Inducing labor

Inducing labor at the end of a pregnancy is not a step that is taken lightly. Often toward the end of the nine months the expectant mother is more than ready for the baby to be delivered. She may be experiencing leg pain, back pain, swelling, loss of appetite, gastro-intestinal problems or gestational diabetes.

But bringing a child into the world before they are physically ready can mean more physical disability for the child that can include lungs that arent ready to breathe on their own, gastrointestinal tract that can develop bleeding, and neurological conditions that will leave long-term disabilities.

So the decision to induce labor is not one that is taken lightly. However, there are situation during which the risk of induction is outweighed by the risk of letting nature take its course. These situations can include when the water breaks and labor doesnt begin. The amniotic fluid (water) provides a protection to both mother and baby against infection and also help to hydrate the babys skin. Without this protection the baby and mother are at high risk for infection after only 24 hours.

In the circumstances where mom has a medical condition that threatens her life or the life of her child such as high blood pressure, uncontrolled diabetes or pre-eclampsia inducing labor is the better of the two choices. In some instances mothers have delivered a full-term still birth child who was showing signs of life just days earlier. In this case doctors will induce labor early to prevent a recurrence of this situation. At other times the doctor may determine that the placenta is no longer functioning properly to oxygenate the baby or the baby doesnt appear to be growing appropriately.

Doctors have a choice of several methods to induce labor that include the use of medications or physical methods. The doctor will first evaluate the status of the cervix to determine if it requires some additional attention to help it flatten and dilate. Sometimes just ripening the cervix is enough to jump start contractions. These techniques can include the use of protoglandins hormones that are inserted into the vagina to help the cervix get ready for labor and delivery.

In other cases the doctor may use a catheter with an uninflated balloon on the tip and insert it into the cervix. When the catheter is inflated it triggers the release of prostaglandins that will help to ripen the cervix. Or doctors have the choice of stripping the membranes during an office visit to stimulate labor. During this procedure the doctor will insert a finger through the cervix that is already starting to dilate and release the lower end of the amniotic sac from the uterus. Moms are then sent home to await the start of labor usually about 1-3 days later.

If doctors feel that labor should initiate more quickly they may choose to rupture the membranes or break the moms water. During this procedure, which can be done in the office if mom is sent directly to the hospital, labor can be jump started within an hour or two. In some cases this doesnt happen so the expectant mother is given the medication pitocin to help start contractions.

There are circumstances under which labor shouldnt be induced such as if tests indicate that the baby cant tolerate contractions or must be delivered immediately, if mother has a placenta previa where the blood vessels from the umbilical cord are embedded in the amniotic membranes and could rupture during labor; if the cord is wrapped around the babys head or neck; if youve had more than one cesarean section or uterine surgery with a vertical incision; there are twins and one is breech or there are triplets or more or if the expectant mother has an active case of genital herpes.

There have been techniques that have been used at home to stimulate labor for many years. Research hasnt shown a strong link between these and the induction of labor so it may be that using them only induces labor if the baby is ready in the first place.

In the first instance women have found that having sex and an orgasm at term can induce labor. The semen contains prostaglandins and the orgasm starts contractions. Stimulation of moms nipples also releases oxytocin and can help to start labor but it can also overstimulate the uterus, contractions and the babys response which can be dangerous and shouldnt be tried at home.

For many years women have been using castor oil, a strong laxative, but there hasnt been definitive proof that this works effectively. And, because it will stimulate the bowels the expectant mother may find this to be very unpleasant.

When inducing labor the decision is best left to the physician who is able to help you weigh the pros and cons of the risks and benefits to the baby. It may seem like an eternity but just another couple of days in the uterus can help make the difference between a baby who is physically and neurologically ready to greet the world and one that will need medical support or may suffer from some long-term effects of the process.