The Induction of Labor
The idea of an induction brings about an array of emotions. Why is this being introduced/discussed? How will this affect my delivery? What methods of induction are there? What are all of my options? What are some natural options? What if I don’t want an induction? Knowing what your options are, the methods, and the process can ease fears and anxieties surrounding a decision like this. Ultimately, it instills confidence for one to make the decision that’s best for them and their baby.
What Does an Induction Mean
According to ACOG, labor induction is the use of medications or other methods to bring on (induce) labor. Having an induction can be a benefit in a pregnancy when fetal stress, maternal stress, or other pregnancy constraints are present. In some instances, inductions are a tool that providers may use without the informed consent of their client. Using one’s BRAIN is an ideal tool in cases where the topic of an induction arises. Discussing the benefits, risks, alternatives, instinctual, and the nothing can bring one to the solution that feels best for them.
Questions to Ask Your Provider About Induction
Are you aware that your provider works for YOU?! Yes that’s right! And therefore you have the right and ability to ask questions, find answers, receive information, and refuse situations. With all that said, a wonderful provider wants what’s in the best interest of you and the baby. Ask questions to get to the decision that makes the best choice for you. Below are a few to help you get started:
- How far along in the pregnancy will you allow me to go before discussing induction?
- What is the criteria that you are using to base the induction on?
- What concerns are present that an induction is being scheduled?
- What is your procedure(s) when inducing?
- What is your rate of successful inductions vs. cesareans?
Understanding a Bishop Score
Bishop Score is a rating tool that is used to identify how successfully a body may go into labor on it’s own. It can also be used to gauge how likely an induction will be successful. Noting that induction doesn’t necessarily mean a cesarean section. Understanding the Bishop Score of an induction is one indication that a cesarean may or may not be the prevalent outcome. A cervical exam and sometimes an ultrasound is conducted. Bishop Scores’ overall total ranges from 0-10, with each category getting 0-3 points each. Which are graded on 5 criteria of the cervix and baby. These are: baby’s location (station) in the pelvis, the cervix’s dilation, position of the cervix, the thinness of the cervix, and the cervix’s consistency.
The higher the Bishop Score (8 or more) the more favorable the opportunity is that an induction will be successful in inducing the body to beginning labor and delivering vaginally. The lower the Bishop Score (5 or less) the greater the chance that additional interventions or a cesarean section may be presented. A score of 6-7 is a neutral indication. Giving the opportunity to make decisions on next steps, and utilizing one’s BRAIN.
What are the Methods of Inductions
Methods of inductions vary and can different depending on preference of the provider and/or birthing facility. Additionally there are both natural and medicated ways to induce the body into labor. Some common methods of induction are: Stripping Membranes, Cytotec, Cervidil, Balloon Bulb, and Pitocin.
Membrane sweep, consists of a provider inserting gloved fingers into the cervix and manually separating the amniotic membranes from the inside the cervix. Cytotec is a pill that is inserted in the cervix. Cytotec can also be given in a drink form that is ingested. Cervidil is a medication that is inserted into the cervix on a long string, and is removed after 12 hours. A Foley bulb, or balloon catheter, contains two inflatable balloons that are inserted while deflated, and then gradually filled with air, water, or saline to dilate the cervix to 4 centimeters.
The Process of an Induction
The process of an induction ranges depending on one’s birthing philosophy, one’s provider, and one’s birthing location. A birthing philosophy is how a person views birth. Is birth a holistic experience? Is birth a medical science? Does birth equal home, hospital, or a mix of both with a birthing center? Did you hire an OBGYN or a Midwife?
Natural ways to induce labor can vary. Knowing that ultimately baby’s will decide when their birthday is. Some natural labor induction methods include: eating pineapple, making love, nipple stimulation, acupuncture, and evening primrose oil to name a few. Please consult with your provider when deciding to invoke induction.
Medically, and depending on the preferences and procedures of the birthing facility, an induction consists of a cervical ripening agent (Cervidil, Cytotec, Foley Bulb, etc). Then monitoring occurs. There may be limitations on movement during the process of an induction. In general, an induction may take on average 72-hours from start to baby. Check in with the birthing facility, as oftentimes when an induction is scheduled, the ultimate determination is the availability of rooms and of the provider schedule.
For some, inductions can be scary. Some view, inductions can as the solution. For some, induction may be the decision that brings them to the birth they desire. Doing your research, discussing with your provider, and reaching out to your doula are some ways to help guide and ease when big decisions like an induction are presented.