There are many reasons your doctor or midwife might suggest that an induction (the process of artificially stimulating the uterus to start labor) might be necessary to have your baby. According to The Listening To Mother’s III survey, More than four out of ten respondents (41%) indicated that their care provider tried to induce their labor. Various reasons could include high blood pressure, low fluids, maternal age, or being past your due date.
So what happens if you need to be induced? Induction might seem intimidating, but knowing what to expect and understanding the process can help reduce the anxiety. Below is the common routine of an induction. If you have any questions don’t hesitate to talk to your doctor!
1. If you are being sent from the office to the hospital, there is almost always enough time to stop home and get your hospital bag and eat a meal (always check with your doctor before assuming this is a safe step!) before arriving at the hospital for admittance. If your induction is being scheduled, you may be advised to call the hospital the day of your induction to make sure there are beds available.
2. Most scheduled inductions start in the evening. You arrive at the hospital between 7-8pm and are placed in a labor and delivery room. Your assigned nurse will gather information, place an iv port, draw blood samples, and get you settled. Your doctor will come in and do a cervical check to determine which course of medication to start with. Most patients who do not have any dilation or effacement start with one of two medications:
Cervidil: A medication placed against the cervix to soften and start the dilation process given every 12 hours. If this medication is chosen, most people will sleep through the night (as well as you can sleep in a hospital!) before Pitocin is administered. Other people may have light cramping that may keep them awake. It's best to try to sleep.
Cytotec: A medication taken orally used to soften the cervix administered every 4 hours. It is more likely to trigger contractions. Often two rounds of this medication are administered.
On occasion, a foley catheter may be used alone or in conjunction with medication. A foley catheter is used to mechanically dilate the cervix. With this method a small rubber tubing is placed inside the cervix and a balloon is inflated to stretch the cervix open. Sometimes your doctor or midwife may also want to break your water with a small hook in order to begin or speed up labor. If your baby or contractions ever need more closely monitored they may need to break the water in order to place the internal monitors.
3. Once any medication is administered you and your baby will be continuously monitored. After the given time for the medication to take effect, your doctor will check you to see if the cervix has made any change. Another round of medication may be given, or it may be time to start Pitocin. (Be sure to ask if you can eat and shower before Pitocin is administered!)
4. Pitocin is given through an IV, administered with saline fluid, and managed by a pump. The dosage of Pitocin goes up by 2 every 30-45 min until your contractions are close together. The goal is for your contractions to be 2-3 min a part. Many hospitals have wireless monitoring so you may move, shower, and walk just like a non-induced labor!
From here an induction looks like a regular labor. This is where you would apply your comfort techniques, you water may break (or may be broken by the doctor or midwife), or you could choose an epidural or other pain relief such as nitrous oxide. There is no right or wrong way to have an induction- it is totally dependent on your body and your baby. Tell us- were you induced? What were the moments that stood out to you?