What’s The Deal with Labor Induction?
The journey of pregnancy has the power to change someone to their core. The joy, the fear, the unknowns, the changing, growing, and evolving – and certainly the questions.
Unless you have worked in the reproductive health care field, or have done extensive research, all this information may be new to you.
As a pregnant person, you have the right to understand just what’s going on in your body, and any medical procedures you may undergo. It’s critical to understand that no matter your birth plan or preferences, education can make a key difference in helping you navigate your birth.
Even if you have plans to have a home birth, or go unmedicated, birth is unpredictable, and it’s important to know your options.
All this to say, we’re here to discuss your options, specifically in the case of induction. You may have heard the term, but aren’t totally clear about what it is, why it’s done, when it’s necessary, and any potential side effects that come with it.
What Is Labor Induction?
To induce labor means to artificially start it using various methods. Some of these methods may also be used to enhance, augment, or “speed up” labor that seems to be progressing slower than providers deem safe.
How Is It Done?
When induction is done in a hospital setting, there are typically various different steps which are performed in a certain order. These may or may not give the body time to adjust and push labor along naturally.
Before beginning an induction, you will have your blood pressure checked, and your baby monitored. This is followed by an “induction assessment”, which includes a vaginal examination and cervical check to see if you have dilated, and if your waters have broken.
Cervical Ripening
The first method utilized is cervical ripening. In order to birth a baby vaginally, the cervix must dilate (open), and efface (thin and soften). If a birthing person’s cervix has not made changes at full term, providers may augment this through the use of artificial prostaglandins, which are administered vaginally.
This is often enough to get labor started, but in some cases a provider may use a catheter with a balloon at the end, called a Foley Balloon, that puts pressure on the cervix, encouraging it to dilate.
Membrane Sweep
Another technique that providers used is called a membrane sweep, or stripping the membranes. This is done by inserting a finger into the vagina to separate the membrane that protects your baby from the lower part of the uterus, by the cervix. This can only be done if the birthing person is already somewhat dilated (1 cm).
Stripping the membranes can help to trigger natural prostaglandins, which help facilitate labor.
While membrane stripping can help induce labor and shorten pregnancy length, it is often incredibly painful and may cause the uterus to contract irregularly. There is also the potential of outside bacteria being introduced to the cervix, potentially leading to infection.
Membrane Rupturing
Rupturing membranes is a technique where providers will artificially break the bag of waters using a device that looks like a crochet hook. This can help to speed up or start labor (if a person is already somewhat dilated).
What many people don’t realize is that it’s not necessary for someone’s water to break prior to birth. In some cases, the amniotic sac may not fully break until pushing or even after the baby is delivered.
In the case of low-risk pregnancies, this can again, potentially introduce foreign bacteria into the cervix and uterus, increasing the risk of infection.
Because of this, depending on your hospital’s policy, breaking the bag of waters typically puts the birthing person on a clock as to how long they have to deliver before turning to a Cesarean section.
Oxytocin
Typically after or in conjunction with the previous methods listed, your provider may begin you on rounds of an artificial version of the hormone Oxytocin, administered through an IV.
Pitocin is only started after a person’s cervix has begun dilating either on its own or through the use of medication or a dilator – like the Foley Balloon.
Pitocin, like Oxytocin, causes the uterus to contract, gradually pushing the baby down and putting pressure on the cervix for it to dilate more. Remember that typically a person dilates to 10 cm before beginning pushing.
Potential risks of a Pitocin induction include fetal distress, a drop in fetal heart rate, infection, overstimulation of the uterus, and fetal death. Some birthing people also report more painful contractions with Pitocin. You are more likely to be limited in terms of mobility, and how much you can move around.
Artificial oxytocin necessitates the need for constant fetal monitoring, which means you’ll be strapped onto another machine.
Because artificial oxytocin triggers contractions – which can be incredibly intense, you may want to speak with your provider about possible pain relief options.
Are There Natural Induction Techniques?
Absolutely! Without giving any medical advice, natural labor techniques have been utilized long before the availability of pharmaceuticals. Some tools utilized in naturally inducing labor are acupuncture, red raspberry leaf, eating dates, breast stimulation, ingesting castor oil, and by having sex.
Why Do People Induce?
There is an endless list about why people or providers may choose to induce, some of them more controversial than others.
There are legitimate medical reasons why someone may induce labor. Some of these are advanced maternal age, risk of placental insufficiency, if the baby has too little amniotic fluid (Oligohydramnos), or if the birthing person has an underlying medical condition which may or may not be related to pregnancy like Preeclampsia, Gestational Diabetes or Rh Disease. For diabetic patients who require insulin, induction is often considered before full term (40 weeks).
In one study, 44% of people who were induced cited the reason being the baby was at full term, or they were near their due date. More and more people however, are being induced prior to being full term – while the average gestational length for someone’s first birth is 41 weeks and a day.
This is where it gets tricky. As more and more research comes out, and we hear about people’s first-hand experiences, we see that induction is not always straightforward. Some people are pushed to undergo induction (and C-Sections) at times that seem more convenient for the provider or hospital, and not necessarily because of the person’s safety.
For some, it makes sense for their life, whether for work or family reasons, to choose early induction – which is totally valid.
Your Body, Your Baby, Your Birth
No matter what your pregnancy and labor journey looks like, we encourage you to stay as informed as possible on possible outcomes and options that may be presented to you. A helpful mantra to remember is “My body. My baby. My birth.”
Facts Checked By:
Dr. Shree Datta is a Consultant Obstetrician and Gynaecologist in London, specialising in women’s health including all menstrual problems such as fibroids and endometriosis. Dr. Shree is a keen advocate for patient choice, having written numerous articles and books to promote patient and clinician information. Her vision resonates with INTIMINA, with the common goals of demystifying periods and delivering the best possible care to her patients.
Article written by:
Dr. Shree Datta is a Consultant Obstetrician and Gynaecologist in London, specialising in women’s health including all menstrual problems such as fibroids and endometriosis. Dr. Shree is a keen advocate for patient choice, having written numerous articles and books to promote patient and clinician information. Her vision resonates with INTIMINA, with the common goals of demystifying periods and delivering the best possible care to her patients.
Article written by:
Natasha (she/her) is a full-spectrum doula and health+wellness copywriter. Her work focuses on deconstructing the shame, stigma, and barriers people carry around birth, sex, health, and beyond, to help people navigate through their lives with more education and empowerment. You can connect with Natasha on IG @natasha.s.weiss.
