Having a Baby?
Labor induction is the procedural use of drugs or other methods to bring on (induce) labor by stimulating uterine contractions. Labor is not usually induced before week 39 of pregnancy unless a specific pregnancy complication requires a doctor to do so. About 20 percent of all pregnancies in America are induced. There are risks associated with labor induction, such as infections and possible need for a Cesarean section. However, statistics indicate that the benefits usually outweigh the risks.
There are many reasons for inducing labor, including the following:
1. Pregnancy is overdue (postmaturity): more than 42 weeks have passed and labor still has not started naturally.
Some women request labor inductions so that they can schedule their childbirth and delivery time. They do so to avoid inconveniences at home or work, but this is generally not recommended. In fact the Food and Drug Administration has opposed elective inductions since 1978 - that is, inductions carried out for convenience.
There are various methods for inducing labor (including natural labor induction techniques), some can be performed in your health care provider's office, and others need to be performed in hospital.
Dilating the Cervix
Sometimes called ripening of the cervix, this method can include drugs or medical devices to soften the cervix, allowing for more stretch. Prostaglandin drugs (a synthetic form of the chemicals naturally produced by the body) can be taken orally or inserted into the vagina. Sometimes a hormone jelly (Prostaglandin or Prepidil gel) is applied to the cervix to ripen it and thereby producing contractions. Applications can be repeated after 4 to 6 hours. In other cases a special dilator tool, such as a Laminaria Stick (a small rod made with dried seaweed) can be used. The stick is inserted inside the cervix, where over a few hours the seaweed sucks in water, expanding and gently pushing the cervix apart. A small balloon tipped catheter tube called a Foley Catheter may also be used. Water is injected through the tube, irritating the uterus which prompts the cervix to dilate. All these procedures can be carried out at your obstetrician’s or midwife's offices.
Breaking Of Waters
Also known as Rupturing of Membranes (ROM), Artificial Rupture of Membranes (AROM) and Amniotomy. This procedure involves breaking the mother’s waters to kick-start contractions. Most women go into labor within hours of having their water broken. A doctor or midwife ruptures the amniotic sac with a small plastic hook, releasing a sudden gush of amniotic fluid. When the sac is ruptured, the body instantly produces more prostaglandin's which starts or increases uterine contractions. This procedure is usually carried out in hospital.
Stripping The Membranes
This procedure involves separating the amniotic sac from the wall of the uterus. This can only be carried out if the cervix is already dilated enough to admit the clinician’s gloved index finger. Inserting the finger, he places it between the cervix and membranes and rotates it to loosen the membranes. The membranes connect the amniotic sac to the wall of the uterus. Irritating the uterus can cause the body to release prostaglandin's and can cause contractions. You may experience slight cramping and spotting when the procedure is over. This procedure can be carried out in your doctor’s office (as well as hospital).
Oxytocin (Pitocin) - Drugs To Induce Labor
Usually applied via an intravenous drip (IV), Oxytocin (Pitocin) is only effective if cervix dilation is at least 3cm (some doctors say 4cm). When Oxytocin is used to induce labor, it can induce contractions and make them stronger. If labor has begun, the IV can be carried on for up to 8 or 10 hours. If Oxytocin does not take effect, it can be repeated on a different day, a process called serial induction. There should be close observation of any contractions and careful checking of the fetal heartbeat (fetal monitoring). The main danger of too much Pitocin, is that it can induce contractions so strong, they rupture the uterus and kill the baby. Induction of labor with Oxytocin should only be performed where it is considered more dangerous not to.
• Premature Birth: Where a woman is not yet full-term, inducing early labor poses risks for the baby, including jaundice (yellowing of the skin and eyes) and difficulties in breathing.
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