The Best Induction

5 Tips for the Best Induction of Labor Possible

Man holding a laboring woman's hand in the hospital
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The induction of labor is a procedure that appears to be on the rise, both for medical and non-medical reasons. That said, if you are having an induction of labor, you’re probably hoping for the best case scenario for labor, even if all you hear from others are nothing but horror stories about being induced. These five tips will help you have the best induction of labor possible.

1 . Know Your Cervix

Before you try to do an induction of labor, you’ll need to know a bit about your cervix.

Your doctor or midwife will do a  vaginal exam to get this information and calculate how likely an induction is to bring on labor, called the Bishop Score. It’s easier to get a cervix to open that is ready or ripe for birth. This includes:

  • Dilation (how open your cervix is)
  • Effacement (how long it is)
  • Station (how low is baby)
  • Position (which way is it angled)
  • Consistency (how firm or soft)

Each of the points above is scored as a 0, 1 or 2. The higher the number, the more likely your cervix will open easily and that labor will begin. If this number is low, you may need to have treatments for cervical ripening before an outright induction of labor is considered.

2. Ask About Your Options 

There is more than one way to do an induction of labor. You have many options. Not every option is right for every woman. What goes into this decision will be: 

  • Maternal conditions (pre-existing complications, VBAC status, number of babies previously born, etc.)
  • Practitioner preference
  • Maternal preference

Since some options, like breaking the bag of waters (amniotomy) can start a clock that says you must have your baby by a certain time, and that may lead to more interventions, these may be lower on your list of ways to start labor.

Talk about your birth preferences with your practitioner to help figure out the best way to achieve those preferences.

3 . Know Your Dates

Statistically speaking, the closer you are to your due date, the easier it is to get labor going. This is because your body and your baby are closer to being ready for spontaneous labor. Sometimes a woman will show up for an induction of labor and already be in the early stages of labor. In this case, the procedures are actually an augmentation of labor (speeding it up) that has already truly begun.

When your due date is not well known or prior to thirty-nine weeks, the risks are very high for your baby and should not be considered without significant medical reasons for induction. The American Congress of Obstetricians and Gynecologists (ACOG) has called for an end to elective induction of labor prior to week thirty-nine to protect your baby from being born too soon.

4. Keep Your Balance 

While you may be excited to finally be on the road to meeting your baby, you may also be concerned about an induction of labor.

It's normal to feel this way. It can be both exciting and scary. Discuss your concerns with your practitioner before going in for an induction. Talk about possible scenarios and know what the options are for you and your baby.

Believe it or not, induction is not an exact science. This means that not every method will work the same way, nor will it necessarily be a fast process.

Once at the hospital, you may need to adopt a more go with the flow attitude, but that doesn’t mean that you have to give everything up that you had wanted from the get go. You still have options and choices. For example, if not using pain relief was important to you, an induction does not mean that you have to accept pain relief. Many women are able to keep parts of their birth plans intact, despite induction of labor, with the proper planning, practitioner support and labor support.

Ask questions about the proposed induction procedures:

  • Will you be able to still move around?
  • Will this method require that you have constant fetal monitoring or only brief periods?
  • What are the likely risks and benefits of each intervention?
  • How long would we try this before trying something else?
  • What happens if this method doesn't work? What's the next step?

5. Find Support 

Don’t forget to have help. Many women do find induced labors to be very different than spontaneous labor. Though the mental and emotional factor is a large part of this toll, meaning support from your family and doula, as well as the medical staff that you have, will be vital to how you think and feel about your birth. While some inductions of labor happen very quickly, others may take much longer than you have anticipated. It may mean that you start an induction on one day and do not have your baby for a day or two depending on the condition of your cervix, the methods tried, and how you and your baby handle labor. In fact, sometimes, you're bored in the beginning of an induction, waiting for something to happen. Then, once labor kicks in, you're full steam ahead. Having a team of supporters will help make this time bearable.

Induction of labor can be a positive experience. Keeping your eyes open and your mind realistic are the keys to being helping you achieve that balance.

Sources:

American College of Obstetricians and Gynecologists. Labor Induction. January 2012.

American College of Obstetricians and Gynecologists. (2014). Practice bulletin #146: Management of late-term and postterm pregnancies. Obstetrics and Gynecology, 124(2, part 1), 390-396.

Declercq ER., Sakala C, Corry MP, Applebaum S,  Herrlich A (2013). Listening to mothers III: pregnancy and childbirth. New York, NY: Childbirth Connection. 

Gülmezoglu AM, Crowther CA, Middleton P, Heatley E. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database of Systematic Reviews 2012, Issue 6. Art. No.: CD004945. DOI: 10.1002/14651858.CD004945.pub3

Jozwiak M, Bloemenkamp KWM, Kelly AJ, Mol BWJ, Irion O, Boulvain M. Mechanical methods for induction of labour. Cochrane Database of Systematic Reviews 2012, Issue 3. Art. No.: CD001233. DOI: 10.1002/14651858.CD001233.pub2

Simpson KR, Newman G,  Chirino OR (2010b). Patients’ perspectives on the role of prepared childbirth education in decision making regarding elective labor induction. Journal of Perinatal Education, 19(30), 21-32. 

Obstetrics: Normal and Problem Pregnancies. Gabbe, S, Niebyl, J, Simpson, JL. Fifth Edition.

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