What’s an induction?
Inductions are a method of trying to get labor started using medication or other means to help begin to ripen and dilate the cervix or improve progression of contractions. An Induction may be suggested for various medical reasons, with pre-labor rupture of membranes, or if labor has not started naturally and a baby is post-term by 2 weeks or more. Elective inductions are also routinely offered to parents as a controlled way of starting labor.
Methods for induction:
· Cytotec or Prostaglandin - use of gel or vaginal insert to soften and thin out the cervix for delivery, providing cervical ripening.
· Mechanical induction/balloon catheter- puts pressure on the cervix to help soften, thin and begin to open as a method of cervical ripening.
· Pitocin-the hormone oxytocin is given through IV to stimulate contractions, can be used to spur slow or stalled labor.
· Membrane sweep/striping- doctor inserts a finger vaginal through the cervix to separate the thin membrane connecting the amniotic sac which releases prostaglandin to help prepare the cervix for delivery and bring on contractions.
· Amniotomy/“breaking the water”- medical provider can rupture the amniotic sac during examination using a hook, if cervix is ready for labor it usually brings on labor in a matter of hours.
Current Research on Inductions: ARRIVE trial
A randomized control study of 6,106 first time, low risk birthing mothers comparing C section rates in women undergoing an elective induction at 39 weeks compared to regular expectant management. The study found a reduction in cesarean rates in the induction group (18.6%) compared to the expectant management group (22%) as well as lower rates of developing pregnancy induced high blood pressure (9% vs. 14%).
Who is an ideal candidate from the Arrive study?
Low-risk, first time mothers giving birth to single, head-down baby and with no major medical conditions at 39 weeks of pregnancy and having a hospital-based birth.
Criteria for a “failed induction”
The protocols for “failed” induction can vary between hospitals, so be sure to be aware of your birthing location’s policy. Per ACOG practice guidelines in response to the ARRIVE study findings, as long as there are no complications, early labor can last over 24 hours and oxytocin (Pitocin) can be given for 12-18 hours after breaking the mother’s water. If exceeding this timeline with the mother remaining in latent phase of labor, then the induction may be considered a failure.
Are you Pregnant and considering an induction?
Check out our fully on demand pregnancy prep class & upcoming LIVE review for our members
Pregnancy Prep LIVE Review
Saturday March 18th at 9:15 EST
We will focus on:
· Hands on techniques to help baby engage with the pelvis during early labor
· Hands on techniques to open up the mid pelvis, and what to do if baby gets stuck or stops descending
· Various modifications for a medicated birth
· Pushing positions and what to look for to reduce the risk of injuries
