There are many questions related to induction of labour but for this issue Caroline May, our midwife, will concentrate on medically inducing labour.
The first methods are predominantly used to ripen the cervix in preparation for labour, rather than induce labour itself and administration of prostaglandin is the most common of these. Prostaglandin is a hormone like substance which is commonly given as a gel or pessary inserted high into the vagina and is often used in first time mums or women whose cervix is not showing signs of imminent labour. This can cause frequent short tightenings which in some women is enough to tip them into labour, but the aim is more to soften the cervix so that the membranes can be ruptured artificially. Another method used to prepare the cervix is to insert a foleys catheter into the cervix and fill the balloon with water. This puts pressure on the cervix with the hope of ripening it. This method is a good option for women who may not be able to use prostaglandins, such as those undertaking a vaginal birth after caesarean.
Artificial rupture of membranes
If the cervix is already ripe, or ready for labour, then the membranes may be ruptured artificially. This involves the Doctor or Midwife performing a vaginal examination and carefully using a small hook to break the bag of waters. In some women this is enough to send them into labour but if not it can be used in combination with an oxytocin drip. This is a synthetic version of the hormone oxytocin and unfortunately it doesn’t work in quite the same way as the naturally produced love hormone, but it does cause contractions. You will need an intravenous drip and the Midwife will increase the rate incrementally until you are having 3 to 4 contractions in 10 minutes that last for around 60 seconds. As with all methods of induction there are risks involved and you and your baby will need to be closely monitored.
Top tips for having labour medically induced
If you are being induced my top tip would be to be patient! Things like a foleys catheter can be left in for up to 24 hours, then you may still need prostaglandins, which may be repeated every 6-12 hours. Make sure you tell your family and friends to be patient too, just because you are going in to be induced on a Monday doesn’t mean your baby will necessarily be born that day and the last thing you need is everyone phoning up with the dreaded “have you had it yet?” question. Keep an open mind with regards to pain relief because if your induction is a long drawn out process you may be very tired by the time you get into established labour, on the other hand you may find things move very quickly and are very intense. The biggest thing to think about though is do you really need to be induced or are there other alternatives?
Caroline May qualified as a Midwife in 1999 and has worked in both community and hospital settings around Australia and in the UK. Currently residing in Perth with her partner and two young children, Caroline is particularly interested in home and waterbirth and is passionate about enabling women to make an informed decision and play an active role in their care. You can find all her articles here.