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If your care provider has recommended an induction, you may be wondering what happens next. Labour induction is a process that uses artificial methods to kickstart labour.
There are two steps to the induction process:
Priming the cervix. If your cervix is long, hard and closed, your care provider will use either a prostaglandin gel or a balloon catheter to soften and open it. This process can take anywhere from six to 48 hours. You may experience light contractions during this time but neither the gel or the balloon catheter induces contractions.
Kickstarting labour. Your care provider will either break your waters (known as artificial rupture of membranes) or hook you up to an IV drip which will administer synthetic oxytocin (syntocinon) to start uterine contractions. Often both these methods will be used.
There are many reasons why an induction is recommended, the most common of which are:
Your waters have broken but labour hasn’t commenced. In this instance, your care provider will recommend induction within 24 hours of your waters breaking to prevent the risk of infection. However, if your waters are green or brown, your care provider will refer to this as meconium staining (your baby has done its first poo) and will regard it as a sign that your baby is stressed. In this instance, induction will be done promptly.
You are over 41 weeks of gestation
You have health concerns (high blood pressure, pre-eclampsia)
Your baby has stopped growing, amniotic fluid is low, or movement has slowed
It’s important to note that induced labour is monitored quite differently from spontaneous labour (where you go into labour without assistance) and there is a higher risk of intervention once induction starts. This is often referred to as the cascade of intervention which is, essentially, a domino effect of one intervention leading to another. For example an induction puts you at higher risk of needing an epidural which, in turn, puts you at higher risk of requiring an instrumental birth or emergency caesarean.
Once you arrive at the hospital for your induction, a vaginal examination will determine what method of induction is best for you (at this stage, your care provider will also monitor your baby’s heart rate and check their position). You can expect vaginal examinations every four hours to determine your progress and you’ll be monitored regularly, too. Your care provider will most likely want to use CTG monitoring which does limit your movement and may prevent you from using the shower or the bath in labour. Induced labour is also considered more painful; instead of a slow build-up of contractions, you experience the peak intensity of a contraction from the get-go which can quickly become overwhelming.
Our advice: embrace the induction process and do your best to work with it. Resistance in labour (both spontaneous and induced) will increase your tension and therefore your pain. If you need to be induced, surrender to the experience, embrace the process and gather all your birth skills to navigate contractions and interventions. If you want to hear positive induction stories, listen to Anna’s in episode #169 and Hilary’s in episode #267.
Your induction will be dictated by your cervix; if it’s closed and hard, you will require prostaglandin or a balloon catheter to soften and open it. However, if your cervix is already dilated (open), your care provider may suggest breaking your waters followed by the syntocinon drip. Generally, most women require more than one of the following methods to induce labour :
If you’re looking for a positive induction story listen to Anna McGahan. In episode 169 episode I talk to Anna about her beautiful VBAC in the midst of Covid-19. She describes her second birth, with daughter Juniper, as birth of juxtapositions: an induced, drug-free, hospitalised, hypnobirth VBAC. It’s a birth story complete with an incredibly positive induction, strong midwife support, unwavering faith in body and mind and the immense healing of redemptive birth after trauma.
birth · 45min
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