Induction – When is it Necessary?

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Medical induction of labor has been steadily increasing since the 1980’s.

In the U.S., 25% of women are induced and 19.2% have their labors “accelerated” artificially (http://www.pregnancy.com.au/birth-choices/birth-information/birth-articles/inducing-labour-naturally.shtml). How do we know, as expecting mothers, whether an induction is truly an emergency or not? What other options do we have?

Here are a few ways that labor is induced:

1. Sweeping of the Membranes. This procedure has been described as a more intense pelvic exam. Your doctor or midwife feels around your cervix (in a “sweeping” motion) to separate the membranes that connect the amniotic sac to the wall of the uterus. As a result, your body will release prostaglandins, hormone-like substances that usually kick start labor. Your doctor may not opt for this solution because not only can it be painful, but it is also not guaranteed to be successful. Sweeping the membranes does not produce “immediate” results, either. It may still take a few days for labor to begin.

2. Hormones. If your cervix is not ripe, your doctor might opt for cytotec (a synthetic version of prostaglandin E1), a small pill that has several potential advantages: it is relatively inexpensive and it can be given via several routes (oral, vaginal, sublingual, buccal). It increases the risk of uterine rupture and should not be used for women who have had a cesarean birth in the past.

3. Foley bulb: Although it is not commonly used anymore, the Foley bulb is a manual method used to ripen/stretch the cervix. This is a small saline-filled balloon that’s inserted into your cervix and then inflated, forcing it to begin opening. Although it does dilate the cervix, it does not ripen it. Hence, it does not necessarily trigger labor.

4. Pitocin: Pitocin mimics oxytocin, the love hormone, which tells your uterus to begin contracting. Given through an IV, Pitocin can be used to get labor started or to rev up sluggish contractions. Risks of Pitocin include contractions that are too strong or close together (they don’t give the uterus a chance to relax and recover and can result in fetal distress.)

5. Rupturing membranes. Your doctor may intentionally break your water to get labor started. Sometimes this does the trick; other times it has to be done in conjunction with Pitocin, which comes with pain and the additional side effects.

Although induction is generally safe, there are still some risks associated with these methods, such as:

– Higher risk of cesarean birth (if your cervix hasn’t begun to thin, soften, and dilate)

– Premature birth (inducing early may result in a premature baby)

– Low heart rate (caused by Pitocin or prostaglandins if they cause too many contractions and diminish your baby’s oxygen supply)

– Infection

– Umbilical cord prolapse (when the cord slips in front of the baby before delivery)

– Uterine rupture

– Bleeding after delivery (Uterine atony)

If these are potential risks you want to avoid, here are some natural induction methods available that are worth a shot. However, keep in mind that they have not been proven to be effective 100% of the time. 

– Castor Oil. It is believed that Egyptians could have been using castor oil as early as 4000 B.C. Women sometimes feel their first contractions 1-3 hours after ingesting the oil, but some may react differently and take slightly longer. Due to its effectiveness, it is not recommended before 39 weeks of pregnancy. Castor oil is not as prevalent as it used to be, however, and doctors have been skeptical about its effectiveness.

– Acupuncture. Acupuncture to jumpstart labor has been practiced in Asia for centuries. One small study at the University of North Carolina found that women who got acupuncture were more likely to give birth without being induced and less likely to deliver by cesarean section (http://www.webmd.com/baby/inducing-labor-naturally-can-it-be-done).

– Bowen Therapy. Created in Australia in the 1950’s, this method stimulates and directs energy flow in the body through gentle, noninvasive movements.

– Raspberry Leaf Tea. It is common belief that raspberry leaf tea helps labor progress more quickly (and less painfully), can cause contractions, and prevent a pregnancy from going longer than 40 weeks. Can’t hurt to try — besides, it tastes delicious!

– Nipple Stimulation / Sexual Intercourse. Because sexual intercourse stimulates the lower uterine segment and oxytocin is released as a result of orgasm, it has been proven to be a successful way to accelerate labor. Similarly, nipple stimulation also produces oxytocin, which accelerates labor and causes contractions. If your body is ready, your cervix will start to soften, thin, and open ready for labour.

I would definitely be open to trying one of the above methods before going the medical/artificial route. Definitely no harm in trying. What about you?

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