Induction of Labour

Labour typically begins spontaneously during the period of 37 to 42 weeks of pregnancy. Labour is a natural process that involves different areas of the body. A number of changes take place to prepare for the birth of your new baby.

The first sign that labour is beginning is when your water breaks. This fluid-filled membrane bag protects the baby in your womb. The cervix begins to soften and dilates to facilitate the movement of the baby out of the birth canal. You begin to have contractions that grow stronger and more evenly spaced as labour progresses.

Spontaneous labour occurs naturally because your body decides it is time for your baby to be born. Sometimes doctors “induce labour” before the time that it would normally occur spontaneously. Medical providers sometimes determine that medical intervention is necessary to protect the mother or baby.

For example, if you have high blood pressure, waiting for labour to start naturally can cause serious risk to you and your baby.

Another reason your doctor might decide to induce labour is that your baby is overdue. If labour hasn’t occurred spontaneously by 41 weeks, your doctor may advise the medical induction of labour.

Finally, your doctor may also induce labour if there are signs of problems with the baby. These include a slow growth rate, a reduction in movement, low fluid, or a failure to start contractions in spite of your water already breaking.

Types of Induction of Labour

Your doctor may choose from a number of induction methods including administering the hormones prostaglandin or syntocinon or artificially rupturing the membrane bag (breaking waters). The best method of induction for you will depend on the reason for inducing labour and your specific situation. In some cases, the doctor uses a combination of methods. Induction of labour usually takes place in the hospital.

-Prostaglandins

Prostaglandin is a hormone that occurs naturally in a woman’s body. It helps prepare your body for the process by softening the cervix. The prostaglandins used for the induction of labour are synthetic, meaning they are made in a lab. This synthetic hormone mimics the natural hormone in your body.  

A Prostaglandin gel or pessary is placed into your vagina to start the process of softening the cervix. Sometimes more than one dosage of the hormone is required. The medical staff will monitor you and your baby from the time they administer the first dosage.

If your water doesn’t break spontaneously, the doctor will need to rupture the membrane bag artificially. If contractions do not begin spontaneously, the doctor may give you syntocinon to get them started.

Artificial Breaking of Waters

To artificially break your waters, the doctor or midwife will break the membrane bag manually. They use a small instrument made for this purpose to make a small hole in the membrane bag. They can only break your waters if the cervix is fully open. The breaking of waters often causes the contractions to start naturally. If not, the doctor will begin a syntocinon infusion.

Syntocinon

Syntocinon is the name given to the synthetic version of the natural hormone Oxytocin. The doctor or midwife administers syntocinon through an IV drip when administering prostaglandins or the artificial breaking of waters does not cause contractions to start. The doctor starts with a small dosage and increases the infusion slowly until you have strong, regular contractions and continues until after your baby’s birth.

Risks Associated with Induction of Labour

-Failure to Induce

Your doctor can only successfully induce labour if the method used softens the cervix and causes it to open. If the doctor is unable to rupture the membrane bag, induction can’t be initiated. At this point, the doctor will explain options and recommendations about what to do. The reason for your induction will determine whether waiting until later for natural labour to occur, using a different method of induction, or having a caesarean section is the best option for you.

-Over-Stimulating the Uterus

On the other end of the spectrum, the induction can cause over-stimulation of the uterus leading to more contractions than needed. This can cause added stress to you and/or your baby. If this occurs during the induction, the doctor will stop the infusion of the synthetic hormones and give you medications to help the uterus relax.

-More Painful Labour

Induced labour often causes more pain than spontaneous labour. Fortunately, your options for pain relief aren’t limited with the induction of labour. Since you usually plan induction in advance, your doctor will discuss your options for pain relief prior to the procedure.

-Increased Need for Intervention

Induction of labour can increase the need for assisted birth with forceps or Ventouse. A larger number of woman require caesarean sections following inductions that those who undergo spontaneous labour. Although induced labour can increase the need for intervention, the risks of waiting may be even greater.

Planning Your Labour in Advance

Some women choose induction of labour as an elective procedure early in their pregnancies. Others wait to see how their pregnancy progresses and whether the process begins spontaneously on-schedule. Regardless of your initial choice, you and your doctor will make the final decision once the end of your pregnancy arrives.

If your doctor recommends the induction of labour, ask what the basis is for that recommendation. Also, ask about the risks of induction in comparison to waiting for labour to begin naturally. Make sure you know all the benefits and risks for all the options you have available to you.

You only have one chance to make the right decision for you and your baby. Make sure you have all the information you need to make the right choice for you.