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Induction of Labour

Reasons for Inducing Labour

There are three reasons that we might talk to you about induction of labour.

Going Overdue

Now you don’t have the gestation of an elephant. At some point your placenta will give up and stop working. The placenta is what feeds your baby so it’s really important that we would induce you before that happens. We’d normally induce you around the 10-14 day over your due date mark.

Medical Conditions

The second reason might be that you’ve got a underlying medical condition that you had before you were pregnant. There may also be a medical condition that you’ve developed during pregnancy. This could be something like your blood pressure creeping up or that you’ve developed gestational diabetes. Doctors will assess whether it’s safer for your baby to stay in the womb a little longer or to be born.

Waters Breaking

The third reason is if your waters break. Now your baby is in like a balloon, like a bag of waters and if that gets broken, here’s a risk that they could develop an infection. So that would be a reason that we would induce you.

What Happens During Induction of Birth?

Hospitals will vary very slightly in terms of when they induce labour and quite how they do it. They’ll communicate this with you, but I’m going to give you an overview so you know what to expect. The hospital will monitor your baby when you first come in. So they’ll check everything is OK to begin with. They’ll then examine you – a vaginal examination using 2 fingers, just to assess the cervix (the neck of the womb). This is just to see what it’s doing, before they actually start looking at inducing labour.

Breaking your Waters

Now by doing that, they’ll be able to make a decision of whether or not they can start induction of labour. They will first look at breaking your waters. If they break your waters, this usually releases a hormone which helps kick start everything. It may be that they don’t need to do anything else and labour progresses normally and naturally by itself. They use an amnihook to actually break your waters, as they examine you, – it sounds worse than it is. It’s like a thin sort of stick, with a little hook on the end. They just slide it between their fingers, as they examine you, and break your waters.

A Pessary

It’s usually not much more uncomfortable than when you’re just having an examination. So if they break your waters, that’s great. They will wait and see what happens. However, they may find that when they assess you, your cervix is shut. There’s no way one of those amnihooks is going to get through a shut cervix. If this is the case, they would then offer you a pessary, usually in gel/tablet form, to induce labour. This would be inserted into the vagina, just to sit below the cervix and this releases synthetic hormones. These actually help to soften or ‘ripen’ the cervix to encourage it to open. This means that you’re more likely to get to the point when you can have your waters broken. When they insert the pessary, they’ll normally get you to stay on the bed for a good hour just so it doesn’t fall out. This gives it time to allow it to start working. They’ll usually monitor the baby in this time. You may find that nothing happens or you may find you start to develop period type pains and a few tightenings. If not a lot’s happening, the midwives will then reexamine you 6 or 8 hours later, to see what the progress is. And if internally they can break your waters, great! If not, they’re likely to repeat the process with another pessary. And this can go on for one or two days!

Don’t get ahead of yourself…

Your baby is unlikely to be born the day that you’re labour is induced. It’s important that you recognise this. If they are, it’s an absolute bonus! Now if they carry on this with the pessaries and nothing happens the only option then eventually, is that you’d have to have a caesarean section. But if they are able to break your waters at some point they’ll usually wait, just a couple of hours to see what’s going on, see if your body kick starts everything and if still nothing happens, there’s the option of a drip.

More Hormones

This would be the option if your waters have already broken in any case. However, your waters may have broken higher up and the midwife might still be able to break them lower down at the opening of the cervix. So if they start talking to you about the drip it’s usually done in the back of your hand and this is syntocinon. This is, again, another hormone that actually forces your uterus to contract. After being given syntocinon there is no choice, your cervix will start to contract and labour will be induced! We give syntocinon to you very slowly to allow your body to get used to it and then we increase it to encourage those contractions. We monitor your baby closely while this is going on.

Pain Relief

When people are in labour, they sometimes talk about a pain ladder. What they mean by that is that they climb up the ‘rungs’ slowly as the pains intensify. But people sometimes find that when they’re induced they feel that they’re thrown up that ladder a few rungs at a time. It can suddenly become really intense. This isn’t everybody’s experience, but if you do find this, just be aware that there’s lots of pain relief available. You’re not going to get any medals for refusing it! If you’ve found this information on induction of labour useful and you’d like a fully comprehensive antenatal course, to prepare you for labour, birth and for early parenting, then check out one of our Antenatal Classes!

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