Labor Induction Procedure - Healthnile.com

Overview

Labor induction occurs when obstetricians start contractions because labor does not begin naturally. This process can help support the health of both the pregnant person and the baby. Medical teams, including specialists in maternal-fetal medicine, may recommend induction for specific medical or safety reasons.

Key Points:

Induction methods may include medications or other options.
The main goal is a safe childbirth for both mother and baby.
The American College of Obstetricians and Gynecologists offers guidance on when to use labor induction.

Reasons for Inducing Labor

Healthcare providers may recommend induction for a range of medical or practical reasons, with the primary goal of ensuring the well-being of both the pregnant person and the baby. Medical reasons to start labor include:

Reason	Description
Diabetes	Both gestational diabetes and preexisting diabetes can make induction necessary, especially if medication is used or sugar levels are high.
High Blood Pressure	High blood pressure during pregnancy can threaten the health of both mother and baby.
Other Medical Issues	Conditions like kidney or heart disease, and obesity, may require early delivery.
Infection	Infections in the uterus are another reason; waiting can be dangerous.
Past Due Date	When pregnancy goes one or two weeks past the estimated due date (postterm), induction helps reduce risks linked with staying pregnant too long.
Water Breaks, No Labor	If the amniotic sac breaks but labor does not begin, infection risk increases, making induction necessary.
Baby Not Growing Well	Slow baby growth (fetal growth restriction) may lead to induction to prevent complications.
Low Amniotic Fluid	Too little amniotic fluid (oligohydramnios) can affect the baby’s health.
Placenta Problems	Early separation of the placenta from the uterus (placental abruption) may make immediate delivery safer.

Some people wish to schedule when they give birth, even if there is no urgent health risk. This is called elective induction. Reasons someone might request this include living far from medical care or having quick labors in the past.

Elective induction helps them plan and avoid unexpected home births without medical support. Before allowing an elective induction of labor, a healthcare professional verifies that the pregnancy has reached at least 39 weeks. This step protects the baby’s health and reduces possible complications.

Providers also consider induction for people who are low-risk and giving birth for the first time (low-risk nulliparous women). For these low-risk patients, inducing labor at 39 to 40 weeks can reduce several risks, such as stillbirth, large baby size, and high pregnancy blood pressure.

The decision to induce, especially without urgent medical reason, is made together with the healthcare professional to ensure it is the best choice for both the parent and baby.

Key Points

Indications range from medical conditions to timing past the due date.
Elective induction is possible but requires careful planning.
Shared decision-making is important to choose the right timing and method.

Potential Complications

Labor induction can lead to several health concerns for both the mother and baby. One possible issue is a failed induction, when labor does not progress after attempts for over 24 hours. In these cases, a cesarean birth (C-section) is often necessary.

Another risk involves the baby’s heart rate. Medicines that start labor may cause the uterus to contract too often or too strongly, which can lower the baby’s oxygen and cause changes in heart rate. This can impact neonatal outcomes and may require quick medical action.

Certain induction methods, such as breaking the water (rupturing membranes), increase the chances of infection. Both the mother and newborn face a greater risk for infection under these conditions.

Uterine rupture is rare but serious. Women who have had a previous C-section or major surgery on the uterus face a higher risk. The uterus may tear along the old scar, which can be life-threatening. Emergency surgery, often a C-section and sometimes removal of the uterus (hysterectomy), may be needed.

Excessive bleeding, or postpartum hemorrhage, is more likely after induced labor. If the uterus does not contract well after the baby is born, a condition called uterine atony, the risk of heavy bleeding increases.

Certain health conditions and pregnancy situations make induction unsafe. These include a vertical C-section scar, placenta previa (placenta covering the cervix), umbilical cord prolapse (cord slipping into the vagina first), breech position, or an active genital herpes infection.

Table: Examples of Risks Linked with Labor Induction

Risk	Who It Affects	Description
Failed induction	Mother and baby	Labor doesn’t progress; may require C-section
Low fetal heart rate	Baby	Less oxygen, abnormal heart rate, may need urgent care
Infection	Mother and baby	Greater chance if water is broken during induction
Uterine rupture	Mother (higher risk if previous surgery)	Tear in uterus, emergency surgery needed
Postpartum hemorrhage	Mother	Heavy bleeding after birth, risks for blood transfusion

Steps To Get Ready

You will usually prepare for labor induction at a hospital or birthing center. The medical team checks the cervix for effacement and may use medicines or tools like a Foley catheter to help with cervical ripening.

The Bishop score might help decide which methods are best. Some people also talk with their providers about additional options such as nipple stimulation, breast massage, or membrane stripping.

What You Might Experience

Steps Taken During Labor Induction

When labor is induced, the medical team uses a variety of safe and tested methods. They keep careful track of uterine activity and the baby’s heart rate throughout the entire process. Some of the main ways to start labor include:

Softening the Cervix:
- Doctors may use prostaglandin medications to help the cervix soften, thin out, and open, getting the body ready for birth. These medications can be placed directly in the vagina or taken by mouth.
- Another option is a mechanical method. This can involve a small tube, called a catheter, with a tiny balloon on the end. When filled with saline and placed in the cervix, the balloon gently helps it to open.
Separating the Membranes:
- Sometimes, a provider will sweep a finger around the inside of the cervix to gently separate the membranes of the amniotic sac from the uterine wall. This method is called membrane sweeping and may help start contractions.
Breaking the Water:
- An amniotomy is a simple procedure in which the provider makes a small opening in the amniotic sac, causing the “water” to break. This is usually only done if the cervix is already partly open and thinned and if the baby’s head is low in the pelvis.
Medicine Given Through the Vein:
- A uterine stimulant may be given by IV to make the uterus contract more strongly and encourage labor. While this medication does not ripen the cervix, it is very effective in increasing uterine contractions after labor has started.

How quickly labor begins depends on the technique, how ready the cervix is, and how the individual responds. Some people begin labor in a short time; for others, it may take several hours.

What Happens After Labor Induction

Once the induction process begins, most people go on to have a vaginal birth. However, if labor does not start or progress enough, the healthcare team may attempt another induction or recommend a C-section. The healthcare team monitors both the parent and the baby, watching for progress and ensuring their safety.