Inductions are such a HUGE topic, I could talk about them all day.
Firstly, let's look at what is an induction?
An induced labour is when you start labour artificially. According to the NHS, around 1 in 5 labours in the UK, are induced.
Labour can be induced for various reasons, the reasoning for an induction is a rather controversial topic in the UK. We'll explore this a little later. For now though, let's look at how...
So, how do you induce labour?
A membrane sweep can be offered. This can be offered to mothers past their EDD. Sweep finger around cervix to separate membranes of the amniotic sac surrounding your baby from your cervix. It separates the membranes from the sac to the cervix. This separation releases hormones (prostaglandins), which may start your labour. You can read more information on stretch and sweeps via this great resource.
Labour can be induced in a variety of ways. It's likely that your care providers will offer you a pessary or gel to insert into your vagina to start with if a sweep has been unsuccessful. The pessary contains a synthetic prostaglandin and is placed high into the vagina next to the neck of the womb. It can take several hours to take effect. The pessary remains in the vagina for up to 24 hours and can be easily removed when required – once labour is established or after 24 hours. If there are no signs of labour, they can even top up, or offer another one.
Another option is something known as a "balloon induction". A balloon is inserted into your cervix and inflated to dilate your cervix so your membranes can be broken. The balloon rubs against and stretches the cervix causing it to produce a hormone called prostaglandin. The prostaglandin causes the cervix to become shorter and soften (ripening). This prepares the cervix for labour and allows your midwife or doctor to break your waters.
The balloon induction is often offered to mothers who have previously had a csection, because the scar is a weak point on the womb wall and there is a risk of it rupturing.
Once the cervix has opened up the next step in the induction process is breaking the waters, also known as artificial rupture of membranes (ARM). This is used to encourage the womb to contract so that labour begins. It's worth reading this review on ARM methods.
If the previous methods are unsuccessful then you may be offered synotocin infusion. This is an artificial form of the natural hormone, oxytocin, and is used to start or strengthen contractions for labour. It is given by a drip in your hand or wrist and is started at a slow rate. It is increased gradually until you are having regular contractions coming at the right strength. Once a syntocinon drip has started, your baby’s heart rate will need to be monitored continuously until delivery. What are the reasons for inducing labour? The NHS lists these reasons for inducing labour:
if you're overdue
if your waters have broken
if you or your baby have a health problem
Another reason may be if your waters have broken but labour hasn't started. This is due to an increased risk of infection. The most common reason for induction in the UK is babies going overdue. It is believed there is a risk to the wellbeing of the mum or baby if the pregnancy is prolonged. On this note, you may find this Danish research interesting. There is also a Cochrane Review on Inductions, for here in the UK. As I mentioned, there is a lot of research into this area. One Doctor in particular, Dr Sara Wickham, has done extensive work on inductions. You can read this great resource from her blog. She has a well-rounded approach to induction practices, the reasons behind it and the experience and emotional impact on women. For example, her article on "what women think" is great.
Further research from the US, explores the social reasons behind inductions. Can I say no? Absolutely. If you have discussed your circumstances and you feel that you wouldn'nt like an induction then you can decline. Infact, I did! Many times! When I was pregnant with Sonny, my second, I was offered a c-section induction (he was presenting Breech so other methods of Induction weren't an option), I politely declined and decided to hang on. I explored my options, and was confident on my date of conception which I trusted more, than the Estimated Due Date that the hospital gave me. Sonny eventually arrived 15 days later, at 42 weeks and 1day. He was healthy, I was healthy, I had a wonderful birth experience and we were discharged from hospital just hours later. Take a look at his birth story if you like. It's important that you realise you have a CHOICE and that you carefully consider your options. For example, instead of being induced, could you go into hospital for daily monitoring instead? It's worth asking the providers the reasons for, against, exlporing alternatives so that you can make the right decisions for you. And don't forget to listen to your gut instincts. Scientific research suggests it is accurate 90% of the time. I hope you found this blog useful.
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Georgia x Some other posts you may like...
On my Birthing Programme we educate couples to understand that your Estimation Due Date is an estimate! It's not an expiration date.
Do you know what percentage of babies come on their Due Date? Go on, take a guess....
At 34 weeks the baby was diagnosed breech (not ideal for a hypno birthing Mama) but worse things could happen, I know!