If you go past your due date, your water breaks and you have no contractions, or if you have other complications at the end of your pregnancy, your doctor may want to use drugs to induce labor. Some drugs are given through an IV and others are inserted into the vagina in order to dilate and thin out the cervix and cause the uterus to contract.
Why Use Drugs to Induce Labor
Many doctors recommend labor induction if:
- You go more than two weeks past your due date
- Your water breaks but you aren't having contractions
- You suffer from a disease like preeclampsia, gestational diabetes
- There is a decrease in the baby's movement
- You need to schedule delivery
Commonly Used Drugs
If you need to have labor induced, you'll probably hear at least one of the following drugs' names tossed around the room:
Pitocin is one of the most commonly used drugs for inducing labor. It's a synthetic version of oxytocin, a hormone your body produces on its own. If you go into labor on your own, you can thank your pituitary gland for producing oxytocin, which then causes the contractions. If your body isn't producing the oxytocin it needs to start labor, the Pitocin will do it almost immediately. The contraction are strong shortly after the introduction of Pitocin to the body and the amount of the drug is monitored and controlled by the doctor via IV. It is normally increased every half hour until strong contractions are only about two minutes apart.
Risks here include uterine rupture, fetal distress, and potential long-term effects on the baby, though evidence is not conclusive.
Dinoprostone, a prostaglandin used to induce childbirth, encourages the cervix to thin out, dilate, and get ready for labor. Also, it is designed to make the uterus contract as it would in labor. It is inserted vaginally by the doctor until it is touching the cervix and is available in gel, tampon, suppository, and extended release insert. Normally, it gradually releases prostaglandin over the course of the next twelve hours.Make sure your doctor knows about any allergies you have, as well as any health conditions such as asthma, anemia, epilepsy, heart disease, high or low blood pressure, glaucoma, and so on.
If you and your doctor agree on using Dinoprostone instead of Pitocin, the use of an IV may not be necessary. The con to this is that you have to lie down for ten minutes to two hours so that the medication can be absorbed and begin to work. Amounts of the drug given will vary by patient.
Other Prostaglandin Suppositories and Gels
There is another prostaglandin suppository on the market called Prepidil. When using this method, one suppository is inserted beside or into the cervix every six hours until it has ripened enough for labor to begin. Similarly, pharmacies can use other types of prostaglandin suppositories to create a gel that works the same way. However, this method can be very messy and the melting of the suppository in order to create the perfect concoction will cause it to lose a bit of its effectiveness.
Misoprostol can be taken orally or inserted into the vagina, but it cannot, however, be used if you have previously had a cesarean due to a heightened risk of uterine rupture. As with all other similar drugs, you and your baby will carefully be monitored throughout the process. Vital signs, fetal heart rate, and uterine activity should all be watched carefully.
If Drugs Make You Uncomfortable
Be sure to talk with your doctor far in advance if you have an aversion to using drugs to induce labor. Having a plan in place with your ob-gyn long before you approach your due date will keep everyone's mind at ease and promote a healthy, lower stress labor, and delivery.
Your doctor will be able to answer questions, put your mind at ease, and discuss possible alternatives. If the induction isn't urgent, your doctor may have suggestions of natural methods for you to try.
When Drugs Shouldn't Be Used to Induce
Sometimes your doctor will not want to use drugs to induce labor at all, especially if you have active genital herpes, cord prolapse (which is when the cord falls ahead of the baby), or placenta previa (a condition in which the placenta moves down to cover part or all of the cervical opening).