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Nine Months : Induction of Labour

What is induced labour?

When labour is started artificially, it is said to be induced. It is always planned in advance and you will be able to discuss advantages and disadvantages with the doctor or midwife.

When is it advised?

Labour is induced when there is danger to the baby or mother in the baby remaining inside the womb.

It may be induced under the following conditions:

* When you are well past your due date and are either in week 41 or 42.(The hospital policy varies on this as some wait for you to be one week overdue while others wait for two). It is best to check with the hospital.

* You have pre-eclampsia and there are complications which will affect you and baby.

* There is placental insufficiency.

* Baby's growth is slowed down or the baby is not moving well.

* When the contractions slow down in the first stage of labour and it is important to restart labour.

One thing that needs to be considered is that induced labour is much more painful than the natural one and you may be required to have an epidural, so that you are prepared for a caesarean or an assisted delivery (using forceps or ventouse cup), if necessary.

What are the different ways in which labour may be induced?

There are three ways to induce labour:

Pessaries: This method is usually not enough all on its own and is used in combination by one or both the other methods below. A pessary/tablet made of prostaglandins(a substance naturally found in womb lining responsible for stimulating uterine contractions to initiate labour) is inserted in your vagina (preferably in the evening or early morning). If cervix is ripe, the pessary stimulates uterine contractions. If the cervix is not ripe, these pessaries will help soften the cervix and open it to the extent that at least ARM can be carried out. The procedure of placing pessaries in your vagina may be repeated several times during the day till a result is achieved. Sometimes, gel may be used in place of pessaries. The advantage of using pessaries or gels is that you can be mobile and can eat while waiting for labour to start.

Artificial rupture of membranes (ARM): Also called breaking of waters, it is an effective way of inducing labour if the cervix is not sufficiently ripe. You will be examined internally by a doctor or midwife and your waters will then be broken using a lomg, thin plastic hook (you would have seen one in your ante-natal classes). This hook is brushed against the delicate membranes of the amniotic sac surrounding the baby and they are broken. Once the membranes are broken, the increased pressure on the cervix causes contractions to become much stronger. This procedure of breaking membranes is painless and is successful in starting labour in majority of the cases. Once waters are broken, mobility may be restricted especially if the next step is to add syntocinon to your drip.

Syntocinon: This is a hormone that is added to your drip to make the contractions stronger and regular. This method is usually combined with ARM. Although very safe, when using syntocinon, contractions may be much more painful, stronger and with shorter intervals between them as compared to those started by natural labour. Mobility is restricted once syntocinon is used as it is added in a drip in your arm.

Is it true that making love can induce labour?

It is true that sex can help to induce labour but only when the term is almost complete or you are overdue. Semen contains prostaglandins, the same substance which is secreted by the womb lining and responsible for softening the cervix and initiating labour. Lovemaking also stimulates the cells of the cervix to secrete their own prostaglandins.

How does breast stimulation affect labour?

Stimulation of breasts can produce very strong contractions. Hence, it is not advisable to practice it to initiate labour unless asked by the doctor or midwife to do so. Nipple stimulation can even reactivate a halted labour.

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