Past 42 weeks pregnant, your doctor or midwife will start suggesting induction of labour as an option.
Unless they can confirm that waiting for a couple of extra weeks will harm neither you nor your baby, you will have to decide on a method to provoke labour artificially. This may not be the way you dreamed of giving birth, but it could be the safest. Just think that keeping both you and your baby from any risk is the priority once you are overdue.
Induction of labour may make you nervous, but who can blame you? After 9 months, you are so ready to kiss your munchkin for the first time and forget about pregnancy. At least, for a while! Most women don't expect going beyond their due date and, when that happens, the feeling can be very overwhelming. At this point, one extra step may sound like a lot of effort, but remember that you are in the hands of professionals.
The first thing you can do to keep yourself calm is read the following article, where you'll find all the information you need to know about induced labour.
When is induction of labour necessary?
Inducing labour isn't that uncommon, after all. One in five labours are induced every year in the UK, so there's no room for big drama if that's your case. But, of course, having your baby artificially can only happen under certain circumstances. You'll be asked to go through an induction of labour when:
As pointed out earlier, doctors won't let you go on being pregnant much time after your due date. As days go by, the chances for your placenta to stop working properly increase –that is, the placenta may stop providing your baby with the right amount of nutrients and oxygen. Waiting for too long could even result in the baby dying in the womb, and that's not an option!
- Your waters break, but the labour doesn't start. Not choosing induction of labour in such scenario could lead to a uterine infection and, as a result, to your baby becoming affected as well. That being said, doctors will decline inducing labour if the baby comes too prematurely.
- The placenta is becoming deteriorated and it can't supply the necessary resources for a healthy baby's development.
- You are suffering from preeclampsia, a condition that can put you and your baby at a high risk.
- You have a chronic disease, such as diabetes or high blood pressure, that is a threat to your health and the health of your child.
What are the different techniques used?
How can a doctor 'trigger' labour? That's an interesting question with many answers. Fortunately, healthcare professionals have different ways to get you going, even if your cervix hasn't started expanding yet. These are the usual procedures for inducing labour (one alone may not be enough!):
- Sweep: this is a traditional, and effective, inducing method. It's based on an internal examination performed by the midwife, who will use her fingers to loosen the membranes surrounding your cervix. It can be a little uncomfortable and cause some bloody discharge. Once you've had it, labour should start within the next 48 hours.
- Prostaglandins: since these hormones stimulate uterine contractions, they usually work very well as an induction of labour technique. When you are admitted to the hospital, the doctor will administer you medication that contains prostaglandins through your vagina, dispensing it with a tablet or gel.
- Breaking the waters: when the cervix is fairly dilated, let's say a few centimetres, the doctor can decide to break the waters rather than other options. He has to use a little plastic device to break the amniotic sac, which makes most mums go into labour soon after.
- Syntocinon drip: when the other listed methods fail, the last resort consists in being administered a Syntocinon drip. This is a synthetic hormone that starts labour off and that's dispensed intravenously. This procedure requires that your baby is constantly monitored.
What does induction of labour feel like?
Putting any exceptions aside, induced labours tend to be more painful than the ones that take place spontaneously. It's pretty common that women who need to have induction end up asking for an epidural or other pain relievers, which they'll have no limited access to. The same is true for assisted deliveries—they seem to be more frequent when inducing labour.
Does it pose any risks?
Though for the most part it's safe, induction of labour does have some risks for you depending on what kind of technique you are offered and the way your body reacts. Some methods, like having prostaglandins, can over-stimulate the uterus, which can turn into severe contractions that will make you suffer (more than usual) and stress your baby out.
Other dangers associated with induced labour include placental detachment and uterine rupture, though the latter is rare. Actually, there are reported cases of uterine rupture especially among women who had had a C-Section in the past and then were given Misoprostol, a medication to start labour, to induce the next labour.
Besides physical side effects, there's a psychological component related to induction of labour. Some future mums get anxious as they wait for these methods to start working. They tend to be afraid and suffer for their babies' health, maybe assuming that the fact of being overdue will harm them. But as long as the process is well-monitored, you shouldn't worry too much. When fear takes over, it is important to get support from your partner, family and friends, but also to sit down and talk calmly about it to your doctor. He or she will hopefully help you feel better by explaining these techniques with detail, which may give you more confidence.
When not to have an induced labour
There are times, not many, when you won't be allowed to have induction of labour. Mostly, that happens when the circumstances are too dangerous for you and your baby, so that a C-Section is required. Don't expect to go through an induction if:
- The contractions get too bad and your baby can't handle them.
- You have placenta previa
- The baby isn't facing downwards, but instead is in a breech presentation
- You had one or more C-Sections in the past
- You carry twins or multiples, and the first of them is in breech position
- You have an active genital herpes or an infection
Natural ways to bring on labour
In a previous article, we already talked thoroughly about how to bring on labour in a natural way. But since we are focused on inducing labour again, it's good to remind you that yes, there are actual methods that you can try on your own before getting medical help. Most of them are meant to trigger uterine contractions without making you leave your comfort zone, in other words, what you can perfectly do on a daily basis: having sex, consuming spicy foods, trying to get some relax or taking a nice walk. Others, like rubbing your nipples to secrete the hormones that start labour, are a little bit trickier. If you are overdue, your doctor will recommend that you try some of those before considering the induction of labour.