Nature guides most aspects of pregnancy, but sometimes she needs a little nudge to get labour going. If your midwife or obstetrician is recommending an induction for you, there are some things you should know.
Here’s what they are and why the intervention isn’t for everyone.
What is labour induction?
Also known as inducing labour, an induction is the medical term used when labour is started by artificial means.
Why would I get one?
Nature typically prepares your body for the birth of your baby in the best way. However if your pregnancy continues two weeks past your due date or your doctor is concerned for you or your baby’s health, inducing labour might be recommended for you.
Reasons for this may include:
- You are nearing 42 weeks pregnant. Being overdue is the most common reason for labour induction.
- Your pregnancy has gone full-term and your water has broken but labour hasn’t started. If you don’t go into labour in the next day or so, there’s an increased risk that you or your baby could develop an infection. In this instance, an induction is often offered 24 hours after your waters break. If you are less than 37 weeks pregnant though, your pregnancy care provider will talk to you about your options.
- You have an infection in your uterus.
- There isn’t enough amniotic fluid surrounding your baby.
- You have diabetes, a high blood pressure disorder or another medical condition such as kidney disease.
- You have a placental abruption, which is when the placenta peels away from the inner wall of the uterus before delivery and it’s safer to deliver your baby sooner rather than later.
Personal reasons for inducing labour
Sometimes there are also non-medical reasons why you may request an induction. For example, you live far away from the hospital and want to time your delivery to ensure you get medical care. You might also have a history of rapid deliveries, or you’ve suffered a previous stillbirth and want to try to avoid complications.
If you have a personal reason for wanting an induction, talk to your pregnancy care provider who will need to confirm your baby’s gestational age is at least 39 weeks. Delivering earlier than 39 weeks can pose health problems to your baby.
Types of induction
There are a few different ways your pregnancy care provider can get labour going for you. Which methods are best for you will depend on your individual case, so you’ll need to discuss the options with them.
Here are some you may be offered:
- Membrane sweep – also known a ‘cervical sweep’, this is where your midwife sweeps your cervix with her finger. This causes the membranes or the amniotic sac surrounding your baby to separate from your cervix and release hormones called ‘prostaglandins’ which can kick-start labour. The procedure doesn’t hurt but may cause discomfort and bleeding.
- Prostaglandin – this is synthetic hormone that causes your cervix to ripen, and may stimulate contractions. It can be in a pessary form (it looks like a tampon), a tablet or a gel, and it is inserted into your vagina. The slow-release pessary usually takes half an hour to absorb so you’ll need to lie on your side for about 30 minutes, after which you can move about. Depending on why you’re being induced you may be able to go home before your contractions start. If you’ve had no contractions after 6 hours though, you may be offered another tablet or gel. A controlled-release pessary can take up to 24 hours to work and if all seems well with you and your baby, it may be up to 24 hours before you’re offered another dose.
- Balloon catheter – if prostaglandins are not recommended for you, then you may be offered what’s called a Foley’s catheter. This is a flexible tube with a balloon on the end that is inserted into your cervix. The balloon is then inflated with water when in position, to put pressure on your cervix – just as a baby’s head does. This should soften and open the cervix. You’ll need to stay in hospital so your midwife can monitor you and your baby, and readjust the catheter as your cervix dilates to maintain the pressure. The balloon catheter may help to start your labour on its own, or you may be offered additional induction methods.
- Breaking the waters – this is where your midwife or doctor breaks your waters to start off labour. A thin probe, a medical glove with a pricked end on one of the fingers, or forceps are used. This doesn’t always start labour so once your waters have been broken you may be given a Syntocinon drip (see below).
- Hormone drip – also called a Syntocinon drip, this is where a synthetic version of the labour-inducing hormone, oxytocin, is given to you intravenously. You may be offered one if a membrane sweep or the presence of Prostaglandin hasn’t started labour, or if you’re having contractions but your labour isn’t progressing. It can sometimes take 24 to 48 hours for a hormone drip to work.
What an induced labour feels like
It’s true that inducing labour usually makes it more painful. In fact women who are induced are more likely to ask for an epidural, according to studies. If you are needing to be induced though, know that your pain-relief options are not restricted by it. You will still have access to all the usual pain-relief options offered by your maternity unit.
What about the birth?
While you may go on to have a standard delivery, the statistics do indicate that an induced labour can increase the need for an assisted delivery, such as the use of forceps and suction to help the baby out.
Natural ways to induce labour
If you’re at the end of your pregnancy you may be looking at ways to bring on labour naturally. While there is no scientific evidence that natural ‘techniques’ such as having sex or eating certain foods work, you may want to give them a go. Other natural (unproven) methods include acupuncture, homeopathy, hot baths and certain exercises.
Having sex won’t cause harm, but you should avoid having sex if your waters have broken as there is an increased risk of infection. If you are heavily pregnant and feeling over it, know that the Australian Health and Welfare Institute cites that more than 35 percent of babies are born after 40 weeks gestation. So you are not alone! Hang in there.