In Birth

So Your Big Day Has Come and Gone

You’re still eagerly waiting for you little one to come into the world. 39 weeks is generally considered a full term birth and a mother should not be induced before then. However, situations do sometimes arise when nature needs a little nudge. If your pregnancy has lasted longer than 41 weeks and 6 days or your health or the health of your baby is at risk your practitioner may decide it’s time to for you to consider induction of labour by medical means. On one hand, you may be excited to get things moving, on the other you’ve heard so many different things about induction you’re somewhat hesitant. The myths surrounding labour induction are endless and often unfounded. And it’s not everybody’s preference. But we all have our different opinions. With all the contradictory information out there the best thing to do is arm yourself with the facts and weed out the myths. Here are some facts surrounding medical induction and what you need to know to go into it with peace of mind.

What Exactly is a Medically Induced Labour?

Medically induced labour is a process used to artificially encourage uterine contractions to bring about labour. This means intervening before ANY contractions have started and labour has not begun. If your contractions already started but aren’t strong enough and labour is assisted this is not considered induction but augmentation. There are many reasons why labour induction is performed including overdue pregnancy, fetal distress, pre-term rupture of the membranes, preeclampsia, gestational diabetes or personal preference. The benefits of labour induction must always be weighed against the potential maternal and fetal risks associated with this procedure. However, when the benefits of an expeditious delivery are greater than the risks of continuing pregnancy, medically inducing labour can be justified as a therapeutic intervention.’I really wanted to give birth without the use of medication, although it seems my little one just does not want to come out; so a little help will be needed. It took me a few days to accept this but the induction of labour is booked in for tomorrow and now I can’t wait to get started.’ Julia, Muma-to-be.

‘I really wanted to give birth without the use of medication, although it seems my little one just does not want to come out; so a little help will be needed. It took me a few days to accept this but the induction of labour is booked in for tomorrow and now I can’t wait to get started.’ Julia, Muma-to-be.

The Myths and Truths of Medical Induction

 Fact #1: Medical induction of labour is on the rise.

TRUE: According to the WHO medically induced labour is on the rise. In developed countries, 1 in 4 labours is medically induced. In the UK medically induced labour counts for 20% of births.  In 1990 the induction rate in the United States was 9.5%, this rose to 23.3 percent by 2012. African countries have the lowest rates of only 1.4% and Asia had the highest with rates as high as 35.5% medically induced. A survey by the American College of Nurse-Midwives found that 9 out of 10 women wouldn’t mind a labour induction even if there were no medical reason. It is clear medical induction is more prevalent in more developed countries and is higher among parents with higher education levels. It is not known whether sociological factors are at play such as convenience and schedules or if the level of medical care is higher, therefore, alerting Mothers of any complications, which would require induction, easier and earlier.

Fact #2: Medical induction is on the rise because it’s more convenient for the OBGYN.

FALSE: This myth is often heard, and while it may be true in some rare cases, most doctors would not perform a medical induction if it were not necessary. A cesarean section is more likely to be the product of convenience, either due to the preference of the parents or the doctor. There are strict guidelines laid out by the World Health Organization dictating when a labour should be medically induced and none of them center around convenience but focus strictly on medical reasons.

Fact #3- Medically induced labours are more painful than natural ones.

FALSE/TRUE: Pitocin (also called Syntocinon), a synthetic form of the naturally-occuring hormone oxytocin, is used to help induce the birth process. Transmitted to the Mum through an IV it helps to speed up the labour. In general syntocinon induced contractions come on stronger and faster than naturally occurring contractions. As a result, the body struggles to quickly start producing more natural pain killing hormones and many women report that their induced contractions were more painful. However other women reported being in less pain as they were prepared for the onset of contractions and were more relieved to get the process moving than focusing on the intensity of their contractions. So the jury is still out on this one as the level of pain felt is dependent on each individual’s situation. In any case, if you know you are going to be induced it’s worth keeping an open mind (as always!) about the use of pain relieving drugs such as epidural analgesia. You may or may not need it, but it’s important to know the option is there and it’s a perfectly safe choice to avoid undue pain.

Fact #4 Most Inductions End In Cesarean Section

FALSE: There are no statistics that support this idea. In fact, recent studies have shown there are fewer emergency cesarean deliveries with labour induction than without it. Researchers found labour induction reduces the risk of cesarean by 12%. While some inductions have led to women having a cesarean section, it is not a truism. An induction follows a number of steps, each more effective than the next. At any point, depending on your luck, the induction can be successful. You may only have step one which is the ripening of the cervix and be spurred on to full labour, or you may have full induction and still no luck. There is no precursor to knowing how far and how long your induction will go on, just like in natural birth. If the induction process is not progressing the labour, the practitioner may suggest cesarean for a number of different reasons. But this is by no means routine or expected with an induction.

Fact #5 An Induced Labour Lasts Longer

FALSE: Again there are no concrete statistics backing this myth either. The whole thing is very subjective. On one hand an overdue birth followed by an induction can seem longer as there is more waiting, stress and medical involvement, but it may not necessarily take longer, just seem longer. An induction can be very successful and get the labour process moving very quickly or it can involve a number of steps and more time. But by no means is it guaranteed to be longer than a natural birth. Natural births can also go on for long periods of time, there is no way of judging before the fact.

‘My first labour started naturally. It ended up taking 36 hours and left me exhausted. The second time round my doctor suggested to me a medical induction of labour at 39 weeks. I went into the hospital in the evening, had an epidural at 6 AM and at 10 AM my baby boy was born.’ Paula, Muma of two.

Fact #6 Medically induced labour increases the risk of assisted deliveries including an increased use of ventouse and forceps.

FALSE: The need for assistance during delivery usually stems from the baby being in a poor position or the mother being distressed. Either of these can take place during an induced or a natural labour. In fact, it is more likely that the doctor would order a cesarean section than an induction if the baby is in an unusual position or the mother is under distress or exhausted. During an induction, several steps lead to the eventual full labour and delivery of the baby. Each one is designed to further prod the mother into labour. At no time would a ventouse or forceps be used unless the baby was full engaged and on it’s way out. Again this could just as easily happen during a natural labour.

FALSE: Again there are no concrete statistics backing this myth either. The whole thing is very subjective. On one hand an over due birth followed by an induction can seem longer as there is more waiting, stress and medical involvement, but it may not necessarily take longer, just seem longer. An induction can be very successful and get the labour process moving very quickly or it can involve a number of steps and more time. But by no means is it guaranteed to be longer than a natural birth. Natural births can also go on for long periods of time, there is no way of judging before the fact.

The Myths Surrounding Medical Induction Are Many.

And while it may not be on the wish list for most mothers, it can be a useful, and sometimes life saving, tool. There are many pros if used during the right situation and doctors have been successfully performing medical inductions for years. We all have our own opinions, and medical induction may be something you don’t want to consider. However if the situation arises and a medical induction is necessary, you can rest assured most of the “horror” stories you’ve heard are untrue. Of course one can always try natural induction before resorting to a medical induction, but this also has it’s pros and cons. I will discuss in one of my next blogs the myths and truths surrounding naturally induced labour. At the end of the day, research whatever choice you make and you will feel much better going ahead armed with knowledge rather than myths.

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UHS Sometimes nature needs a nudge 1

If you’ve read this blog to the end, and are interested in this topic, you may also like to read: Birth Plans – Yay or Nay?  or  The Alternative Birth Plan.

Calm breathing can help you cope with any changes in your labour and birth. Sofie offers Birth Breathing consultations which are beneficial no matter what direction your labour takes.

Like to chat to someone about your labour and birth, book a Labour and Birth Debrief with Sofie.  These are held by home visit or Skype.

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