If you've landed on this page, your doctor has probably talked about 'inducing labour' with you. You're scared and do not know if you should opt for it. You ask your friends and relatives who have been through it and all your hear from them is the amount of pain it caused them. Well, that doesn't help, doesn't it? You want to know the pros and cons of the procedure, if it is really indicated for you. What are the implications if you decide to wait it out instead of choosing this option? In this post, Dr Veena Zaveri, consultant gynecologist from Kohinoor Hospital, Mumbai tells you all that you ought to know about induced labour.
What is induced labour? Why is it required?
Inducing labour is a process where your labour pains are set in artificially to help you progress into labour. This option is put forward due to a medical emergency or if the mother is suffering from any other health condition that might cause a threat to the baby's health and well-being in the womb.
There are multiple reasons that would compel your practitioner or the doctor to induce your labour like,
Your water broke but the contractions gave you a miss.
You are two weeks beyond your expected date and your labour has not set in naturally yet. The longer the pregnancy continues, the larger the baby grows in the womb, which can intervene in the natural birth process and lead to an emergency C-section.
An infection in the uterus that threatens baby's well-being.
There is too little amniotic fluid surrounding the baby and hence your baby isn't thriving well within.
Your placenta has started to deteriorate; it has either peeled of the walls of the uterus partially or completely leading to placenta abruption. In this case nutrients are not delivered to your baby appropriately which can lead to stillbirth or other health issues in the child.
A medical condition like high blood pressure or diabetes in the mother which can put the baby at risk.
Your baby has stopped growing at the expected pace.
How is labour induced?
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Some of the ways through which labour can be induced are:
Insertion of prostaglandins: To dilate the cervix your doctor would insert medications containing prostaglandins into the vagina in gel or tablet form. The medication then helps the cervix to open and the contractions to set in.
Being on drips: To augment labour you might be put on drips to receive oxytocin through an IV pump to set up the contractions. Oxytocin is a hormone which when released in the system sets the uterus into contractions thus starting the labour process.
Other methods: If your cervix is dilated and your contractions have not set in yet, your doctor might insert a finger through the cervix to separate the amniotic sac from the lower part of the uterus which releases prostaglandins and possibly gets the contractions to start.
How is induced labour different from natural labour?
Induced labour can cause intense pain and prolong the labour process whereas natural labour is less painful and shorter in duration. Moreover being an artificial process induced labours are difficult to start with and may not always give desired results.
What are the risks of induced labour?
Though inducing labour is generally a safe option but it does come with its own share of risks.
Failure to progress into labour: Induced labours are usually long and more painful. Many times the induction fails to help get into smooth labour which can lead to an emergency C-section.
Foetal distress: After inducing your baby's foetal heart rate is checked and monitored closely. If the baby shows any signs of distress like a racing heart rate, less oxygen supply through the umbilical cord or your contractions are coming in too fast due to inducing which can stress her out chances are you might have to go under the knife.
Uterine rupture: Though very rare but some medications given during labour induction can lead to a serious complication where the uterus might tear open along the scar line of a previous C-section or a major uterine surgery.
How is one chosen for inducing labour?
A sonography with a color Doppler is done to check if the blood flow to the foetus is normal and the umbilical cord is not wrapped around the neck of the baby. A non stress test or foetal heart tracing is done to check if the baby would be able to tolerate labour. In case of foetal distress or umbilical cord wrapped around the neck your doctor might want to give induction a miss.
What if one chooses to wait for labour to set in naturally and not induce?
One can wait up to two weeks post the due date for labour to set in naturally with very close monitoring. Anything beyond that can lead to other complications in the womb which may be dangerous for the foetus, such as
Increase in the size of the foetus and decrease in the water levels.
Chances of umbilical cord compression increases.
The placenta becomes calcified or hyper mature.
Prolonged stay in the womb can up the chances of foetal distress too.
Can an epidural be used when the labour is induced?
Artificially set in labour is considered to be more painful than natural labour. Epidural stands to be safe to help one ease the pains and progress towards birthing.
Can induced labour result in natural delivery?
No. Complications can arise at anytime during labour. Usually foetal distress and non-progression of labour after induction leads to a C-section.
What are the pros and cons of inducing labour?
The pros are that inducing can lead to a vaginal birth and assure a faster healing devoid of any cut in the abdomen. The cons are its more painful, prolonged and if complications arise it can lead to a C-section.
When should you not opt for induced labour?
One should not choose this option when:
Tests reveal that baby would not be able to tolerate the pressures of labour.
You have placenta previa where the placenta is lying low and close to the cervix.
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