Induced Labor

Bayo Ajibola

Labor is termed as induced when it doesn’t begin naturally on its own. This usually happens when a doctor has a credible medical reason to artificially kick-start labor and is aimed at keeping the baby safe and healthy. Letting nature take its course may be a great idea but sometimes the body may need a little push for the sake of the baby.

You may be offered an induction if:

  • Your waters break but labor is taking time to kick in. You will be offered an induction after 24 hours because you and your baby are at risk of an infection at this point.
  • You are past 41 weeks and no sign of labor. This may depend on hospital policy though.
  • You have a condition, chronic or acute, that puts you or your baby at risk. This includes kidney disease, pre-eclampsia and any other that the doctor may point out.
  • You suffer from diabetes. There is a chance that your baby will be bigger than normal. Upon investigation, if the baby is growing normally then the doctor may recommend an induction after 38 weeks and if the baby is big the doctor may prescribe a C-section.
  • You are 40 or above. This age group comes with a higher rate of stillbirth and induction at 39 to 40 weeks may reduce this risk.

Some women want an induction because they may want the timelines to coincide with something, say the arrival of their partner. Others may opt for one if they previously had a stillbirth and are worried about it happening again.

Induction largely depends on your body and whether it’s ready for labor. Doctors may offer it to you but you have the option to ask questions and even refuse. Talk it through with your partner and clear all the doubts you may have with the doctor before you agree to it.

How labor is induced

There are a number of different options for induction. Some are medical and some aren’t but have medical backing so, don’t worry about it.

Membrane sweep

This is done by passing a finger around the opening of your cervix. Sweeps are done at term and are unadvisable if your waters have already broken due to the risk of infection.

The purpose of a membrane sweep is to stimulate the production of prostaglandin and this may set labor in motion. The midwife or doctor tries to separate the membranes (the sac holding the amniotic fluid around the baby) from the cervix. If you are not dilated enough for a sweep, the doctor may massage or stretch your cervix instead.

You may have several membrane sweeps before labor begins and it may be uncomfortable or even painful having them. You may feel some cramps and have some bleeding but this is expected. If you feel you don’t want a sweep let your midwife know.

Prostaglandin

This is a hormone-like substance that acts by ripening your cervix. The doctor will check your Bishop score and baby’s heartbeat first before administering it.

It comes in form of a gel, tablet or pessary and is inserted into the vagina. You can take a walk as you wait for it to take effect or even go home, depending on why you’re being induced. You may feel a little nauseous, feverish or have diarrhea and your vagina may feel a little sore. There’s a chance of overstimulation and this may be stressful for the baby due to the frequent, long and intense contractions that come with it. Doctors can however reverse overstimulation.

Artificial Rupture of Membranes

Also known as ARM or breaking the waters, this is done using a glove with a pricked end or a long thin probe. The doctor manually makes a break in the membranes. It may not get labor started so it is usually done after labor has already begun.

Syntocinon

This is the synthetic form of oxytocin. This is offered when all the above haven’t worked or labor has already begun but isn’t progressing. It is administered through an intravenous drip.

The contractions are more intense than natural ones so you will be offered some pain relief.

The method used will depend on how ready your cervix is. Make a point of going through the pain-relief options with your doctor before you get into labor because chances are you will need them with induction.


Bayo Ajibola

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