section is more common than ever before. Canada’s C-section rate has risen dramatically in the last two decades, from 17% of all births in 1995 to nearly 29% in 2011/2012.
Why is this?
This increase could be driven by the fact that women are having children later in life, ladies are having bigger babies than deemed safe to deliver vaginally, and other obstetric complications.
But does a labour induction automatically mean you will have a C-Section? Not necessarily. There is some evidence to support induced labour may actually lower your risk of having the dreaded C-section, although more studies need to be done to fully confirm this theory. And at the end of the day, having a C-section could save your life and the life of your baby.
Induction of labour can be a scary thought for expectant moms. Be sure to discuss your options with your doctor, so if the time arrives, you can feel comfortable with any decisions made.