Medical Induction

Medical induction may be advised to avoid prolonged labour and foetal distress. It may be wise to know your options. Induction procedures are used to bring on labour when it has not begun naturally. It is usually carried out when medical professionals consider the health of the baby and/or the mother to be otherwise at risk.

Many doctors consider induction necessary once a woman is past her due date or if the placenta has ceased to function.

When labour begins naturally hormones are released into the bloodstream. When labour is induced medical professionals try to obtain a similar result by flooding the system with hormones, often until they reach a level that is higher than would occur in a natural labour.Although a doctor may suggest induced labour based on reasons considered necessary, it is important that you ask and are told the details of what induction involves. You may then decide to accept or refuse the treatment on offer.    

Oxytocin drip

The most popular method of induction uses syntocinon, a synthetic hormone that mimics the action of oxytocin, the hormone that is naturally produced by the body that causes the uterus to contract. This is often referred to as an oxytocin drip. The drip can be lessened or increased accordingly. Often it is turned down or removed once 5cm dilation is reached. Some medical professionals prefer to keep the drip in place until after the third stage of labour in order to control the bleeding from the uterine wall once the placenta has been removed. If a drip is advised, you may wish to ask for a long tube so that movement is less restricted. It is common for women to complain of backache following the use of an oxytocin drip tube that was too short. You may also wish to ask for the insertion to be made into the arm that you least use.

Artificial Rupture of the Membranes

Known as ARM or amniotomy, artificial rupture of the membranes is frequently done in hospitals and has become accepted as normal routine. It should not be carried out until you are 4cm dilated and are considered to be in active labour.

ARM involves the puncturing of the membranous sac using a small tool a little like a crochet hook. In a natural labour, the membranes are allowed to rupture spontaneously, usually by the end of the first stage. Sometimes the membranes rupture when the midwife or doctor carries out an internal. Rupturing is not painful. You may feel a rush of warm liquid and once this has occurred, contractions usually intensify.

ARM can quicken labour by 30-45 minutes. It is useful in that it allows medical professionals to examine the condition of the amniotic fluid to determine the baby’s welfare. When a baby becomes distressed, it often releases merconium from its bowels into the amniotic fluid. The risk of ARM is that is disrupts the cushioning protecting the baby and directly exposes it to the pressure of the contractions. It may also increase the pressure on the umbilical cord and affect the flow of blood through it. ARM also increases the risk of ascending infection and in many cases requires the use of hormones to further accelerate labour.

Prostaglandin Gels

Prostaglandin pessaries are inserted in and around the cervix to help ripen the cervix and encourage dilation. If pessaries are inserted in the evening, labour usually starts the following morning. The advantage of prostaglandin pessaries is that you have the freedom to move about. In most cases the simultaneous use of ARM or an oxytocin drip is unnecessary.

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