09/15/2022
Did you know?
In the past two years, I have noticed an increase in induction rates. Studies show that approximately, 1 in 4 women are being induced. Whether the mother is a first-time mom or on her fourth pregnancy, doctors seem to be suggesting inductions more often than not. While inductions are said to be used in cases of maternal and fetal risks, the rate of induction is climbing despite healthy pregnancies. Today, we will discuss the different types of induction methods, risks of induction, and a method that doctors sometimes use to determine if your induction has a good chance of a positive outcome.
Stripping or sweeping the membranes
* The healthcare provider inserts his fingers up to the cervix and separates the bag of waters from the lower part of the uterus.
* This is often done during a pelvic exam and is one of the most commonly reported acts done without consent from the patient
* May release prostaglandins which help soften the cervix and prepare your body to go into labor
* This is often reported as very uncomfortable and painful
* Bleeding and spotting often happen afterwards
* This can cause increased pain during contractions
Cervical Ripening Agents
* Medications such as Cervadil or Cytotec (Misoprostol) are inserted near the cervix or even taken orally
* This is often one of the first methods of inductions and is less invasive than some other methods
* Because the medications are synthetic hormones, the cervix may not respond
* Cytotec has caused severe side effects such as hemorrhaging, uterine rupture, and death
* Cytotec has also caused permanent disabilities in babies
* While Cervadil is FDA-approved, Cytotec is NOT FDA-approved and has been a source of controversy for years
Foley bulb
* A foley bulb looks like a catheter with an inflatable bulb
*It is inserted in the cervix and expanded to put pressure on the cervix and cause it to ripen
* It is reported as one of the most-effective ways to induce labor
*It has a lower risk of leading to a c-section than other methods of induction
*Hospitals may require continuous fetal monitoring during the process
* It does increase risk of infection
Artificial Rupture of Membranes (Breaking the Waters)
* Healthcare provider uses a long hook to puncture the amniotic sac
* As the fluid releases, it causes baby's head to drop against the cervix and potentially start contractions or increase the strength of contractions
* It may shorten labor slightly
* It increases the risk of infection
* It increases risk of cord prolapse if done before baby has descended into the pelvis
* It puts you on the hospital's "clock" to have baby, which is usually 12-24 hours post rupture of membranes
Pitocin
* A synthetic hormone meant to mimic oxytocin administered
through an IV
* The dosage can be controlled
* Often very effective in causing strong contractions
* Can cause very intense contractions without the usual breaks
* Continuous monitoring is required
* Intense contractions can lead to fetal distress
* If given before the cervix is ripe, it can be cause for long labor
* Can lead to a cascade of interventions due to intensity of contractions being too hard on mom and baby
Now that we've covered all these methods of induction, I wanted to encourage you to remember you have a voice regarding your labor and delivery. You can question your provider when induction is brought up.
A bishop score is a scaling system used to determine how favorable your cervix is for labor. While it is unknown how predictive this score can really be, as all of our bodies ripen in such unique timing and ways, it may still be a useful tool to assess whether you should wait before introducing any synthetic induction methods. When your provider brings up induction, ask them what your bishop score is and why they believe you need to be induced. Don't be afraid to ask questions.
Inductions have been known to lead to serious complications, cesarean sections, long labors, and negative labor experiences. Remember your baby comes when your body and your baby are ready. Even if your body is "ripe" according to what your doctor thinks, baby may still need more growth. Waiting on the natural process of labor is one of the safest things you can do for you and your baby.
What about you? Have you been encouraged into an induction? I would love to hear how your induction experiences have been. What was your doctor's reason for inducing?
