Induction - Be Empowered Birth Series

Induction

Be Empowered Birth Series

Induction may be described as planned initiation of the onset of labor. Two common reasons for induction of labor can include maternal or provider preference, and medical necessity.

There are many reasons parents or providers may elect induction over spontaneous onset of labor ranging from the need of the mother to a medical indication if the baby is not thriving in the uterus, if mother has a medical condition such as high blood pressure, or if they pregnancy has continued past the due date as depending on mother and provider preferences.

When it comes to induction, there are both natural and pharmacological methods available. If induction is likely, the mother may be given a few days to try natural methods of induction before taking medication to stimulate the onset of labor. The provider may also assess the cervix and assign a bishop score. In this, the provider is looking at five qualities of the cervix: effacement, dilation, softness, alignment, and station of baby. The bishop score can be used to help determine the best options and timeframe for induction as well.

Some natural methods of induction are nipple stimulation, which increases oxytocin production; walking (especially curb-walking), which incorporates gravity and opens the pelvis; acupressure and acupuncture; sexual stimulation, which triggers oxytocin production; ingestion of castor oil, which stimulates the bowels; and homeopathic or herbal remedies. Always be sure to communicate with your provider about natural induction measures. Especially castor oil and herbal remedies, since they can be very effective, but also include other side effects.

Manual methods of induction include stripping or sweeping the membranes, breaking the amniotic sac of water, or using a Foley catheter. A membrane sweep can be performed in the provider’s office during a weekly appointment. The provider will insert a finger between the cervix and the amniotic sac, and sweep around the opening of the cervix to loosen the membranes. It can feel like a very uncomfortable vaginal exam, but the mother can go home afterwards and wait for labor to progress. If the amniotic sac is broken as a means of induction, the mother will be required to stay in the place of birth (hospital or birth center) so her provider may monitor the progression of labor and wellness of baby. Finally, a foley catheter is a balloon held in place with a catheter inside the cervix that is inflated to dilate the cervix and typically falls out around 5cm.

Prostaglandins or synthetic oxytocin (Pitocin) are pharmaceutical options for inducing labor. Prostaglandins are found in semen and also produced by the mother in spontaneous labor. These help soften the cervix when labor begins, which is why sexual intercourse is recommended as a natural induction method. In synthetic form, prostaglandins may be given either orally or vaginally in a tablet, through an IV, or via injection into the cervix. Pitocin is given intravenously. These are often used in conjunction with one another, according to provider preference.

Though this is just an overview of induction options, it is important for you to know you have options, as well as learn about the benefits and risks to each of these options. During our Be Empowered Childbirth Classes we dive deep into all of these options to help you learn and know more so you can be empowered!

Mothers should consult with their provider and other members of their birth team before attempting any method of self-induction.