Medically Induced Labor – When, Why and How?
Some say that medically induced labor should be avoided at all costs, since it increases the risks for both mom and baby.
Others mean that inducing labor is great because it makes childbirth possible to plan and thereby be safe. Well both views can be right, depending on your situation.
Here you’ll find the pros and cons, whys and hows of medically induced labor. Natural induction of labor is different and you can read about it here.
Info on Medically Induced Labor
Why inducing labor?
The most common reason for inducing labor is that there are some serious risks for the mom or baby from continuing the pregnancy. It can relate to indication of fetal illness such as the baby not growing as he or she should, the due date has been passed by more than 2 weeks or maternal illness such as preclampsia, high blood pressure, diabetes, etc. Labor can also be induced if your water has broken, but the contractions don’t start naturally or if there is not enough amniotic fluid surrounding your baby in the uterus.
Sometimes labor is also induced, or proposed to be induced for more practical reasons, such as a holiday coming up or dad’s traveling at work. But since there are risks and disadvantages connected with inducing labor, make sure you make an informed choice!
What are the risks?
While an induced labor and delivery often works out just as great as a natural one, there are well documented risks with medically induced labor. They include:
Nevertheless, if your or your baby’s health are at risk, a controlled induction of labor can be by far the best way to handle the situation.
- Increased risk of premature baby, even if you believe your baby is term. The due date can have been miscalculated, and even just a week or two of premature birth can cause problems with both breathing and suckling for your baby.
- Uterine Rupture – A very rare, but serious condition where the uterine wall can do everything from having a weak spot to actually tearing open, with a huge risk for both mom and baby. Several studies show an increased risk of uterine rupture in connection with induced labor for moms who have previously had a C-section. The greatest risk in such case is if labor is induced using prostaglandin medications.
- Induced labor also more often that naturally started childbirth ends up with a C-section, forceps delivery and vacuum births.
- Stress for the baby. Since induced contractions are often stronger and more regular early on, this can be stressful for the baby. Monitoring s very important and this stress can be a reason for the higher share of vacuum births etc when labor is induced.
How is it done?
Medical induction of labor can be done in several ways. Where the process starts depends on how far your own body has come with preparing for childbirth. If your cervix has already softened and shortened, the process is somewhat easier.
If you start from scratch, without any softened cervix, the doctor usually use prostaglandin tablets that are placed in the vagina, and prostaglandin gels that are applied directly to the cervix. Then you go home and hopefully some 12 hours later when you check back, the ripening has started and the medication to start the actual contractions can begin.
The medication used is synthetic oxytocin, called Pitocin. It is given through an intravenous drip. What Pitocin does is to mimics the body’s natural oxytocin, which is otherwise the hormone starting and continuing the contractions.
To speed up the process, the doctor may also make a small tearing of the water bag. This may lead to a speed up of the birthing process.
How will the actual labor be when induced?
Induced labor, if successful, is often faster than a natural labor due to the medication used. This may sound nice, but it also means that it may be more painful. If you or your baby is at risk, this is a low cost for securing your health, but always ask WHY if induction is proposed by your doctor.
On the other hand, it can be great, calm and completely normal too!
When should it be avoided?
If the induction is merely planned for convenience reasons, rather than safety, think twice. Is there any way the dad to be can change his work schedule? Can grandma come and live with you? Can you make sure you have a car that can take you to hospital quickly?
Do what you can to avoid induced labor for other reasons than safety due to both the health risks and the risks of a less pleasant birth experience.
Questions to ask your Dr
Well the first and most obvious question to ask is of course why. And make sure you really understand his or her answer!
Secondly a good follow up question is what if we don’t? If it is not an acute situation, you might want to wait for a few days at least, to increase the chances of a natural childbirth.
Third, ask how the induction will be done and what the options are. As explained above, medical induction can be carried out in different ways and it is important that you understand how this is planned to happen, and what to expect from it.
At the same time you may want to discuss general pain relief, since induced labor can sometimes be very strong and medical pain relief can be needed.
Video on inducing labor
Below follows a short video with a doctor explaining different ways to medically induce labor.
Recommended books to learn more
Here you’ll find two helpful books on childbirth.