You’ve kept every prenatal appointment, yet your healthcare provider has now advised it’s more risky for your baby to remain in the uterus and she’s recommending that it’s time for your baby to be born.
You’ve only heard controversial things about inductions, especially the risks of such before 39 weeks gestation, and now you’re not sure what to do. You’re 40 weeks and you were hoping your labor would start on its own and that you could have a natural, non-medicated birth. If you’re like a lot of women, you’re anxious about what to expect and to have your own labor kick in.
Also read: Induction Decisions
With an induction, a drug that will cause your uterus to contract is given to start labor, which in turn causes your cervix to shorten (effacement) and to open (dilation).
There are different medications and methods that can be used to get labor going but probably the most common is pitocin, which is given by IV.
If you’re undergoing induction, you’ll likely be asked to come to the hospital early in the morning. Once you’re settled into a room, you’ll have monitors placed on your abdomen—one to monitor uterine contractions and the other to monitor your baby’s heart rate. You can watch this data on a bedside monitor and nurses also have a read-out at their station.
Monitoring is important with an induction because it will let your nurse know how well you and your baby are tolerating the pitocin. Your blood pressure and pulse will also be monitored. Expect your nurse to be in and out of your room frequently.
Once you’ve been on monitors for at least 30 minutes, your nurse will begin the pitocin. Typically, your doctor or midwife will assess you after all of this has been started. If your cervix is dilated, she may decide to rupture the membranes (the bag of waters that surround your baby) with a long hook that goes up the vagina and into the cervix. It’s not a painful procedure—just uncomfortable. At that point, you’ll feel a warm gush of fluid until your baby is born. Your nurses will change wet bed pads as needed or when you ask—don’t be embarrassed—this is expected!
Once your water breaks, you may feel an increase in the intensity of your contractions—most women do. Make sure you have already addressed any pain control desires ahead of time.
Because you’ll need to have your baby monitored during induction, your labor may be limited to your room, either in bed, on a chair or a birthing ball. When you need to empty your bladder, your nurse will help you to the bathroom. Some hospitals offer a way for women to walk around while receiving pitocin, but if you’ve opted for an epidural for pain relief, you may be limited to moving around in your room.
Most inductions take several hours, especially if it’s your first baby, but once you’re in labor, it should occur as labor naturally would.
You may be worried about risks around induction and there are risks. First there’s the possibility of this becoming a “failed induction,” which means your cervix did not change in response to the medication and you may have to repeat the process all over again the next day.
Second, you’re also at increased likelihood for a cesarean birth, especially if it seems that you or your baby aren’t tolerating the pitocin. Sometimes your contractions become too hard and last too long, which affects your baby. In those instances, an emergency “stat” cesarean for “fetal distress” may take place.
Cesarean is major abdominal surgery with a longer recovery period than natural birth. And, as with any surgery, you’re at increased risk for bleeding, infection, blood clots, and in some cases the incision can separate during the early postpartum period, lengthening your recovery.
Inductions should only be chosen for medical reasons—rather than convenience, the desire to get pregnancy over or even scheduling issues. Most inductions are performed without any adverse outcomes, and you can still bring your birth plan but it may change significantly so that your healthcare team can make this birth a memorable and safe experience.
During induction, and hopefully labor, you’ll use the breathing techniques, aromatherapy, music therapy, and other coping tools you learned in childbirth classes. Bring your doula, your supportive partner, an open mind, and should you need an induction, may it be a blessed journey.