Induction of labor is a common experience for pregnant women. It is a way to help you get a vaginal birth jump-started. There are two reasons you might need labor induced. One is that delaying labor and birth any longer could be a danger to you or your baby. The other is that your pregnancy has gone beyond 42 weeks without labor.
Inducing labor for the convenience of you or your obstetrical care provider is not a reason. As a basic rule, labor should not be induced before 39 weeks unless you or your baby are in danger. Those last few weeks are an important time for the development of your baby’s brain and lungs.
The main advantage of labor induction options is that they get you into labor, and hopefully out of danger. Disadvantages common to many inductions options are a risk of premature birth and a risk of needing a C-section:
- Determining an exact due date is not completely reliable. Inducing labor may cause your baby to be a bit premature. This is usually not a problem, but there is a slight risk your baby will not get the full benefit of the last few weeks in the womb.
- Once you induce labor, especially if your eater breaks or you start to have string contractions, vaginal birth needs to happen within a safe amount of time. If you don’t progress to a vaginal birth in that time, C-section may be the best option. This is most common in first-time m others.
Ways to Start Labor
There are two things that need to happen for labor to start. Your cervix needs to widen and thin to allow your baby to pass. This is called cervical ripening. You also need to start having strong and regular contractions to push your baby out. Some induction options help your cervix ripen and some help contractions get going.
Your provider will use a scale called the Bishop Scale to rate your cervical ripening. It goes from 0 to 13. If your score is less than 6, you may benefit from an induction option to increase ripening:
- These naturally occurring hormones are given to increase cervical ripening. They can be given as an oral medication or as a vaginal suppository. Prostaglandins are natural hormones and they can stimulate labor. You are not tied to an IV. You can move around. One big disadvantage is that you can’t use this method if you have had a C-section in the past. Prostaglandins could increase your risk for rupture of your uterus after C-section.
There are three other ways to ripen your cervix that require manipulating the cervix. Because a device or finger is inserted into the cervix, these options add a low risk of infection:
- Stripping the cervix. Your provider sweeps a finger inside your cervix to separate the amniotic sac from the cervix. This can cause some spotting and cramping.
- A water-absorbing substance that is placed into your cervix. As it absorbs water, it helps the cervix ripen.
- A balloon catheter. A thin tube with a bulb placed through your vagina into your cervix. The bulb is filled with water to open the cervix.
If your cervix is ready but you are not having contractions, there are three ways to stimulate contractions and induce labor:
- Your provider may break your water with a sterile hook. This will often start labor contractions. It also allows your provider to examine your amniotic fluid and place a heart monitor directly on your baby through your cervix. The disadvantage is that once water breaks there is a risk of infection. Your baby’s umbilical cord may also loop down into your cervix and be trapped. This procedure may be uncomfortable and if it does not work, C-section may be the next step.
- This is a man-made version of a natural hormone that stimulates labor. It may start strong contractions. Disadvantages are that the contractions may be too strong. They can be painful and you may need to have an epidural. They may also be strong enough to decrease the fetal heart.
- Nipple stimulation. Stimulating your nipples with your fingers or with a breast pump is the most natural way to stimulate contractions. This is what happens when you breastfeed the first time. Nipple stimulation triggers your uterus to contract which help pass afterbirth and stops uterine bleeding. This option is safe but less effective than other options. It can be something you try first.
In most cases, labor induction can be part of a normal labor and delivery experience. If your provider talks about inducing labor, always ask the reason why and ask what the options are. Make sure you understand the pros and cons of each option.