Sometimes labour and birth need to be started early, this could be due to health concerns for the mother or for the baby. This is known as an induction of labour.
Why might I need to be induced?
You may be recommended to have an induction if you have high blood pressure, pre-eclampsia, diabetes, cholestasis, you have gone past your due date, your waters have broken but you haven’t gone into labour, placental problems, amniotic fluid level concerns or maternal choice.
You may be recommended to have an induction if your baby is suspected to be macrosomic (>4500g), there are concerns that your baby is no longer growing, decreased fetal movements, abnormalities detected on an ultrasound scan, abnormalities detected when a fetal heart rate check is performed or any other medical concerns with your baby.
How is an induction performed?
There are many ways that your labour can be started. Generally, your midwife or doctor will perform a vaginal examination to determine if your cervix is ready (favourable) for labour. If your cervix is not ready, you will need to have cervical ripening in the form of a small tablet or gel inserted into the vagina to chemically change the cervix or balloon catheter inserted into the cervix to put pressure on the cervix and cause it to mechanically open.
Once your cervix is ready, your doctor or midwife will break your waters. This is called an ARM which stands for ‘Artificial Rupture of Membranes’. Once your waters are broken, you will be given a few hours to see if your body starts contracting on its own. If you don’t go into labour after your waters being broken, you will be given an intravenous (IV) medication called Syntocinon. This is an artificial form of the body’s natural hormone, oxytocin. This drip will continue up until your baby and placenta are delivered.
Are there any risks of an induction?
There are some risks of an induction, so it is important that you are fully aware of the risks and why you are being recommended an induction prior to starting it.
- Around 20% of women who undergo an induction, end up with a failed induction that requires a caesarean section.
- Your baby may find the induction stressful. Sometimes the abnormal or excessive contractions may lower your baby’s heart rate and cause them to go into fetal distress. This may increase your risk of needing an assisted delivery (forceps, vacuum or caesarean).
- Having an induction can sometimes result in your uterus not contracting down properly after birth, which can lead to an increased blood loss.
- Slight increase in infection from excessive vaginal examinations along with having your waters broken for a long period of time.
It is important to note, that induction of labour has many benefits when it comes to the physical or mental wellbeing of the mother and baby. In Australia, we are very lucky to be able to have the option of having safe inductions when they are required.
Always speak to your healthcare provider for your own specific circumstances.