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Inducing Labor: The Best Option When Natural Labor Isn’t One

By Joanne Goldbort, PhD, RN

Inducing Labor: The Best Option When Natural Labor Isn’t One

Carrying a baby to full term can seem like an eternity. Mother Nature’s design for birthing a 40-week-gestation infant begins to lose its attraction as the time gets closer. Giving birth at a scheduled date and time is alluring, and, why not? While inductions aren’t without their risks, they’re an option you and your healthcare provider should discuss, especially if you go past your due date with no indications that labor is going to begin anytime soon.

Now that we have the technology and science to induce labor, scheduled births only seem natural. Right, but in effect, elective inductions—scheduling an induced labor without a medical reason to do so—have increased the number of newborn admissions to the neonatal intensive care unit. They can increase your baby’s risk for having complications that would cause him to need speical care in a neonatal intensive care setting, for example. It’s simply not smart or safe to induce labor on a woman whose baby is less than 39 gestational weeks old, unless there is a compelling medical reason to do so.

Undergoing induction

During an induction, you will receive medication to start uterine contractions that will lead to active labor by thinning and opening your cervix so that your baby can be born. Late during your prenatal visits, your healthcare provider will perform a vaginal exam to determine the “readiness” of your cervix for the process of labor. Depending on what they find, and if you’re scheduled for an induction, you may experience an induction in a number of ways.

If your cervix is considered “long, thick and closed, and posterior, then your healthcare provider will schedule you for what’s called cervical ripening. Drugs, known as prostaglandins, will be inserted into your vagina by your provider to soften your cervix. Two of the most common prostaglandins used are Prepidil, which is a gel inserted via syringe directly into the cervix and is slowly absorbed, or Cervidil, which is a medicated strip that is placed behind your cervix by your care provider that has a long string attached to it, like a tampon. Cervidil is left in place overnight and then removed via tugging it out with the string.

Then your cervix is checked once again for labor readiness. If your cervix is starting to thin and dilate, some healthcare providers will choose to use an oral medication (typically Cytotec) to start contractions and not use any additional prostaglandins. Their goal is to get you to experience contractions every 5 to 10 minutes to begin your labor.

Your induction may then move to the hospital where Pitocin (also known as Oxytocin) is an IV medication that is is typically started after any vaginal medication has been removed. Pitocin is used to strengthen and increase the frequency of your contractions. Your care providers will monoitor your contractions, including your baby’s fetal heart tones, during this process to ensure both you and your baby are tolerating the induction and labor healthfully.

Because inductions can increase your risk of giving birth via cesarean section (surgery), most heatlhcare providers advice women not to eat or drink prior to an induction, but talk to your individual healthcare provider to determine what’s considered safe for you and your particular situation.

An induction is meant to bring about birth, so when you go to the hospital to check in for your induction, remember to bring your suitcase with all the items both you and your baby will need to return home, including an infant car seat. And if you’re schedule for an induction, may it truly be a labor of love.

Joanne Goldbort, PhD, RN, is director of Maternal & Child Services at Union Hospital Health Group in Terre Haute, Indiana. She is also an expert advisor to Healthy Mom & Baby magazine and Health4Mom.org.

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