Introduction
Induction of labour is a common procedure in obstetrics. About 20% of women will have an induction of labour.
Inducing a labour effectively means starting off a labour artificially in a woman who is not already in labour.
Induction of labour is recommended when it is considered that the mother and/or the baby’s health will benefit.
Common reasons for induction include:
- The pregnancy has gone longer than 41 weeks.
- The mother has had complicating issues in the pregnancy such as high blood pressure, pre-eclampsia, gestational diabetes or pre-existing Type 1 or Type 2 diabetes.
- There are concerns that the baby may be compromised or unwell in the uterus.
- The waters have broken, and natural labour has not occurred with 24 hours of the waters breaking.
- The waters have broken, and it is observed there some of baby’s poo (meconium) in the amnionic fluid after the waters break. This can be a sign baby is not entirely well in the uterus and mandates that induction be started as soon as possible.
The induction process begins by using a small plastic hook to gently make a hole in the membranes in front of the baby’s head through the cervix (the neck of the uterus).
An IV drip is then placed in the hand, and a hormone infusion called Syntocinon is infused into the drip to stimulate the uterus to start contracting and the labour to start. The level of Syntocinon is increased until the mother is having uterine contractions 3-4 times in every 10-minute time period, and the contractions are lasting at 30-40 seconds and are painful.
Before an induction is booked, Dr Friebe will perform a vaginal examination in the rooms to assess how dilated, how long, and how soft the cervix is, as well as assessing how well the baby’s head is engaged in the pelvis.
Should the cervix be too closed, or too firm or too long for the membranes to be reached, then a small ribbon called Cervidil or Misodel is placed in the vagina the night before the induction is booked to soften, shorten, and dilate the cervix to allow the waters to be released the next morning. The baby’s head also must be engaged (i.e. - the baby must have “dropped”) in the pelvis for an induction to be undertaken safely, as releasing the waters with the baby’s head still floating out of the pelvis can lead to a cord prolapse, a serious complication which leads to an emergency Caesarean Section.
It is important to remember that induction of labour is not without its risks, and should be undertaken only when appropriate. Dr Friebe will discuss pros and cons of induction before induction of labour is undertaken so the couple is clear and aware of what will happen.