I’ve heard all the reasons why providers want to do an induction. Some are necessary and some are just for convenience, Let’s go through a couple of them. I have heard providers tell people that their baby is going to be big, that their provider is going to be on vacation, and in some cases, people elect for induction because they are tired of being pregnant. That being said, there are some very real reasons for induction. A few of those are preeclampsia, fetal growth restriction, RH incompatibility, 42 weeks past guess date, Oligohydramnios (not enough amniotic fluid). There are many reasons why an induction could be necessary, but what I want you to understand more than that is the process, and that it can take days. Yes, days. I have actually heard providers tell their patients that they will meet their baby much sooner with an induction, and I am here to tell you that in most cases, that is not true. It’s a process.
Let’s talk more about the process, and what to expect. First, you need to understand that induction and actual labor are two separate events. They are not one and the same. The first step is to ripen (soften) the cervix. This is done by using Cervidil or Cytotec. This process can be taken orally or vaginally. The usual dose is 50mcg orally or 25mcg vaginally, and can be repeated every 4 hours if contractions are absent or not painful. In other instances, a small tube (catheter) with an inflatable balloon on the end is inserted into the cervix. Filling the balloon with saline and resting it against the inside of the cervix helps ripen the cervix. Once your cervix is sufficiently relaxed or dilated, your provider will begin the second step. This usually involves stimulating the body to produce contractions if they have not started on their own. A medication called Pitocin is used to stimulate contractions. This is usually administered through an IV drip, and they begin with a small dose, and this can be gradually increased until contractions are strong and frequent. Unless your pregnancy has been diagnosed as high risk, you will be able to eat and move throughout this process, however, monitoring is consistent throughout this process. Once the Pitocin has begun to contract the uterus, sometimes your body will take over and they are able to shut the Pitocin off, and other times it increased at steady intervals usually every 30-60 min. This is when we are dilating the cervix.
There are risks associated with induction, however, as in most hospital interventions, the benefit can outweigh the risk depending on your individual situation. Some of the risks can be a failed induction. According to Mayo Clinic, about 75% of inductions are successful vaginal births, and the remaining 25% result in a c-section. We could see a low fetal heart rate from the medications used during the induction. There is a rare but serious complication of uterine rupture, and lastly the risk of more serious bleeding which usually occurs due to the medications.
I have been seeing inductions suggested much more than I have seen in the past, and I think people need to be aware of how it is done, and some of the risks that could be involved. More often than not I am seeing inductions suggested with not enough clarity and understanding. It is a process, and a process that can sometimes be beneficial to both the birthing person and the baby, just make sure to ask all of the questions and understand that induction is not easier or shorter. It is sometimes being sold as a quick fix, and honestly, there is nothing quick about it.
Here are a few questions to ask if your provider suggests an induction.
Why do I need an induction of labor?
When is my due date?
Do we have other alternatives, including waiting?
What percentage of patients in your practice are induced?
How will an induction change my birth plan?
When are you wanting to induce?
What will you be using to induce?
What is my Bishop Score?
What are my options if it isn’t working or progressing?
What are the risks?
I think that if an individual goes into any medical procedure with our questions answered, and being heard, we will feel a lot more confident and trusting. Remember an induction is not a guarantee to C-section. I have been at many inductions that ended in a vaginal delivery. I just want to make sure that you understand the process and know how to get answers.
XoXO-HOlly