Helping Things Along: Why Your Doc May Need to Induce Labor

Nowadays, healthcare professionals strive to allow pregnancies to reach full term, typically around 39 weeks, before considering elective induction of labor. However, there are certain instances where intervention becomes necessary. Let's take a closer look at why a doctor might choose to induce labor and what you can anticipate if it happens to you.

What Labor Induction Is

Labor induction, also known as inducing labor, involves initiating the process of childbirth intentionally instead of waiting for it to occur naturally. Healthcare providers do this in specific situations where there are concerns about the health of the mother or the fetus or when the pregnancy has exceeded its due date. Additionally, labor may be induced if it has become stagnant or is not progressing as expected. The purpose of induction is to expedite the childbirth process in circumstances where it is deemed necessary for the well-being of the mother and the baby.

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Why Labor Induction May Be Performed

The decision to induce labor takes into account various factors, including the mother's health and the condition of the cervix, as well as the baby's health, gestational age, weight, size, and position in the uterus. According to the Mayo Clinic, there are several reasons why labor may be induced, such as:

• Approaching 1 to 2 weeks past the due date without the onset of labor (post-term pregnancy).
• Absence of labor after the amniotic sac has ruptured (pre-labor rupture of membranes).
• Presence of uterine infection (chorioamnionitis).
• Baby's estimated weight falling below the 10th percentile for gestational age (fetal growth restriction).
• Insufficient amniotic fluid surrounding the baby (oligohydramnios).
• Development of gestational diabetes or pre-existing diabetes.
• Development of high blood pressure with signs of organ damage (preeclampsia) during pregnancy, or pre-existing high blood pressure.
• Partial or complete detachment of the placenta from the uterine wall before delivery (placental abruption).
• Presence of certain medical conditions like heart, lung, kidney disease, or obesity.

Elective labor induction, on the other hand, refers to initiating labor for convenience without any medical necessity. It can be beneficial for women who reside far from the hospital or birthing center or those who have a history of rapid deliveries. A scheduled induction also may be recommended to prevent prolonged pregnancy. In such cases, healthcare providers ensure that the baby's gestational age is at least 39 weeks or older before proceeding with induction to reduce the risk of health complications.

Recent studies have shown that low-risk pregnancies can be considered for labor induction between 39 to 40 weeks. This timing has been found to reduce various risks, including stillbirth, large baby size, and the development of late-onset high blood pressure. It is important for women and their healthcare providers to collaborate in making decisions regarding labor induction at 39 to 40 weeks.

Ways to Induce Labor

Before proceeding with labor induction, your healthcare provider will conduct an examination to assess the condition of your cervix. They will carefully consider the advantages and disadvantages of inducing labor. Throughout the induction process, your doctor will continuously monitor the well-being of the fetus to ensure it is tolerating labor properly.

Healthcare providers have several guaranteed ways to induce labor, depending on the condition of your cervix in terms of softness, dilation, and effacement. If your cervix is not effaced or dilated, your healthcare provider may first use methods to ripen the cervix:

• Stripping the membranes: Your doctor or midwife can gently pass a finger over the amniotic sac membranes to release natural chemicals called prostaglandins. These chemicals soften the cervix and can initiate contractions, serving as an initial approach to starting labor.
• Prostaglandins: Prostaglandins, acting as hormone-like substances in the body, can help soften and ripen the cervix. Your provider may administer prostaglandins as a pill or as a suppository in the vagina to induce labor. Common prostaglandins used for induction are misoprostol (Cytotec®) and dinoprostone (Cervidil®).
• Balloon catheter: A small tube with a balloon at the top is inserted into the cervix. The balloon is then filled with saline to create pressure, which aids in the ripening and dilation of the cervix.

Once the cervix has ripened, your provider may recommend methods to enhance uterine contractions and promote the descent of the baby through the birth canal:

• Amniotomy: Your healthcare provider uses a small plastic hook to break the amniotic sac through the cervix. This procedure is performed when the cervix is partially dilated and effaced. It is generally not painful.
• Oxytocin (Pitocin®): Oxytocin is a hormone naturally present in the body that stimulates contractions. In some cases, synthetic oxytocin, called Pitocin®, may be administered intravenously to initiate or accelerate labor contractions.

The response to labor induction can vary greatly among individuals. While some people may respond swiftly, others may take several hours to show progress. There are no set rules regarding the duration of labor or the time it takes until delivery. However, in most cases, the majority of individuals transition into "active" labor within 24 hours after induction. Active labor is typically characterized by the cervix dilating to around 6 centimeters in diameter.

Natural Ways to Induce Labor

Once you’re past your due date, you may start feeling a bit anxious and eager to get the show on the road. This leads some individuals to try to induce labor naturally. Before proceeding with this, however, there are a few considerations you should keep in mind. Doctors at the Cleveland Clinic warn that you should not attempt any natural induction methods unless you meet the following criteria:

• You have gotten approval from your healthcare provider.
• Your baby is head down.
• There are no current complications with your pregnancy that would cause these methods to be unsafe.
• You’re at least 37 weeks pregnant.
• There are no conditions that might make a vaginal delivery or unmonitored labor dangerous, such as a prior cesarean delivery or a placenta issue.

Once you’ve got the green light from your doctor or midwife, take a look at these suggestions on how to induce labor naturally. These methods include exercise, sex, nipple stimulation, acupuncture, acupressure, eating date fruit, and using evening primrose oil.

The Bottom Line

In certain situations, a labor induction becomes necessary to ensure the well-being of both the mother and the fetus. Reasons for induction can include being past the due date or encountering health complications during pregnancy. Your healthcare provider will use medications or techniques like breaking the water to induce labor if deemed necessary. While it may not align with your original birth plan, it's important to remember that your provider is making recommendations based on what they believe is best for you. Don't hesitate to seek clarification and ask questions to understand what to anticipate during the process.

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. Please contact your health provider if you have any medical questions or concerns about your child or yourself.

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