Jordan Ellis
Inducing labour is a process that may be recommended when there are concerns about the health of the mother or the baby. It can also be recommended if labour has not started naturally. Typically, induction is not performed before 39 weeks of pregnancy unless there is a medical reason to do so. Inductions can be scheduled in advance, but labour may take many hours to start after induction and can progress slowly at first. If the induction is not successful, you may be sent home to try again later, or your doctor may recommend a C-section.
| Characteristics | Values |
|---|---|
| Induction methods | Membrane sweep, pessary, hormone drip, medication, amniotomy |
| When to induce labour | After 34 weeks, preferably after 39 weeks |
| Induction duration | Could take hours to days to begin active labour |
| Induction pain | More painful than natural labour |
| Pain relief options | All options available, including epidural, water birth, pain medication |
| Induction risks | Assisted delivery, forceps, ventouse suction, C-section |
| Induction preparation | Pack hospital bag, eat and drink as normal |
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What You'll Learn
Induction methods
Before inducing labour, the provider will examine the cervix to see how "ripe" it is. If the cervix is hard and closed, the first step in inducing labour is to ripen the cervix. If the cervix is already starting to ripen, it could change how the provider approaches induction.
There are several methods for inducing labour. One method is to break the water and give Pitocin in an IV. Another method is a membrane sweep, which typically happens late in pregnancy as a first attempt to jumpstart labour. A third method is a pessary. A fourth method is a hormone drip. A fifth method is oxytocin, which can induce contractions more quickly, within 30 minutes. Doctors usually do not use this until after trying other methods.
Inducing labour can have some risks, which depend on the method chosen by the healthcare provider. One risk is that the induction won't work to trigger labour. Another risk is receiving too much oxytocin too quickly, which may overstimulate the uterus, causing it to contract too frequently. This overstimulation can lead to complications, including problems with the umbilical cord and the fetus's heart rate.
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Length of stay
The length of stay in the hospital after being induced varies from person to person. Typically, induced labour could be faster, shorter, or the same length as the average spontaneous (non-induced) labour. In some cases, you could deliver your baby on the same day as your labour induction, or it could be the next day, depending on how your body responds to the medication and how long your labour takes.
Induction of labour is usually recommended when there are concerns about the health of the mother or the fetus. It may also be recommended if labour has not started naturally. Inductions are not usually performed before 39 weeks of pregnancy unless medically necessary. Inductions before 39 weeks may be recommended if the health of the mother or fetus is at risk. In the case of a failed induction, you may be sent home and advised to schedule another appointment to try induction again. If the mother and fetus are not doing well after the attempted induction, a cesarean delivery may be required.
If your waters break after 34 weeks, you will have the option of induction or expectant management. Expectant management involves healthcare professionals monitoring the condition of the mother and the baby, allowing the pregnancy to progress naturally as long as it is safe for both. If your baby is born before 37 weeks, they may be vulnerable to problems related to being premature.
Induction of labour is carried out using medications or other methods to start contractions of the uterus for a vaginal birth. These methods include a membrane sweep, pessary, or hormone drip.
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Pain relief options
NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) are a common treatment for acute pain. They relieve pain and reduce inflammation. Common NSAIDs include Aspirin (Bayer, St. Joseph) and ibuprofen. Ketorolac is another NSAID that has been shown to have more analgesic power than oral ibuprofen, although it can cause significant bleeding after some surgical procedures.
Opioids
Opioids are prescription medications that bind to receptors in the brain and body to reduce pain signals. They are powerful medications that can be addictive and habit-forming, leading to opioid use disorder. Due to these risks, healthcare providers are prescribing opioids less often and in smaller doses. Some opioids include morphine and meperidine, with the former being suggested over the latter due to its lower toxicity and greater efficacy.
Periosteal Block
This method involves blocking the opioid receptors in the periosteum, which can have an analgesic effect. A study by Tageldin et al. showed that this method could be more effective than other analgesic techniques, resulting in a shorter hospital stay and greater patient satisfaction.
In addition to medication, there are complementary approaches to pain management, including relaxation techniques, meditation, movement therapies, acupuncture, and massage. These techniques can provide relief from acute pain during and after procedures, as well as some forms of chronic pain.
It is important to note that pain management is not just about keeping patients comfortable, but also aiding their recovery. Proper pain management can help reduce the risk of complications and speed up healing.
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Induction risks
Induction is usually recommended if the mother has a health condition like gestational diabetes, high blood pressure, preeclampsia, or intrahepatic cholestasis of pregnancy. It may also be recommended if there is a placental abruption, or if there is an infection in the uterus. Induction may also be considered if the mother lives far from the hospital and had a rapid delivery with a previous birth.
While induction can help lower the risk of complications from certain medical conditions, it does carry some risks. For example, induction may not always be successful, and labour may not start. If the mother's waters are broken and labour does not start or progress quickly enough, an emergency C-section may be required to prevent infection. Induction may also increase the likelihood of an assisted delivery, where forceps or ventouse suction are used to help the baby out.
In some cases, induction methods can cause the uterus to contract too frequently, which may lead to complications with the umbilical cord and the foetus's heart rate. This may also increase the risk of a C-section.
It is important to note that the decision to induce labour is made after carefully weighing the risks and benefits by healthcare professionals. Induction is recommended when the benefits are considered to outweigh the risks.
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Preparing for induction
Know the Reasons for Induction
Doctors may recommend labour induction for various reasons. It could be due to medical conditions such as diabetes, high blood pressure, or intrahepatic cholestasis of pregnancy. Additionally, if your waters break after 34 weeks, you may choose induction or expectant management, where healthcare professionals monitor your condition and your baby's wellbeing. Your doctor will discuss the benefits and risks of induction and explain the steps involved.
Understand the Process
Induction of labour is a process where a midwife or doctor uses methods such as membrane sweep, pessary, or hormone drip to start labour artificially. One common method is a membrane sweep, where the doctor gently separates the amniotic sac from the cervix to encourage the production of prostaglandin, a hormone that prepares the cervix for birth. Labour induction can take time, and you may need more than one method to successfully induce labour.
Prepare Your Hospital Bag
Pack your hospital bag as you would for natural labour. Include essential items such as your ID, phone charger, and health insurance information. Don't forget to pack some entertainment, like a music player or a tablet, as labour induction can take many hours, and you'll want to keep yourself occupied. You may also want to bring items to create a calm and relaxing environment, such as electronic candles or twinkle lights, to make your hospital room more comfortable.
Have a Support System
Consider having a support team or a birth partner during the induction. They can provide emotional support, help you with decision-making, and assist with physical comfort measures like back massages. It's always helpful to have someone by your side during this process.
Stay Calm and Relaxed
The idea of induction can be anxiety-inducing, but remember that millions of mothers go through successful inductions every year. Take time to relax and breathe. Go for a walk, practise deep breathing, and remind yourself that you are capable and well-prepared. A calm mindset can help create a positive and joyful birth experience.
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Frequently asked questions
If your labour does not progress after induction, and you and your baby are doing well, you may be sent home. You can then schedule another appointment to try induction again. If your labour starts, you should go back to the hospital. If you or your baby are not doing well, a cesarean delivery may be required.
If the induction doesn't work, you will have to return to the hospital to try induction again or wait for spontaneous labour. Your doctor may also recommend a C-section.
Labour induction may take a while to work, so you should expect to stay in the hospital for at least 24 hours. After the induction, you could deliver your baby on the same day or the next day, depending on how your labour progresses.
