Medical induction happens when labor is started artificially in cases such as preeclampsia, poorly controlled gestational diabetes, placental abruption or a pregnancy that has continued on longer than 42 weeks. There are also times where induction can happen for non-medical reasons, such as parents wanting a certain date of delivery, a certain care provider or travel plans for relatives.
The estimated date of delivery (EDD) is usually calculated by the 40 weeks after the first start of the woman’s last period and later confirmed by an ultrasound. In most cases, after 40 weeks the mother and baby are being monitored more closely, making sure that the baby is moving everyday to insure that it is getting enough oxygen. Test like Non Stress Test and an ultrasound might be done, if these test are abnormal then induction is usually recommended. Midwifery practices, usually do not do these tests until the mother is past 41 weeks, and if there is another reason to suspect that the pregnancy is not going well.
Medical Methods of Induction
Amniotomy (AROM)
This is used when the cervix is “ripen” and partially dilated. The membranes are ruptured with an amniohook, which allows the amnionic fluid to drain from the uterus. The release of amnionic fluid usually starts contractions, and the baby’s head has to also be engaged to prevent a cord prolapse. This method is also used to increase the intensity of labor but sometimes the lack of the bag of waters makes the contractions more intense making is harder for the mother to relax and the baby to turn. (1)
Stripping the Membranes
Stripping or “sweeping” the membranes involves a doctor or midwife to place their finger into the cervix and separating the amniotic sac from the uterine wall. This causes a release of natural prostaglandins causing cramping and contractions. The stripping of the membranes usually is done towards the end of pregnancy during a routine visit. If you do not want this to be done to you, let your care provider know since it can be done with or without consent. (2)
Cytotec (Misoprostol)
Cytotec was originally formulated for treatment of ulcers, now it comes with a strong warning when used in pregnancy and labor as it causes spontaneous abortions. This drug brings on hard labor quickly and suddenly. It is also very inexpensive making it very popular to use with doctors. Some side effects include (3):
-Uterine Rupture
-Retained Placenta
-Amnionic Fluid Embolism
-Hemorrhage
-Damage to Cervix
Pitocin
Pitocin is sterile and clear colorless solution of synthetic oxytocin. It is used to induce labor, progress a slow labor and after the birth of the placenta to control bleeding. Pitocin is usually given in an IV and mixed with an IV bag of fluids of electrolytes and dextrose solution. The dosage is different based on the hospital, this is mainly because the doctors look to see how well the mother and baby are tolerating the dose. Sometimes the dose may decrease if the baby is in distress and the opportunity for the baby to recover and the mother to move positions is offered or the care provider might proceed to a c-section (4).
Non-Pharmaceutical Induction
Here are some well know labor induction methods that have been proven to work for a lot of women to get their labor going. A lot of times these methods may not work because labor is not ready to begin on its own. A mother should always consult her healthcare provider when thinking about using any of these, especially any herbal remedies.
Nipple Stimulation
Causes the release of Oxytocin in the mother causing the uterine contractions. Has been known to cause prolonged contractions and should be used with caution.
Acupressure/Massage
Massage therapist that are trained in pregnancy know which pressure points to avoid in order to avoid premature labor. They can also be used to help mothers who are past their due dates.
Acupuncture
Chiropractors and acupuncturists offer a series of treatments that seem to bring on labor after the second or third treatment.
Castor Oil
Can bring on abdominal cramping or diarrhea which can cause a woman’s body to be ready for labor. This may continue throughout labor, which can cause discomfort and put a mother at risk for dehydration.
Walking
The moving of the pelvis helps the baby settle into a better position which can help labor advance.
Essential Oils
Clary sage is used by some midwives along with the pressure points to get labor going.
It is your turn to tell me which ones have your used in order to get your labor going? Share down below if any medical induction methods were communicated to you to get you into labor.
Much love,
Krystina RN, BSN, CBE
