Should You Be Induced

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Even if you had the most comfortable and amazing pregnancy, after being pregnant for close to 40 weeks you’re ready to meet your baby, right? Some babies arrive before the due date but many come past the dues date, especially babies born to first time moms. Very rarely is a baby born on the actual due date. It does happen but the odds are not in favor.

We really don’t know what causes labor to start.  For some women it starts on pretty close to their due date and other women seem to stay pregnant forever. We do know that labor starts naturally when certain hormones are activated. Your baby may also be responsible for starting the process by releasing estrogen. There are 3 hormones responsible for labor. They are estrogen, prostaglandins and oxytocin.

If your pregnancy has gone beyond 39 weeks your doctor may suggest induction. Doctors don’t agree on when a pregnancy has gone on too long. It can be anywhere from 39 weeks to 42 weeks. If you have high blood pressure or gestational diabetes your doctor will most likely suggest induction before 42 weeks. And if you go into labor on your own and contractions begin but then slow down to the point where there is no progress, induction may be necessary. Also if your water breaks and labor doesn’t start on its own it’s pretty certain your doctor will want to induce you.

Statistically the risks of waiting beyond 42 weeks is greater than the risk of being induced. But as with most interventions there are risks. 75% of first time moms don’t go into labor when induced. This is considered “failure to progress” and usually leads to a C-section. Many women and healthcare practitioners believe that induction is the precursor to a C-section and chose to avoid being induced at all cost. The correlation between induction and C-section isn’t necessarily true.

There is something called the Bishop Score which can predict whether an induction will be successful or not. I believe all pregnant women should be aware of this and have a discussion with their doctor when their doctor starts to talk about induction. The Bishop Score (also known as Pelvic Score) is the most commonly used method to rate the readiness of the cervix for induction of labor. The Bishop Score points to 5 measurements of the pelvic examination dilation, effacement of the cervix, station of the fetus, consistency of the cervix, and position of the cervix. If these conditions are favorable then you can expect the induction to lead to labor. If not then they will most likely lead to a C-section.

If conditions are favorable and an induction is required there are 3 ways to induce labor medically.

  •  Prostaglandins can be used. These are hormone like vaginal suppositories, gels or tablets that cause softening, thinning and dilation of the cervix which may bring on contractions and the start of labor.
  •  Stripping the membranes. This is sometimes called “breaking the bag of waters.” A small hook or finger is inserted into the vagina to separate the membranes from the lower uterus. This causes your “water to break” releasing amniotic fluid and hopefully starting labor.
  •  Pitocin is given intravenously. This is a synthetic form of oxytocin. It is not the same as oxytocin which is the “feel- good” hormone. Pitocin causes very intense contractions.

Sometimes women will do whatever they can to start labor themselves, hoping to avoid medical interventions.

Many women have been told they should take walks and walk as much as possible. This may speed up a slow labor but will probably not start labor.

Acupuncture which is used in Eastern medicine, uses very small needles inserted along energy lines to stimulate labor. It may work but not always. Acupressure used finger pressure along these same points so no needles are involved. It is less effective than acupuncture.

Other methods which may be used but only with the consent of your doctor or midwife are, sexual intercourse, nipple stimulation and castor oil laxatives. Always check with your doctor before trying any of these methods of induction.

So there you have it! There are many ways to start labor. Some more effective than others. There are always risks involved in any intervention. If you pregnancy goes beyond 42 weeks your doctor will most likely suggest induction. Always talk to him or her about the Bishops Score to see what the likelihood of success is.

I’d love to hear from you. Have you ever been told that you should be induced? What was your experience like? Please reply by leaving a comment below.