Reasons to Induce Labour
In most instances of labour induction, the mother-to-be has already reached full term (which begins in week 39 of pregnancy), and a variety of variables might influence the choice to induce labour. In general, if labour does not begin on its own by week 40, your doctor may consider induction.However, in rare cases, your doctor may induce labour even if your baby has not reached full term. In many cases, choosing not to induce labour might jeopardise the health of either the baby or the mother. These instances may include:
- High blood pressure
- Gestational Diabetes
- Slow infant development and low amniotic fluid levels
- A placental abruption
- Your water has ruptured, but contractions have not begun
How to Induce Labour?
There are two types of approaches for inducing labour: natural and medical. Having sex, eating hot foods, and getting acupuncture are some of the natural ways to reportedly accelerate labour at home, but there's no scientific proof that any of these methods work.When physicians believe it is genuinely time to deliver, they may explore a medical labour induction. These tactics are significantly more researched and dependable, and the method used may vary depending on several circumstances, including the baby's size, how dilated or effaced the cervix is, and whether the induction is an emergency or a normal one or around 39 weeks.
The Labour Induction Process
Before sending you to labour and delivery, your doctor may do a membrane sweep, provide prostaglandins, or place a trans-cervical Foley catheter. If that intervention fails, they may plan an induction, which involves being admitted to the hospital and receiving an intravenous dosage of Pitocin. However, in other cases, the outpatient procedure is completely avoided, and your doctor may request that you be at the hospital the night before your induction.It might take 12 to 48 hours to complete the induction process once you are brought to the hospital and given Pitocin. This may seem like a long time to labour, but induced labours aren't always longer than spontaneous ones.
Different Methods of Medical Induction
Medical professionals may suggest one or more of various ways for inducing labour. It depends on how soft your cervix is and if you're dilated or effaced.If your cervix is not effaced or dilated, your doctor may employ one of the following treatments to ripen it first:
Stripping the membranes
Your provider runs a gloved finger across the membranes that link the amniotic sac to your uterus. This action causes the release of naturally occurring molecules known as prostaglandins. These substances soften the cervix, allowing contractions to begin. This does not work for everyone, but it is a decent first step towards commencing labour.Prostaglandins
Prostaglandins are chemicals that function as hormones in the body. They help to soften and ripen the cervix. To induce labour, your provider may provide prostaglandins in the form of a tablet or a vaginal suppository. The two most often used prostaglandins for labour induction are misoprostol (Cytotec®) and dinoprostone (Cervidil®).Balloon catheter
Your doctor inserts a small tube with a balloon at the head into your cervix. They then fill the balloon with saline, causing it to inflate. This pressure might ripen your cervix and cause it to expand.Once your cervix has ripened, your doctor may propose the following procedures to boost the strength of your uterine contractions. Contractions help your baby go down the delivery canal.
Amniotomy
Your healthcare practitioner inserts a small, plastic hook into your cervix to rupture the amniotic sac. Your cervix must be partly dilated and effaced before this operation. This is not painful.Oxytocin
Oxytocin (Pitocin®) is a hormone in your body that produces contractions. Your physician may use synthetic oxytocin to initiate or accelerate labour contractions. Oxytocin is administered intravenously (via an IV).What Are the Natural Ways to Encourage Labour?
Your due date is an updated prediction about when your baby will arrive. While many parents birth perfectly healthy infants two weeks before or beyond the expected due date, it is suggested that people wait at least 39 weeks for delivery.Most of these remedies are anecdotal and lack substantial proof that they work, so always consult with your healthcare provider before trying them.
How can I encourage labour naturally?
1. Exercise
Exercise may include anything that raises the heart rate, such as a long walk. Even if this strategy does not work, it is an excellent way to reduce tension and prepare your body for the job ahead.According to research, beginning in week 38 of pregnancy, walking for 30 minutes three times a week at 4 kilometres (km) or 2.5 miles (m) per hour may help induce labour. It might also help to limit interventions during vaginal birth.
2. Sex
Though research has not uncovered proof that having sex causes the onset of labour; yet, there are several reasons why having sex might induce labour.Sexual activity, particularly an orgasm, may produce oxytocin, which may aid to stimulate uterine contractions.
Also, for pregnant women who have intercourse with males, prostaglandin hormones in sperm may help ripen the cervix.
Having intercourse is safe in the final weeks of pregnancy, but not after your water has burst. This may raise your risk of infection.
3. Nipple stimulation
Stimulating your nipples might induce your uterus to contract, which may result in labour.Nipple stimulation triggers oxytocin production. Oxytocin is the hormone that stimulates the uterus to contract and the breasts to release milk.
In fact, if you choose to breastfeed or chestfeed your baby immediately after birth, the same stimulation will help your uterus shrink back to its former size.
You or your spouse may manually stimulate your nipples or try using a breast pump.
According to research, breast stimulation may be an effective method for:
- Induce and enhance labour
- Avoid a medical induction
- Reduce rates of postpartum haemorrhage
However, it seems that the effectiveness is best after at least three days of breast stimulation.
4. Acupuncture
Acupuncture has been practiced for thousands of years. It's uncertain how acupuncture works. It may also cause changes in hormones or the neurological system.However, acupuncture should only be performed by a qualified acupuncturist.
According to research the primary advantage of acupuncture is greater cervical softening.
5. Acupressure
Some researchers claim that acupressure may induce labour. Before using acupressure on yourself, make sure you have sufficient knowledhe from a skilled acupressure specialist.However, there is little evidence that acupressure is beneficial in inducing labour. However, even if acupressure does not start your labour, it may be an effective approach to relieve pain and suffering.
6. Eating dates
Eating dates during the final weeks of pregnancy increases cervical ripening and dilation before labour, reducing the need for Pitocin during labour.While it is not safe to attempt to induce labour on your own using drugs or supplements. Some researchers believe that having intercourse or stimulating your nipples might induce labour. However, no research has shown this. If you're nervous about meeting your baby, speak to your physician. They may offer suggestions for things you may do to start the labour process.
Indications for Elective Induction
When labour induction is sought for no medical reason, it is termed an elective labour. This may occur for a number of reasons, including:- Location: Living far from a hospital or birthing centre
- History of quick delivery: Having a history of quick births or fears about not being at the hospital on time
- Fatigue or pain: Feeling fatigued or uncomfortable during pregnancy
- Psychological or logistical reasons: Other emotional or practical factors, such as scheduling issues at work or daycare
Before an elective induction, a healthcare expert will confirm that the baby is at least 39 weeks gestation. For healthy women with low-risk pregnancies, inducing labour at 39 to 40 weeks may be as safe as waiting for spontaneous labour. In fact, it may sometimes lessen the chance of some pregnancy-related complications, including the need for a C-section.
However, it is important to highlight that voluntary induction is the exception, not the norm. The dangers and benefits of labour induction should always be balanced against the advantages of maintaining the pregnancy. You should also participate in the decision-making process and comprehend what is going on with your body.
The Bishop Score
Bishop score is a measure that predicts how near you are to labour. Your doctor will inspect your cervix and calculate your Bishop score depending on the changes in your cervix and the position of your baby's head. Your final score may help predict whether induction will result in a successful vaginal delivery. Your score might vary from zero to 13, with zero suggesting that you are not ready for induction and 13 indicating a higher possibility of success.Your cervix joins your birth canal and uterus. It features a little aperture in the centre, similar to a doughnut. As your body prepares for labour and delivery, your cervix softens, thins, and opens. This might occur many weeks or days before your baby's birth. Your Bishop score measures how prepared your cervix is for labour by examining how it has altered.
It's also known as a pelvic score or cervix score.
When is Bishop's score used?
Typically, healthcare providers do not calculate your Bishop score until you are more than 40 weeks pregnant. This is because induction is normally not considered until post-term (41 or 42 weeks of pregnancy). If your healthcare practitioner believes it is essential, they may utilise the Bishop score before the 40-week mark.Certain medical issues, as well as your and the baby's general health, may restrict the Bishop score's usefulness. If you have placenta previa, a Caesarean section (C-section) may be a safer option. If your membranes have burst early, a pelvic inspection of the cervix may be dangerous.
How is the Bishop score calculated?
Your healthcare professional calculates your Bishop score using the following five factors:- Cervical dilation: It refers to the degree to which your cervix is open. A completely dilated cervix measures roughly ten centimetres. Dilation is measured with fingers and then converted to centimetres.
- Effacement of the cervix: This refers to how thin or short your cervix is. Fully effaced (or 100% effaced) indicates that your cervix is "paper-thin."
- Consistency of the cervix: The consistency of the cervix relates to how tough it is. A softer, more flexible cervix is more prone to dilation. Consider the firmness of the tip of your nose vs the softness of your lips.
- Position of Cervix: The location of your cervix shifts closer to your delivery canal as labour progresses. This is known as being anterior. If you are in a posterior posture, you are farther from labour.
- Foetal position (or foetal station): This is the measurement of your baby's head in respect to the ischial spine (a location in your pelvis). Doctors provide a rating depending on whether the head is above or below that position in the pelvis. A positive score indicates that your baby's head has fallen into the delivery canal, while a negative number indicates that it remains high.
Each factor is assigned a score. Your ultimate Bishop score is calculated by adding the five individual scores. A higher Bishop score indicates that inducing labour is likely to be effective.
Is inducing labour painful
How painful it is to start labour relies on a number of things, such as:- If you've received an epidural or other anaesthetic to relieve or block your discomfort
- What form of induction does your physician employ
Having your membranes stripped is often done late in pregnancy as a first effort to initiate labour. It may feel somewhat painful, and you may have cramps or spotting immediately after.
If your provider breaks your water, you may experience a tugging or popping feeling, followed by a deluge or trickle of fluids from your vagina. This should not be unpleasant.
Medication for labour induction may cause discomfort since they stimulate uterine contractions to become more intense. Labour contractions may be highly uncomfortable and feel similar to severe menstruation cramps.
However, depending on when labour induction begins, you may already have had an epidural (the most frequent pain medicine for delivery). In this instance, you could not feel anything. If your labour pain grows too extreme, your physician may prescribe an epidural.
What Are the Risks of Labour Induction?
Labour induction is not for everyone. It may not be a possibility if you have had a C-section with a vertical incision or extensive uterine surgery. It may also be ineffective if the placenta blocks the cervix, known as placenta previa, or if the umbilical cord protrudes down the vagina ahead of the infant, known as prolapsed umbilical cord.Another reason not to induce is if the baby is at a certain position in the uterus. These include laying buttocks first (breech) or lying sideways.
Inducing labour has risks, including:
- Induction was not completed successfully: An induction may fail if adequate induction methods do not result in a vaginal birth after 24 hours or longer. Then a C-section could be required.
- Low foetal heart rate: Medicines used to induce labour may produce excessive or unusual contractions. This may reduce the baby's oxygen supply while also lowering or changing the baby's heart rate.
- Infection: Some techniques of labour induction, such as rupture of the membranes, may increase the risk of infection for both you and your baby.
- Uterine rupture: This is an uncommon but significant problem. The uterus breaks along the scar from a previous C-section or extensive uterine surgery. If the uterus ruptures, an emergency C-section is required to avoid life-threatening complications. The uterus may have to be removed.
- Bleeding upon birth: Labour induction increases the likelihood that the uterine muscles may not contract properly after giving delivery. This disease, known as uterine atony, may cause severe postpartum haemorrhage.
Inducing labour is a serious option. Consult with your doctor to determine what is best for you and your baby.
Monitoring During Induced Labour
Monitoring during induced labour is critical to the safety and well-being of both the mother and the infant. Here are the important factors involved:- Continuous foetal heart rate monitoring: This method uses electronic foetal monitoring (EFM) to continually watch the baby's heart rate. It aids in detecting any indicators of discomfort.
- Maternal vital signs: Regular examinations of the mother's blood pressure, heart rate, and temperature are required to monitor her health during labour.
- Contract analysis: Monitoring the frequency, length, and severity of contractions helps evaluate if labour is going normally.
- Signs of complications: Medical professionals search for aberrant foetal heart rates (decelerations), excessive uterine activity (tachysystole), or indicators of mother discomfort.
- Informed decision making: Continuous monitoring enables quick actions in the event of difficulties, allowing for more informed labour management decisions.
Post-Term Induction
The average pregnancy lasts 40 weeks and begins with the woman's last menstrual cycle. Pregnancies that go longer than 42 weeks are referred to as 'post-term' or 'postdate', and a woman and her doctor may elect to induce labour. Obesity, having a first kid, and being over the age of 30 are all risk factors for post-term birth.Post-term induction is a treatment used to induce labour in pregnant women whose pregnancy has progressed beyond 42 weeks, or 294 days, from the first day of their last menstrual period. A healthcare professional may opt to induce labour if testing shows that the foetus is no longer healthy enough to stay in the uterus.
Some advantages of inducing labour in a late-term pregnancy include:
- Reduced chance of infant death
- Reduced necessity for a caesarean birth
- Lower risk of meconium aspiration syndrome in the infant
During labour, a healthcare worker will monitor the baby's heart rate for any changes that might suggest low oxygen levels. If the baby's condition changes, a caesarean section may be required. Other difficulties that might occur during labour include:
- Meconium aspiration: Post-term foetuses are more likely to pass meconium (their first stool) during labour, which raises the possibility of meconium aspiration. Following birth, the infant may need suctioning and particular care.
- Amnioinfusion: If there is insufficient amniotic fluid or the foetus is pushing on the umbilical cord, sterile fluid may be introduced into the uterus to replenish the amniotic fluid and cushion the baby and cord.
How to Prepare for Labour Induction?
When you know you're going to be induced, whether inpatient or outpatient, it's ideal to have your hospital bag packed and ready to go—because you'll be admitted to the hospital right away or shortly after. You may also wish to keep your employer aware once you have scheduled an induction or when you begin outpatient labour induction techniques.Emotional and psychological preparation:
You may also psychologically prepare for a labour induction by asking your doctor questions. It is recommended that you inquire about the labour induction techniques used by your hospital, the pain treatment alternatives available to you, and if there is a maximum number of support personnel permitted to accompany you throughout labour.Set reasonable expectations:
Perhaps an induction was not what you had in mind. Try to maintain an open mind! Induced labour differs greatly from spontaneous labour, but this does not imply you must abandon your whole birth plan. Take time to evaluate your thoughts and feelings regarding your labour and delivery plans. The mental and emotional elements of labour and delivery are already challenging, and induction has its own set of advantages and hazards.Pack entertainment:
This may be occurring, but it is not always quick. Don't allow the wait time to get to you. Load an electronic gadget with films, on-demand TV and literature inside your hospital bag. Pack a diary and set aside a few minutes to write down your current labour and delivery thoughts. Make a playlist with songs for soothing. Don't forget to bring chargers for any mobile gadgets, headphones, and comfortable, loose clothes.Grant your partner permission to scoot:
If the induction lasts more than 12 to 24 hours, try letting your companion get some fresh air. A bored induction partner might become an annoyance during labour and delivery, so let your spouse pack their own hospital bag. Tell them to bring some nibbles and a comfy cushion. Once in the hospital, express your emotions as best you can before telling them to go get you some ice cream.FAQs on Labour Induction: Key Facts and What to Expect?
- How long does it take to give birth following an induction?
If you are induced, which is the case for three out of ten women, it may take some time before you go into labour, so don't be concerned if it takes two or three days. - Is inducing labour difficult for the baby?
Medicines used to induce labour may produce excessive or unusual contractions. This may reduce the baby's oxygen supply while also lowering or changing the baby's heart rate.
