When it comes to delivery planning, labor can be initiated naturally or, under some circumstances may need to be induced. Labor induction may need to be utilized for a variety of different reasons. Sometimes labor does not begin naturally by the 40-week mark and the baby is well past its expected due. If the water breaks, but labor has not begun, medication may be used to start contractions. Additional reasons for induction may include: uterine infections, fetal growth restriction, lack of amniotic fluid, gestational diabetes, preeclampsia, placental abruption, or other medical conditions.
While labor induction may be deemed necessary by a medical provider, there are some risks involved and many things to consider prior to elective or recommended labor induction. Regardless of the reason for induction, there are a variety of methods for inducing labor. From exercise to medications to medical procedures, here’s a look at some of the numerous approaches for inducing labor.
Natural Approaches for Inducing Labor
While exercise is not a guaranteed option for inducing labor for every woman, some effective exercises to help the body prepare for delivery include pelvic lifts, lunges, walking or stair climbing.
To achieve pelvic lifts, lie down on your back, keeping the knees bent, your foot on the floor. Begin by flattening your back against the floor and simultaneously bend the pelvic area upwards and hold for approximately 10 seconds and slowly release.
Lunges can be achieved by standing with both legs together and taking one big step forward into a lunge with one leg. Additionally, lunges can be done by pushing up against the wall for additional stability.
There are a number of reasons that sex can help induce labor, one reason is that sex releases oxytocin, which may help jumpstart contractions. While sex is safe at full term during your pregnancy, be sure to avoid sex once after your water has broken as doing so may increase the risk for infection.
Both acupuncture and acupressure can play a positive role in inducing labor.
While natural herbal remedies may be effective to induce labor, it is important to check with your midwife or doctor prior to partaking of herbal remedies. Some of the common natural ingredients that can be used for inducing labor naturally include castor oil, which can stimulate your gut and uterus to cause the first contraction, raspberry leaf, which acts as a uterine tonic to stimulate labor, licorice, motherwort, fenugreek, cumin tea, and thyme tea.
Medically Assisted Approaches for Inducing Labor
Pitocin, A Synthetic Form of Oxytocin
When women go into labor naturally, the body produces the hormone oxytocin to produce contractions. Pitocin is a synthetic form of this hormone used to stimulate the uterus to contract. It is given via IV, starting at a low dose and gradually increasing until regular contractions are occurring. Pitocin can stimulate labor to begin and also speed up a labor that may have stalled.
Pitocin is not without its risks, as it can cause abnormal and excessive contractions. These can lower the baby’s oxygen level and decrease the heart rate. If this occurs, a caesarean section may be necessary to ensure a safe delivery. In rare cases, Pitocin can result in uterine rupture, which will necessitate an emergency C-section and may result in the removal of the uterus. Pitocin can also increase the risk of bleeding after delivery due to the uterus not contracting after the baby is born.
Prostaglandins, a.k.a. Suppositories
Prostaglandins are used to induce labor. These are suppositories are inserted into the vagina, typically in the evening so that labor will begin by the next morning. This method is often used before starting Pitocin administration or using a Foley catheter to induce labor so that the mother can freely move around without being encumbered by intravenous tubing and machines early in the process.
A Foley catheter is sometimes used to help ripen the cervix during induction. The deflated balloon is inserted into the cervix and then slowly inflated with saline. This can encourage the cervix to soften and dilate. This method is typically used prior to giving Pitocin to start contractions.
Membrane sweeps are a common method of labor induction. This procedure is commonly performed in a doctor’s office, but may also be done prior to starting medications or inserting prostaglandins to induce labor. During this procedure, a doctor inserts a finger into the cervix and manually separates the amniotic sac from the cervix. This can stimulate the natural production of prostaglandins and help to bring on labor. This is typically the first step a physician or midwife will use to try to bring labor on. The advantage of this method is that it is usually done at the doctor’s office and does not require any medication. It can produce mild cramping and may be a bit uncomfortable during the procedure. It is relatively non-invasive compared to other methods but can be unreliable in producing labor.
Membrane Rupture for Regulating Contractions
When the amniotic sac ruptures, natural prostaglandins are increased which can speed up contractions. In order to increase the regularity of contractions, the membranes may be ruptured artificially. This is done by inserting a sterile, thin hook made of plastic into the cervix. The hook is rubbed up against the amniotic sac until it catches it and ruptures the bag. In addition to producing prostaglandins, the baby’s head will now be against the cervix. This causes contractions to become stronger with the pressure of the baby’s head helping to dilate the cervix.
Rupturing the membranes can shorten labor times by up to an hour. It also allows the amniotic fluid to be examined for meconium. The presence of meconium in the amniotic fluid can indicate fetal distress during labor. The artificial rupture of membranes allows access to the baby’s head where a fetal heart rate monitor can be placed for more accurate monitoring.
While this type of approach for inducing labor can be effective, there can also be a number of complications when the membranes are ruptured prior to the start of labor. If the baby has not fully engaged in the pelvic space, he/she may turn breech during labor which can cause complications. If the baby’s head is not engaged, the umbilical cord may be able to slip out ahead of the baby. This is a medical emergency and would necessitate an emergency C-section to ensure the baby is getting enough oxygen. If the membranes are ruptured and labor has not begun there may be an increased risk of infection if the birth does not occur within 48 hours.
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