The Ins and Outs of Inducing Labor
Many Mamas enter their pregnancy journey with a plan in mind on how she wants her blessed little bundle to enter this world. Epidural? Natural? Water birth? Or C-Section? What if I have to be induced? Many Mamas hear the word Induced and immediately want dismiss it. However, it is important to know why inducing labor may be necessary. I found it helpful to educate myself on what this process entails, why doctors suggest it, and what Mamas should consider if it’s being discussed.
I was Induced with Both my Kids
To begin, with my first labor experience, my doctor put us on the schedule for an induction at 41 weeks. My doctor felt that because of Julia’s size and the shape of my pelvic bones, that this could be helpful in delivering a large baby. They did an ultrasound at 38 weeks and she was measuring 2 weeks ahead. However, when it was Go-Day, my body just wasn’t ready yet. My cervix wasn’t dilated enough when they began the induction, and Pitocin was ramping up the contractions but I did not progress. I tried the bouncy ball, dancing, squats, you name it. These things combined made for a long day. I finally reached the level needed for the doctor to break my water and from that point forward, labor progressed as it should have.
Sadly, the day of laboring caused the start of Chorioamnionitis(“chorio”), which is an infection of the uterus. In my case, this set because my water had been broken for an extended period of time. I had an intense, high fever, painful body aches, blood pressure problems, and the moment Julia came out, she was whisked away to start antibiotics in the NICU. As they say, Hindsight is 20-20. Looking back, I wish I would have waited a little longer–even a few more days, to see if I could go into labor on my own. In the end, it all worked out alright, and I learned a lot.
Medically Inducing Labor
Medically Inducing labor means that your doctor will intervene using a medication called Pitocin. This will help start or speed up contractions to help labor progress. What many people don’t know, is that Pitocin is actually the synthetic version of Oxytocin, which is the same hormone our bodies produce to begin contracting the uterus. For their own reasons, many women are against the use of Pitocin. However, these are a few of the reasons why women are induced and therefore need it.
Your blood pressure is too high.
There are a number of reasons why high blood pressure can be dangerous for Mama and baby. For some further reading on this topic, visit the Mayo Clinic website. Generally, your doctor will schedule an induction at or around 37 weeks if this is the case. Some women have great experiences with this process because they are dilated enough where the Pitocin helps. Conversely, other Mamas may need to use additional procedures like a balloon catheter to help the cervix dilate, or even use synthetic prostaglandins to ripen the cervix. They will do a ton of monitoring throughout, including closely monitoring the baby and using a variety of medications to keep blood pressure at a healthy level.
Your water may break before labor begins.
This is what happened to me with my son Brooks. Imagine a little pin prick on the top of a balloon filled with water. My water had only trickled out a few little spots. After 7 hours of trying to progress labor on my own by walking, dancing, squatting, bouncing on the ball, and lunging (it was Christmas Day and I was trying to make the best of it!), it hadn’t progressed enough. The doctors needed to intervene with Pitocin and induce labor. Brooks and I were more susceptible to contract chorio again. In this case, I was dilated enough that the Pitocin did its magic. Thankfully, it got me far enough for the doctor to fully break my water, as I had a “fore-bag.” ** Cue immediate, intense labor as soon as this happened.
You’ve reached two weeks beyond your due date.
If labor hasn’t begun on its own or you are not showing any signs of progressing, this may be necessary for the health of Mama and baby. Of course, you still have the choice to wait, but your doctor may suggest this as a precautionary measure. You may have an in office procedure done where the doctor will strip the membranes. This means the doctor will sweep a circular motion inside the cervix between the thin membranes of the amniotic sac. This procedure works to induce labor for many Mamas! It did not, however work for me–the doctor did it twice with Julia and once with Brooks.
Your body needs help controlling bleeding after delivery.
Although you’re not inducing the beginning stage of labor, this will help contract the uterus after delivering the placenta by controlling the bleeding. It helps squeeze down on the exposed blood vessels. I follow Megan King Edmond’s blog and she shared how the doctors used this with labor with her twins.
Inducing Labor as an Election
Conversely, an Elected Induction means that there is no medical reason to get the baby out. Having made it to 41 weeks, I can see the desire for this because I was SO ready to meet her. However, doctors now days (even since 2016 when Julia was born) are pulling away from elected inductions. For obvious reasons, there are many things that can go wrong if your body is not ready to deliver baby and inducing labor using Pitocin or other means.
The Bishop Score
So, what do Mamas need to have in order to qualify for an Elected Induction? Your doctor will (or should!) perform what’s called the Bishop Score test in order to see if your body is ready to deliver baby safely. In order to qualify, the doctor will look for:
- The cervix dilation. You need to be dilated to a certain centimeter in order to “score” in this category.
- How thin, shortened, or effaced your cervix is.
- How far the baby’s head is positioned in the pelvis.
- Where the cervix is in relation to baby’s head.
- The ripeness or softness of the cervix–soft is better.
So How do I Know What’s Right for Me?
In closing, whatever your choice is will feel right to you. Being induced might be on the table for you whether you’re a first time Mama or a Mama a few times around. Additionally, if you’re at those end of term appointments and you’re not dilating, not progressing, or not showing any signs of laboring on your own, it may be best to wait it out. Trust me, I know it’s tough to wait, wait, wait… My unsolicited advice is to let the baby stay in as long as you can. I was gigantic by the time I was 41 weeks, but it truly is a mind over matter thing! Remain positive and use those extra days as a last minute chance to rest, go on dates with your spouse, or nest.
In the meantime, you can reread this POST from last week about Hypnobirth. After all, no matter what’s on the table when the day comes, this was an extremely helpful story about preparing your mind and body for baby’s birthday.
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