For most pregnancies there is no need to “induce” labor, which means to move it forward through artificial means. But there are some situations in which doctors will call for induction because waiting for labor to happen on its own might not be safe for the baby or the mother. Some reasons for inducing labor include an overdue baby, risk to the fetus, ruptured membranes, stalled labor, high blood pressure, or other maternal health complications. Additionally, some women are induced for non-medical reasons – such as if they live far away from the hospital and they fear they may not get there in time – but inducing for such reasons remains controversial.
Methods of Inducing Labor
Before your doctor decides to induce labor, you may hear talk about your Bishop score. This is a scoring system that helps the doctor assess whether labor should be induced and if induction will be successful. The scoring system measures the dilation, effacement, consistency, and position of the cervix, as well as the fetal position. If the signs point toward the need to induce labor, your doctor may employ a variety of techniques, including:
Stripping the membranes: Although this method is not proven to induce labor per se, it is sometimes used to prepare women for labor. To strip or sweep your membranes, your doctor inserts a finger into your cervix to separate part of the amniotic sac from the uterus. This action releases some of the prostaglandin hormone that can soften your cervix. It may be moderately uncomfortable or painful, and you may have some spotting afterwards.
Prostaglandin gel: This gel, which is applied directly to your cervix, contains the hormone prostaglandin. Prostaglandin softens your cervix and helps prepare it to stretch out for labor. The application of the gel should be painless; some women have mild irritation or cramping afterwards. For some women the use of the gel alone is enough to start contractions within a few hours. More commonly, the gel is used conjunction with Pitocin and it usually allows the doctor to achieve success with a smaller dose of Pitocin.
Breaking the bag of waters: If your water has not already broken, your doctor may do an amniotomy, which is the official term for breaking a small hole in your amniotic sac. She will perform this vaginally using a special hook-like tool that looks scarier than it really is (the procedure should not hurt more than a regular vaginal exam). Once your amniotic fluid is flowing, contractions should begin if they haven’t already. The disadvantage of this method is that once your water is broken, you must go forward with labor or else you risk infection. If your labor remains stalled at this point, you may need the additional help of Pitocin.
Pitocin: The use of Pitocin, a synthetic version of the hormone oxytocin, is probably the most commonly known method for inducing labor. Pitocin is delivered intravenously so that the exact amount of the hormone can be regulated. Once you have received Pitocin, your baby is monitored continuously to make sure that she does not have an adverse reaction and to make sure the contractions progress normally. For those mothers who plan on natural childbirth, it’s important to note that sometimes the contractions caused by Pitocin are too intense to manage without pain medication such as an epidural.
Once Labor is Induced
Once you have been induced, your doctor will monitor you carefully to assess your contractions, the progress of your labor, and the condition of the baby. Some of the potential risks that come with inducing labor include a more painful labor, a premature baby, or uterine rupture. If you need to be induced and your body is not quite ready, the process may take a while, especially for first-time moms. Also, if the induction does not work and labor is stalled, you may need to undergo a c-section. Ideally, however, the contractions will grow stronger and progress like a natural labor culminating in the vaginal birth of your baby.
Some moms who are in the long, final days of pregnancy may imagine induction to be a relief. But remember, it is a serious medical intervention and it should not be undertaken lightly. Unless your doctor specifically recommends inducing labor, it is best to wait for it to happen on its own. It will be soon enough that you will get a chance to meet and enjoy your new little one.