Sometimes it is preferable to use medical techniques to begin labor rather than wait for the body to begin labor naturally. In the US, nearly one in five labors is induced.
The most common reason for labor induction is that the pregnancy has gone two or more weeks past the due date. In this situation, the baby may get too large for a vaginal delivery or may not be able to receive enough oxygen through the placenta (the organ that links the mother and the baby). Other reasons for induction include the following:
The risk factors are the same as those for a labor that begins on its own. Risk factors that likely will rule out an induction and result in a cesarean birth include the following:
The same general guidelines and recommendations apply for an induction as for a spontaneous birth . However, there are some differences:
To deliver your baby vaginally, the cervix needs to “ripen” or efface. When effaced, the cervix softens, thins, and opens to prepare for delivery. If your cervix is not doing this already, your doctor may give you a medicine to aid this process. The medicine could be a gel that is applied to the cervix, a suppository put in the vagina, or a pill taken by mouth.
There are also procedures that your doctor can do to aid this process. Your doctor could:
If contractions have not started once your cervix is ripe, your doctor will give you a drug that causes contractions. The drug is a man-made version of a hormone called oxytocin, which is produced by your body during active labor. The drug can be adjusted throughout labor to strengthen or weaken the contractions as needed. Once contractions begin, the labor and birth process mirrors that of a spontaneous delivery.
The same pain medications are available for an induced labor as for a spontaneous delivery. Most women opt for an epidural or spinal block .
Just like in a spontaneous birth, the following may occur:
It can be hours to several days from the time you are induced until you deliver your baby. If your cervix is not ripe when you are scheduled for the induction, labor and delivery could take 2-3 days. Inductions for first-time mothers and those taking place preterm generally take more time.
In some cases, your doctor may give you medications, such as glyceryl trinitrate and dinoprostone, to reduce the time from induction to delivery. *¹
Yes, labor is painful, but you can learn various techniques to try to lessen the pain. You should learn as much as possible about childbirth ahead of time so that you can decide if you want to use an epidural or other pain medication.
The same possible complications that may occur from a spontaneous delivery also apply to inductions. In addition, inductions carry the following risks:
The average length of stay for all births is 2.4 days.
Postoperative care following an induced labor is the same as for a spontaneous birth.
After you leave the hospital, call your doctor if any of the following occurs:
RESOURCES:
American Academy of Family Physicians
http://familydoctor.org/
Women's Health.gov
http://www.womenshealth.gov/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm/
References:
Harman JH, Kim A. Current trends in cervical ripening and labor induction. Am Fam Physician . 1999;60:477-484.
Inducing Labor: your questions answered. MayoClinic.com website. Available at http://www.mayoclinic.com/invoke.cfm?ID=PR00117 . Accessed August 29, 2005.
Labor and delivery procedures. The Merck Manual website. Available at http://www.merck.com/mmhe/sec22/ch261/ch261e.html . Accessed August 30, 2005.
Labor induction. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/990800ap/990800a.html . Accessed August 29, 2005.
Longer hospital stays for childbirth. National Center for Health Statistics website. Available at http://www.cdc.gov/nchs/products/pubs/pubd/hestats/hospbirth.htm . Accessed August 30, 2005.
Morey SS. ACOG develops guidelines for induction of labor. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/20000715/practice.html . Accessed August 29, 2005.
*8/8/2006 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Nunes FP, Campos AP, Pedroso SR, et al. Intravaginal glyceryl trinitrate and dinoprostone for cervical ripening and induction of labor. Am J Obstet Gynecol . 2006;194:1022-1026.
Last reviewed February 2009 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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