Induction: What to Expect

The majority of labours begin naturally, but some women are given a helping hand in kick-starting labour. There are a few different methods of induction, and procedures vary between hospitals. Speak to your healthcare provider to find out more about induction procedures in your area.

Why might induction be necessary?
This will vary between hospitals, between healthcare providers, and even between patients, but some possible reasons for induction include:

  • being overdue – some hospitals like to induce from week 41, and others wait until week 42
  • diabetes – if you have been diagnosed with diabetes, you are likely to be offered early induction to reduce the risk of labour complications
  • your waters have broken but labour hasn’t started – if labour hasn’t started 24 hours after your waters broke, your healthcare provider may want to talk about induction to prevent the risk of infection
  • pre-eclampsia and other medical conditions – if you have been diagnosed with a condition that endangers you or your baby, your healthcare provider may wish to induce labour early
  • if fetal growth problems are detected – if a growth scan shows that your baby has stopped growing, your healthcare provider may wish to opt for induction

How is labour induced?
Induction methods vary between hospitals, and may depend on your individual circumstances. Possible induction methods include:

  • prostaglandin – this hormone causes the cervix to soften during labour. A pessary or tablet of prostaglandin will be placed into your vagina. If after six hours your contractions have not started, you may be offered another pessary or tablet.
  • synthetic oxytocin  – if prostaglandin has not kick started labour, you will be offered synthetic oxytocin through an intravenous drip. Your waters will be broken before the drip is administered. Synthetic oxytocin causes more powerful contractions than natural labour, and your baby will be monitored throughout to check for signs of distress.

What does induced labour feel like?
Induced labour is said to be more painful than natural labour, this is because the contractions are more powerful. You will have access to pain relief during labour, so make sure you discuss your options with your healthcare provider in advance.

What if I don’t want to be induced?
There are times when induction is necessary to save a life. If, for example, you have developed pre-eclampsia, induction is the best option to protect both you and your baby. However, if you feel that you are being offered induction unnecessarily, speak to your healthcare provider. Your healthcare provider will want to inform you of the risks, but you are well within your rights to request more information and question the need for induction.

Is your labour being induced? Have you been through an induced labor and have tips to share?

Written by Fiona, proud owner of a toddler, @fiona_peacock

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

Induction Basics

You have passed your due date, and your doctor suggests getting your labor started. Or maybe your water has broken but contractions haven’t begun on their own. Perhaps you or your baby have a complication that necessitates birth sooner rather than later, and your healthcare provider suggests induction.

While the medical technology to bring about labor is exciting, it’s also a little scary if you’re not sure what’s about to happen. Here’s a quick primer on induction basics to help you start your learning:

How is labor induced?

Induction is most often done in the hospital so you and your baby can be monitored for any complications. The most common means of induction are:

– Stripping the membranes: During a vaginal exam, your healthcare provider will push the amniotic sac away from the cervix in an attempt to release hormones to start labor. This is often done during an office visit rather than in the hospital, and it is the least effective means of starting labor. You may experience some cramping and light bleeding afterwards.

– Breaking your water: Artificial Rupture of the Membranes (AROM) is done with a crochet-like hook inserted then removed during a vaginal exam in order to put a hole in the amniotic sac. You would need to be a bit dilated for this procedure to be done. The thought is that without the cushion of fluid, your baby’s head will put pressure on the cervix and stimulate the release of hormones to start labor. AROM is better at stimulating a labor that has slowed than it is at starting a labor from scratch. This can be a long, drawn-out process if your body isn’t quite ready for labor to start, and often leads to  additional interventions, such as continuous fetal monitoring.

– Prostaglandins: Prostaglandins are produced naturally in your body and cause the cervix to soften before labor begins. A synthetic form of the substance can be placed near the cervix or taken orally in pill form.

– Pitocin / Syntocinon: Oxytocin is the hormone of labor that causes the uterine muscle to contract and release, thus opening and thinning the cervix so the baby can be born. A synthetic form of this hormone is often used intravenously to bring on labor contractions (and needs to be done in the hospital). It requires that a mom have an IV line started and often continuous fetal monitoring performed, which may limit her options as far as natural comfort measures. The amount of the drug can be adjusted depending on contraction strength – if contractions remain weak, levels will be increased gradually, and if contractions are too strong, levels can be decreased for your comfort and safety. A woman is much more likely to use pain medication with this type of induction.

Are there any natural ways to start labor?

While not fool-proof, some women decide to avoid the medical induction (therefore limiting the associated interventions) by trying natural means of getting labor started. Some of these might include:

– Sex – orgasm releases oxytocin and semen is full of prostaglandins, though this method only works if your body is already primed for labor to start

– Nipple stimulation – releases oxytocin, can be done manually or with a breast pump, but often needs to be done over a long period of time

– Acupuncture / Acupressure – these methods of Traditional Chinese Medicine have been used successfully for thousands of years to start labor

– Herbs – these are like medications so check with your provider first and work with an herbalist, homeopathic specialist or naturopath to ensure you are using them correctly, some typical ones are evening primrose oil, black cohosh, and raspberry leaf

As with any proposed intervention, ask questions until you feel comfortable making an informed decision about whether or not to consent to induction. Ask about the risks and benefits, the alternatives, and urgency of the situation. Ask how it will be performed, and what will happen if the first method doesn’t get labor going. The answers to these questions, along with the induction basics above, will help you feel confident making the right decision for you and your baby.

Written by Michelle: IBCLC, writer, editor, childbirth instructor, and mother to 4 busy kids

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.