INDUCING BIRTH

Being Induced

YOU'VE PROBABLY HEARD THE HORROR STORIES: induced at 8am, contractions so immediate and so violent that the body's natural painkillers don't get a look-in and it's too late for an epidural, baby delivered within the hour to a mother swearing she'll never have another. At the other end of the spectrum are the mothers-to-be who order an epidural before their induction, then cruise their way through the birth without feeling a single contraction. In an ideal world, a woman's body and her baby would be allowed to choose the right time for their parting of ways to begin. Most pregnant women can safely be allowed to run at least 10 days past their due date (counted at 40 weeks from the first day of the last menstrual period) before their midwife or obstetrician considers an induction.

Reasons for an induction

In some cases where medical complications may be putting the baby or the mother at risk, labor may be induced earlier. For example, pre-eclampsia (also known as toxemia or hypertension) can strike during pregnancy, reducing blood and oxygen supply to the baby and to the mother's vital organs. High blood pressure, swelling of the hands, feet or face, and proteins in the urine are all indicators of possible pre-eclampsia, so your lead maternity career (LMC) will monitor these closely throughout your pregnancy. It can be fatal for mother and baby, so your pregnancy may be induced prior to your due date. Women with diabetes in pregnancy will also be closely monitored, as fluctuating sugar levels in the mother's blood can affect the health of the unborn baby. Sometimes the baby will receive too much sugar and grow very large, in which case labor may be induced before it gets too big to fit through the birth canal. At the other end of the spectrum, an induction may also be necessary if the baby is failing to grow as much as it should. This usually happens because it's not getting enough nutrients from the placenta, and sometimes doctors feel that the baby will have a better chance if labor is induced so the baby can be looked after outside the womb. Finally, the increased risk of infection means that an induction is likely to be performed if your contractions haven't started 24 hours after your waters have broken.

So, what happens?

What does your LMC do to get the show on the road? The gentlest method is to insert a hormonal substance into the vagina to stimulate the cervix and kick off contractions. This approach is likely to most closely mimic a natural labor, as it can take hours for the action to start and the contractions to build up. Alternatively, once your cervix has started dilating, your LMC may speed things along by artificially rupturing the membranes using a small hook. This almost invariably triggers contractions, which may come suddenly and intensely. A third option is stimulating contractions using a syntocinon drip. Here, a needle will be inserted into your arm and synthetic oxytocin pumped into your bloodstream to mimic the rhythm of natural contractions. Labors that are induced are more likely than natural labors to require further medical intervention, such as forceps delivery or caesarean section, so it's important to remember labor is not an end in itself, but a means to achieving your ultimate goal of a healthy baby and a happy mother. Whatever it takes to get there, congratulations!