Induction of Labor – How, When And Why To Induce Labor
The pregnancy journey has the power to change someone to the core. The joy, the fear, the unknown, the changing, growing and developing – and certainly the questions.
All of this information may be new to you unless you have worked in the reproductive health field or have done extensive research.
As a pregnant person, you have the right to understand what is going on in your body and what medical interventions you may be doing. It’s important to understand that regardless of your birth plan or preferences, education can make a huge difference in how you navigate your birth.
Even if you plan on being born at home or without medical care, birth is unpredictable and it is important to know your options.
With all of that said, we’re here to discuss your options, specifically in the case of induction. You may have heard the term but are not entirely sure what it is, why it is done, when it is needed, and what possible side effects it has.
What is work induction?
To induce work means to start it artificially using various methods. Some of these methods can also be used to improve, augment, or “speed up” work that appears to be moving more slowly than vendors believe is safe.
how is it done?
When induction is done in a hospital, there is usually a sequence of surgeries a provider begins that can give the body time to adjust and move on naturally.
The first method is the maturation of the cervix. To give birth to a baby vaginally, the cervix must dilate (open) and obliterate (thin and soft). If a childbearing person’s cervix has not made changes at full time, providers can supplement this with the use of artificial substances Prostaglandins like dinoprostone and misoprostol.
This is often enough to start labor, but in some cases a provider may use a catheter with a balloon on the end called a Foley balloonThis puts pressure on the cervix and encourages it to expand.
Stripping the membranes
Another technique that vendors use is called Membrane removal. To do this, insert a finger into the vagina to separate the membrane that protects your baby from the lower part of the uterus through the cervix. This is only possible if the person giving birth is already slightly enlarged (1 cm).
Stripping off the membranes can help trigger natural prostaglandins that make the job easier.
While peeling off the membrane can help induce labor and shorten the length of pregnancy, it is often incredibly painful and can cause the uterus to contract irregularly. There is also a chance that outside bacteria could enter the cervix and potentially lead to infection.
Breaking membranes is a technique where vendors artificially break the water bag using a device that looks like a crochet hook. This can help speed up or start labor (if a person is already a little dilated).
What many people fail to realize is that there is no need for someone’s water to break before birth. In some cases, the amniotic sac may only break completely after the baby is pushed or even after delivery.
In low-risk pregnancies, this can in turn potentially bring foreign bacteria into the cervix and uterus, increasing the risk of infection.
For this reason, depending on your hospital’s guidelines, the person giving birth will usually determine how long to deliver before turning to a caesarean section.
Typically, your provider will start rounds of after or in conjunction with the methods listed earlier Pitocin, an artificial version of the hormone oxytocin, given through an IV.
Pitocin is only started after a person’s cervix dilates, either by itself or through the use of medication or a dilator – such as the Foley balloon.
Pitocin, like oxytocin, causes the uterus to contract, gradually pushing the baby down, and putting pressure on the cervix to keep it expanding. Keep in mind that a person usually stretches to 4 inches before you start pushing.
Potential risks of pitocin induction include fetal stress, a drop in fetal heart rate, infection, overstimulation of the uterus, and death of the fetus. Some birthing people also report more painful contractions with pitocin. It is more likely that you are restricted in terms of mobility and freedom of movement.
Pitocin requires constant monitoring of the fetus, which means you are tied to a different machine.
Are there natural induction techniques?
Absolutely! Without medical advice, natural labor techniques were used long before medicines were available. Some tools that are used to naturally induce labor are acupuncture, red raspberry leaf, Eat dates, Breast stimulation, take in castor oil, and from to have sex.
Why do people induce?
There is an endless list of why people or providers choose to induce something, some of which are more controversial than others.
There are legitimate ones medical reasons why someone can induce labor. Some of these are the separation of the placenta from the uterus (Rupture of the placenta) the baby has too little amniotic fluid (Oligohydramnos), or the person giving birth has an underlying condition that may or may not be related to pregnancy pre-eclampsia, Gestational diabetes or Rh disease.
In one study44% of the induced people stated that the baby was about to deliver (40 weeks) or about to be due. More and more people are prompted before full term, often at the discretion of the provider.
However, the average gestation period for a person’s first birth is 41 weeks and one day.
It gets difficult here. As more research comes out and we hear of people’s firsthand experiences, we see that induction is not always easy. Some people are forced to undergo induction (and caesarean sections) which appear more convenient to the provider or hospital, and not necessarily for safety reasons.
For some, for professional or family reasons, it makes sense to opt for an early introduction – which is absolutely valid.
Your body, your baby, your birth
Regardless of what your pregnancy and labor are, we encourage you to stay as informed as possible about possible outcomes and options that may be presented to you. A helpful mantra to remember is “My body. My baby. My birth.”
Natasha’s passion for reproductive health began at the age of fourteen when she was present at the birth of her youngest sister. Her incredible experiences as a birthing doula gave her insights into the magical realm of childbirth, pregnancy and everything in between. Your role as an obstetrician is her way of serving as an activist. She uses writing as a key educational tool to change the way we view reproductive health as a whole.