A Birth Center’s Take on Inductions
Induction is a widely discussed topic in the birth world. Today, we are discussing our philosophy on inductions and when they can be beneficial or detrimental to labor and birth. Labor is the process by which regular uterine contractions bring about cervical dilation that eventually leads to the delivery of the baby and the placenta.
Induction of labor is when you’re stimulating uterine contractions by a method other than what occurs naturally. It is used to achieve vaginal birth when labor has not yet started naturally. It can be done using medical or pharmaceutical interventions.
Healthcare providers often recommend inductions when the mother or baby’s health is threatened. However, there can be other reasons for induction as well.
Reasons for Labor Induction in the Hospital
Hospitals may resort to labor induction for the following reasons:
- The expectation for birth at an estimated time: new moms often read up on ideal birth times and may get disgruntled if they do not live up to them. It can cause anxiety and apprehension so they may request an induction to hasten things
- Misguided pressure from family: the family is usually very excited about welcoming a baby, oftentimes they grow impatient if the onset of labor hasn’t yet occurred at the time they expected it to
- Fatigue from pregnancy: if the pregnancy has extended beyond the 38-week mark, mothers often get tired. It’s a mixture of fatigue and anxiety, eventually making them request an induction
Methods of Induction in the Hospital
If you’re getting induced at a hospital, they might use one of the following techniques:
- Cervical ripening agents such as Cytotec (oral misoprostol) or Cervidil (vaginal insert) or Prostaglandin gels. All of these work in the same way by softening the cervix to allow for cervical dilation and uterine contractions.
- Artificial Rupture of Membranes is when your doctor inserts an instrument to manually break off your membranes, it increases the pressure on your cervix and may start labor.
- You might be put on synthetic oxytocin via a drip, this may stimulate contractions.
Possible Ramifications of being Induced
While induction of labor is sometimes indicated in pregnancy to benefit the mother and baby, when it is not medically necessary, there may be possible repercussions such as:
- Prolonged labor: sometimes using methods to stimulate the uterus may instead cause it to enter a state called uterine inertia. It is when the uterus is no longer contracting efficiently, delaying the progress of labor.
- Tetanic contractions: overstimulating the uterus can cause tetany due to excessive contractions.
- Reduced fetal heart rate: overstimulation of the uterus may affect the baby, causing decreased oxygen supply and reduced heart rate.
- Induction adds a time constraint for having the baby because you need to have the baby after a set amount of time to avoid infections.
Our Approach
At Willow Midwife Center, we can encourage natural labor to start when the baby is ready. However, we do have ways to encourage natural labor to start if it becomes necessary.
We can offer a membrane sweep to moms who are 41+ weeks. A Membrane sweep stimulates the cervix to help initiate labor. We also can use a Foley balloon or Cook catheter which are mechanical ways to thin and open the cervix to promote labor to start. Lastly, we can offer a Castor Oil shake. Castor oil causes uterine contractions and consuming a controlled amount may stimulate contractions.