Inducing Labor

Why Would I Need my Labor Induced?

• You’ve gone past your due-date. After 42 weeks, the risk of placental malfunction increases dramatically. Additionally, many care providers fear birthing a ‘too-big’ baby and might induce you early to avoid this problem.
• You or your baby have developed complications, including but not limited to preeclampsia, unreassuring fetal heart rate, or a decrease in fetal movement.
• Convenience. Some doctors will consider inducing labor if you’re tired of being pregnant, to ensure your partner will be there or to ensure your doctor will be there.
• Your membranes rupture and contractions don’t begin within a set amount of time, usually around 6-12 hours. Due to the risk of infection, many care providers will start pitocin to ensure your baby will be born within twenty-four hours.

Inducing Labor

There are four main techniques for inducing labor: anmiotomy, Pitocin, cervical ripening agents and a foley catheter.

Amniotomy

In an amniotomy your care provider will artificially rupture your membranes. Your care provider will use an amniohook, which looks like a crochet hook, to hook a small tear in your bag of membranes.

• The advantages to this method include:
  • This is a fairly non-invasive way to induce labor, there are no chemicals involved.
  • Often your care provider will allow you to go unmonitored for lengths of time--allowing showers, perhaps a bath, walking, various positions and a full range of movement.
• The disadvantages to this method include:
  • There is no turning back. Once the membranes have been ruptured you will have the baby within 24 to 36 hours, even if it’s via a cesarean.
  • There is an increased risk of infection. When your uterus gets infected, your body temperature goes up, putting the baby at risk. Additionally, your uterus will not contract as effectively when its infected, resulting in a longer labor pattern and more painful contractions without any benefit for you or your baby.
  • If labor does not begin or is in a non-progressive pattern, your care provider will start pitocin.

Pitocin

Pitocin is a synthetic of what our body produces naturally, oxytocin. Pitocin is introduced slowly via an IV.

• The advantages to this inducing labor method include:
  • If labor does not begin and your membranes are intact, the Pitocin can be turned off and you can still go home to try again another day.
  • Pitocin does tend to work well in starting contractions, if your body is ready.
  • Your care provider will start you on a low dose and increase as needed. The dosage also can be turned down or off if necessary.
• The disadvantages to this method include:
  • You will need continuous fetal monitoring. This does not mean you have to be in bed, but it means you need to stay attached to the monitor. At hospitals with portable monitoring units, you can still walk the halls and might be able to take showers.
  • Pitocin has the potential to generate harder and more painful contractions. It makes contractions similar to transition contractions--only you might be dilated four centimeters when you experience them.
  • Some babies do not react well to the Pitocin-induced contractions, and you might have the Pitocin turned off, turned on and turned off again, depending on what’s going on with your baby.
  • You will be required to have an IV delivering Pitocin and fluids.

Cervical Ripening Agents

Cervical ripening agents are various hormones and chemicals inserted into the vagina next to the cervix. The goal is exactly what it sounds like--to ripen an undilated, uneffaced cervix and increase the chance of the induction being successful. Your health care provider will not give you cervical ripening agents if you are contracting on your own, and most care providers will not give it if your water is broken.

• The advantages to this technique include:
  • Typically does not cause uncomfortable contractions; although there are exceptions.
  • Some care providers will allow you go to home after inserting the agent.
  • If a cervix is unfavorable, this can help make a favorable induction.
• The disadvantages to this technique include:
  • Some obstetricians require you to be on continuous fetal heart rate monitoring.
  • Cervical ripening agents have been known to cause uterine over-stimulation, uterine rupture and fetal distress.

Foley Catheter

Your care provider will insert a foley catheter into your cervix and inflate it to cause manual dilation of up to 4 centimeters.

• The advantages to this method include:
  • There are no chemicals involved; although you will probably need Pitocin to start contractions.
  • This can change an unfavorable induction to a favorable induction.
• The disadvantages to this method include:
  • This is an extremely invasive and uncomfortable procedure. The placement can be extremely uncomfortable.
  • A foley catheter may not work as expected and may not cause dilation.
  • Pitocin will probably still need to be used to continue labor and start contractions.
  • Not all physicians offer this option.

In Conclusion

The decision to induce labor does carry risks that you need to be aware of before you agree to it. Additionally, inducing labor does make labor harder and more difficult. However, an induction can be very important for the health of you and your baby and can ensure a healthy labor and baby.

• Natural Ways to Induce Labor
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• Early Pregnancy Symptoms

• Self Induction of Labor
• Does Induction Speed Up Labor
• Herbs for Labor Induction
• Pitocin
• Breaking the Water

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