Induction of labour where your labour is started artificially will happen to around 20% of us each year in the UK. Some women can’t wait to get started in labour, meet their baby and are counting the days till the end of pregnancy. Others relish every moment they feel their baby moving inside and don’t want it to end. Or at least not until baby and body decide the time is right.
Not all fruit ripen and fall at the same time.
And so it is the same for mamas and their babies. This is not the blog post to discuss the benefits or risks of induction..but the reality of how you might cope with this way of giving birth.
It’s not the same as a naturally starting labour where your hormones work in tune with each other. In a naturally starting labour the hormone oxytocin rises to increase the strength and power of each contraction whilst the endorphins; your natural opiates, are increasing in intensity too enabling you to cope each step of the way. (Even if you don’t feel like you’re coping!)
An induction is a bit different. It’s a medical intervention that uses a variety of methods to prepare the cervix,open the cervix and help you birth your baby. So it is trying to get your body into labour by artificial means.
The general pathway of induction goes like this…
The stretch and sweep
It’s a vaginal examination, where a finger is inserted into the cervix and it is ‘massaged’ . Usually offered as the first step in the process. The sweep aims to stir up a release of your hormones,prostaglandins, which may start to soften and open the cervix. See this video post for some inside info on sweeps. And don’t forget to watch part two!
It can cause a bit of bleeding, and can create niggling contractions, sometimes quite painful ones. If you’re ready to go into labour then it may ‘tip you over’. But if it’s your first baby it may just start the process of softening the cervix. Watch the vids for more info.
The pessary is a little tampon inserted high into the vagina, via a vaginal examination, releasing artificial hormones over a 24 hour period. Sometimes it can be tricky to reach the cervix on examination as often the cervix is high and pointing towards the back. You may be asked to make two fists and pop them under your buttocks to raise and change the position of the pelvis and make it easier to reach. This drug aims to soften the cervix and open it a little. Sometimes it can tip you into labour and can cause strong contractions. Some hospitals allow you to go home, but most will expect you to stay in for 24 hrs as the baby will need some monitoring.
You will be monitored before the pessary is inserted to check baby is ok. Then be monitored afterwards to ensure baby is still ok.
It can be a l-o-n-g wait while it works…
Breaking the waters
Once the cervix has opened enough, and this may only be 1-2cms, the waters can be broken. This would usually be done on the delivery suite by a midwife. It can be uncomfortable because again it means having an examination, and you may have had a few by now! It shouldn’t be painful to break the waters and it doesn’t hurt the baby. Releasing the waters encourages the baby’s head to press firmly onto the cervix. It sometimes causes labour to start, especially if you’ve had a baby before. This may bring on strong contractions more quickly than a naturally starting labour where the waters break by themselves. Once the waters are broken you will probably continue to leak fluid so will need to wear a pad.
The hormone drip
The final step uses a synthetic hormone, syntocinon, via a drip to artificially create contractions. The aim of the drip is to create steady, rhythmical contractions that will open the cervix enabling your baby to be born. For this you will need a cannula – small plastic tube – placed in your hand which stays in for the whole labour. You will be advised not to eat because you are now classed as having a higher risk of potentially needing a caesarean. You can have sips of water. You will be advised to have continuous monitoring throughout the labour as well. This checks that the drip is not creating too many contractions and that your baby is coping with them.
Not everyone has every step. Every mama and baby is individual but this is a possible pathway through induction.
This is the first in a series of articles about induction. The next one will be:
So how do you cope with each step?
You can also get access to your own hospital Trust guideline on the net. Just google ‘induction of labour (insert NHS Trust) guideline. Most are up on the net for public access.