Induction of Labour

Almost all babies are born within two weeks before or after their due date. If you and the baby are doing well, there is no particular risk to either of you in the first week after your due date. After that, however, the risk increases that you or the baby will develop health problems. Then the birth can be induced. Doctors and midwives have various options at their disposal. They can administer medication as well as mechanically assist. However, not all procedures are suitable for every pregnancy. Also, there is no guarantee that birth induction will always work. It is best to talk to your midwife and doctors about what induction of labour procedures are offered by the hospital or birth centre where you will be giving birth. Have the pros and cons explained to you. Induction of labour is not an emergency. Whether and when to induce labour is a personal decision. You can make the decision together with the doctors who look after you.

There are many reasons for inducing a birth artificially. The most important is whether there is an increased risk of complications during childbirth. This, in turn, depends on how far past the calculated due date the baby is and whether there are indications that the baby is at risk from a pregnancy that has lasted even longer. Also how old you are, if you have already given birth, if you smoke, how much you weigh, and how big the baby is can be crucial. A common reason for induction of labour is what is known as a pregnancy being overdue. If the birth is a little late, one first speaks of a missed due date. A pregnancy is considered overdue if it lasts more than 42 weeks. It is mainly associated with dangers for the baby. The main risk is that the placenta will gradually be unable to supply it properly. It also increases the risk of infection within the uterus and complications during childbirth. You yourself are usually not more at risk in the event of an overdue pregnancy. However, the birth can be more difficult if the baby grows too big. Even if the due date is missed, most births proceed without complications. In order to limit risks, however, doctors and midwives usually set a specific time at which induction of labour is advisable, even if the pregnant person and the baby are doing well.

When birth begins and how it proceeds is controlled by hormones. Doctors take advantage of this effect by administering hormones in drug form to induce labour. An example of this are prostaglandins. These are active ingredients that ensure a relaxed, soft and ‘ripe’ cervix. Prostaglandins, for example, can be applied as a gel to the cervix to make it ripen. They can also be administered as a tablet or vaginal suppository. Sometimes these measures are enough to start labour. If the cervix is already ripe and slightly open, but the contractions are not yet strong enough, further hormones are used. These are either other prostaglandins or oxytocin administered through an IV drip. The amount of hormones is adjusted so that the contractions are as normal as possible. This means that they do not occur at too short intervals and do not become too strong. The induced birth should not be forced, but should proceed as much as possible like a spontaneous birth.

For most pregnant people, induction of labour does not cause severe discomfort. Nevertheless, side effects may occur. In the case of prostaglandin, these are mainly gastrointestinal problems such as nausea, vomiting and diarrhoea. Oxytocin can cause water to accumulate in the body or a lack of sodium. If you have had a c-section in a previous delivery, experts advise against drug induction of labour.

Midwives and doctors can also induce birth by special hand movements or with the help of instruments. This is called a mechanical induction of labour. One of these procedures is a membrane sweep. A doctor or midwife carefully inserts a finger into the vagina and detaches the amniotic sac from the cervix. Another possibility is a cervical ripening balloon. In this procedure, one or two balloons attached to the end of a tube are inserted into the vagina. The balloons are then filled with a liquid. This causes the cervix to dilate. Both the membrane sweep and the use of the balloons aim to ripen the cervix and thus induce labour. Another method is the amniotomy. This procedure involves opening the amniotic sac. Reasons for this are, for example, a particularly long first stage of labour or weak contractions.

Some pregnant people report that intercourse has helped them stimulate labour. Sometimes it is also said that gently stroking the nipples helps if the cervix is already slightly open and soft. In both cases, it is supposedly the release of the hormone oxytocin that sets the birth in motion. It is also often said that exercise, acupuncture or special labour teas can help induce labour. Even though some of these methods have been used for a long time, their effectiveness is controversial. The benefits of all these techniques are not scientifically proven. As with all methods of induction of labour, you should only use them in consultation with your midwife or doctor.