You and your partner have written the perfect birth plan, and you’re excited for baby’s “birth” day. Then, your pregnancy care provider tells you that you’ll need to have your labor induced. This recommendation comes as quite a surprise, leaving you feeling anxious. Well, there’s no reason to be curious or fearful, we’re going to break down the details of this common birth intervention.
Induction of Labor Reasons
An induction is when your pregnancy care provider starts your labor using synthetic hormones that mimic the hormones your body naturally makes to start labor (oxytocin). The reasons for inducing vary and often depend on your medical history but are sometimes your provider’s preference. A few medical conditions that may lead to an induction are:
- Pregnancy past 41 weeks
- Problems with your placenta
- High blood pressure especially if in combination with:
- Protein in your urine
- Headaches that don’t go away
- Vision changes
- Dizziness
- Nausea/vomiting
- Sudden weight gain over 1 or 2 days
- Upper right-side belly pain
- Difficulty breathing
- Cholestasis, a serious liver condition that causes severe itching
- Your water breaks early before 37 weeks but labor does not start
- Your baby isn’t growing well
- Diabetes
Some pregnancy care providers will consider inducing your labor as you draw closer to your due date if you live far from the hospital where you’ll give birth or if you have a history of rapid births. Research shows it’s best to wait for labor to start on its own.
Induction may also be needed if your baby is experiencing issues with their heart rate, umbilical cord, amniotic fluid, or if they aren’t continuing to grow well. At each prenatal visit, ask your pregnancy provider to explain the results of their observations, exams, procedures, and tests.
Use the information provided to make decisions and to advocate for yourself and your baby through shared decision-making with your partner and pregnancy care provider. This is especially important if you desire to be safely induced at 39 weeks. Research shows waiting until this time in your pregnancy reduces health risks for your baby.
Induction of Labor Methods
There are several ways that your pregnancy care provider can perform an induction.
- Membrane Sweep:
Your provider inserts one or two gloved fingers into your cervix. They make a sweeping motion to separate baby’s amniotic sac from your uterus. This procedure can be uncomfortable, but if successful, it can cause contractions to start.
- Inflatable Balloon:
A small tube with an inflatable balloon is inserted into your vagina and rests against your cervix. The balloon is filled with clean water. The pressure from the water in the balloon causes the cervix to dilate (open). At about 5-6 cm open, the balloon falls out and additional methods can be used if needed.
- Breaking the Water:
There are many funny movies with scenes of ‘water breaking’ that usually show a gush of fluid when a pregnant woman stands. However, for an induction, your cervix has to be partially open, thin, and baby’s head deep in your pelvis before your provider can break your water. They will use a plastic hook to make a small opening in the amniotic sac. This process is not painful and may occur during a vaginal exam. Once the amniotic sac is opened, it releases natural chemicals and hormones that will most likely stimulate contractions.
State what you’re comfortable having done to help start your labor. If you don’t want your pregnancy care provider to break your water, tell them and include this in your birth plan. Also, tell your partner and the nurses providing care for you. Keep in mind that breaking your water does come with the risk of the umbilical cord dropping through the cervix before the baby and a risk for infection.
- Medication:
Medications that soften the cervix can be used to induce labor. Once the cervix is soft and thin, it’s easier to open. One commonly used medication, Pitocin, is a synthetic form of the hormone oxytocin. Your body releases oxytocin into your bloodstream when you cuddle with a loved one, your nipples are stimulated, or when you have an orgasm. Its nickname is the ‘love hormone.’ Pitocin is given through an IV in small doses to safely induce labor contractions until they’re in a consistent pattern.
Many women who’ve had Pitocin used to induce labor experience fast and strong contractions, which can be painful. When your body doesn’t kick-start the labor process, other hormones that help you cope aren’t as active.
Induction of labor may take 2-3 days and can lead to what has been called a ‘cascade of interventions’ that result in either vaginal birth with assistance from your provider or cesarean birth. Be decisive about your wants and desires in your birthing plan. You’ll be prepared if induction of labor is offered as an option to birth your baby.
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