For some women, labor is slow to begin. In these cases, health care providers may give the woman medications or use other methods to bring on labor. This
is called inducing labor or labor induction.”The following labor related information has been adapted from the March of Dimes
and other websites listed at the bottom of this page.
Some women may prefer to have an induction, even without medical need. Inducing labor may appeal to both the woman and the health care provider because it helps them plan their schedules.
According to the U.S. Centers for Disease Control, about one in five births in the United States is induced. The March of Dimes (Induction
by request) recommends that labor be induced only when the health of the woman or baby is at risk.
What Is Labor?
A woman is in labor when she has short, regular contractions of the uterus. These contractions lead to changes in her cervix. The cervix is the narrow, outer end of the uterus. During labor, the cervix
becomes softer and shorter, thins out, and then opens before birth. During delivery, the baby comes through the cervix into the vagina (birth canal). For additional information please visit the
page labor and birth.
Why Is Labor Induced?
The most common reason for labor induction is that the pregnancy has gone 2 weeks or more past the due date. The baby may get too big if you carry it this far past your due date. It may not be
able to get enough food from inside your body. Your doctor might also recommend labor induction if:
- The pregnant woman has high blood pressure caused by pregnancy.
- The woman has an infection in her uterus (womb).
- The woman's water has broken, but contractions haven't begun.
- The woman has health problems, such as diabetes, that could harm her or her baby.
- A growth problem is causing the baby to be small.
How Is Labor Induced?
The health care provider may use one or more of these techniques to induce labor. Below are listed four of the most common ways used to induce labor:
- Separating the amniotic sac from the wall of the uterus (also called “stripping the membranes): The amniotic sac is the lining inside the uterus (womb) that contains the baby.
The health care provider gently puts a gloved finger through the woman's cervix. Using the same gloved finger, the provider then separates the sac from the uterine wall. When this is
done, the woman may feel some cramping or have some spotting. This procedure may be done in the provider's office.
- Ripening the cervix: The provider places a small tablet or suppository in the vagina up against the cervix. (A suppository is a medication that melts once it is
in place). This helps to soften and thin the cervix. After receiving the medication, the woman may start to have gentle labor contractions.
- Giving the woman a drug to start contractions: A commonly used drug is oxytocin (Pitocin). It has been available since the 1940s. A woman's body makes oxytocin naturally. The synthetic
form (Pitocin) may be given through a small tube in the woman’s arm called an IV tube. (The initials IV stand for intravenous, which means within a vein.) The drug may make the
woman's contractions very strong.
- Breaking the woman's water (also called rupturing the membranes): The health care provider uses a small instrument to break the sac that contains the baby. The woman usually doesn't
feel pain. But she may feel a warm gush of fluid.
What can I expect during labor induction?
In most cases, induction goes well, and the woman delivers her baby through the birth canal (vaginally). An induction can take a few hours or as long as two or three days. It depends on how the
woman's body responds to the treatment she receives. Typically, induction takes longer if this is the first pregnancy or if the baby is not full term.
It will be helpful if you remember that every pregnancy is different. Having an induction is not a sign of failure. It may be the best thing for your health and the health of your baby.
Also, before you go to the hospital, eat only light foods since the medicines used for inducing labor may upset your stomach.
Are there any risks to labor induction?
Like any medical procedure, induction has side effects and risks. Some of them are described below:
- The primary risk you face is that if your labor does not start with medicine, you might need to have a cesarean section (also called a "C" section).
The risk of infection is always a concern in any surgical procedure and C-sections leave a scar in the uterus.
- The medicines can make labor contractions very strong and lower the baby's heart rate. Throughout an induction, medical staff carefully monitor the baby's heart rate.
- Women who have inductions and their babies are at increased risk of infection.
- The baby may have problems with the umbilical cord. For example, the cord may slip into the vagina before the baby does. This is more likely to occur if the baby is breech (feet or bottom first, instead
of head first). Also, the cord may be compressed, decreasing the baby's oxygen supply.
- Uterine rupture is a rare complication of induction. A rupture is a tear in the uterus. This can cause serious bleeding. Women who have previously had a cesarean section are at increased risk of
uterine rupture.
- It can be hard to pinpoint the date your baby was conceived. Being off by just a week or two can result in a premature birth. Inductions may contribute to the growing number of babies who are
born late preterm, between 34 and 36 weeks gestation. These babies are more likely to have medical problems than babies born a few weeks later at full term (37-42 weeks).
What are the circumstances in which labor should not be induced?
You may need to have a c-section rather than a labor induction whenever it would be unsafe to labor and deliver vaginally, including the following situations:
- Tests indicate that your baby needs to be delivered immediately because the baby is in distress or can not tolerate contractions.
- You have a placenta previa (Placenta previa is a condition that may occur during pregnancy when the placenta implants in the lower part of the uterus and is close to or covering the cervical opening
to the birth canal.), vasa previa (when blood vessels from the umbilical cord are embedded in the amniotic membranes and at risk for rupture during labor), or the cord is lying in front of your baby's head
and could be compressed as his head enters the birth canal or prolapse through your cervix when your water breaks.
- Your baby is in a breech or transverse position, meaning that the baby is not delivering head-first.
- You have had more than one c-section. (Some practitioners believe that women with even one previous c-section should not be induced.)
- You are having twins, triplets or more.
- You have an active genital herpes infection.
Are there any techniques I can try myself to get my labor going?
Do-it-yourself techniques to induce labor have not been proven to be both safe and effective. Below are some of the techniques you may have heard about, but should avoid:
- Nipple stimulation: Twisting or pinching your nipples releases your own natural oxytocin. Nipple stimulation requires monitoring because it can sometimes cause prolonged contractions that could stress
your baby and depress his heart rate.
- Sexual intercourse: Semen contains some prostaglandin and having an orgasm may stimulate a few contractions, but having sex will not induce labor.
- Castor oil: Castor oil is a strong laxative, and stimulating your bowels may cause some contractions, but no good studies have proven it consistently effective, and you are likely to find the effect
very unpleasant.
- Herbal remedies: These can be are risky because they can hyperstimulate your uterus and may be unsafe for your baby for other reasons as well.
Remember that your health care provider will discuss labor induction with you and will recommend inducing your labor only when she/he believes that the risks to you and your baby of waiting for labor
to begin on its own are higher than the risks of intervening.
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