Understanding Labour Induction

Reasons for Labour Induction

Labour induction, often called induction, is a medical intervention that artificially initiates uterine contractions before natural labour begins spontaneously.

Some may ask if it is better to be induced or wait for spontaneous natural labour. The reasons and decision for deciding on labour induction can differ and is made based on careful assessment and monitoring, considering the individual circumstances of each pregnancy. Factors such as the mother and baby’s health, gestational age, and pre-existing medical conditions will be taken into consideration.

A typical full-term pregnancy is approximately 40 weeks. One common reason for inducing labour is when a pregnancy has exceeded the expected due date, or in other words, ‘you are overdue’. Labour induction may be suggested if you have reached Week 41 or later without signs of labour and spontaneous labour still does not commence. Extended gestations can carry increased risks of stillbirth or health complications to the baby.

When the amniotic sac ruptures (‘your waters broke’) but contractions did not start, it may be necessary to induce labour to reduce the risk of infection to the mother and baby. If your baby is delivered before reaching 37 weeks of gestation, they may be at risk of complications related to premature birth. In instances where the amniotic sac ruptures before the 34th week, induction will only be suggested if other relevant factors indicate it as the best course of action for both you and your baby.

Induction may also be recommended if the mother or the baby has a medical condition that makes continuing the pregnancy unsafe. These conditions may include gestational diabetes, preeclampsia, placental issues, or specific foetal health concerns.

Methods for Labour Induction

There are a few methods used by healthcare professionals to induce labour depending on individual circumstances and health considerations.

• Membrane sweep (cervical sweep): This is a standard procedure whereby a sweeping motion by using the fingers is done to separate the amniotic sac from the cervix. This action stimulates the release of hormones, particularly prostaglandins, which play a key role in softening and thinning the cervix. As the cervix becomes more favourable for labour, it may lead to cervical effacement (thinning) and dilation (opening), potentially kickstarting the onset of labour.
• Amniotomy: Referring to the medical term of the rupturing of the amniotic sac, which surrounds the baby in the womb. This is often called ‘breaking the water’. This procedure is performed in a sterile environment by healthcare professionals during the active phase of labour. Once the amniotic sac is ruptured, uterine contractions are accelerated, thus potentially reducing the duration of labour.
• Synthetic prostaglandin medications: Prostaglandins can be administered vaginally to help initiate cervical thinning and opening, making the cervix more receptive to contractions. This method is used when a woman’s cervix is not yet ‘ripened’ or favourable for labour.
• Synthetic hormone oxytocin: The administration of the synthetic hormone oxytocin is done intravenously to strengthen and regulate uterine contractions when the labour progress is slow. By doing so, labour can be induced quickly, and vaginal delivery progress is enabled.
• Labour balloon or balloon catheter: Healthcare professionals may opt to use a labour balloon or balloon catheter for induction instead of pharmaceutical methods, as it is more readily available and may pose fewer risks, such as uterine hyperstimulation.

The pain experienced during induced labour can vary from person to person but is usually more intense compared to spontaneous labour. Pain management options, such as epidurals and intravenous pain medications, are available to help manage discomfort during labour.

The amount of time it takes to give birth after being induced varies widely depending on individual’s response to the induction process, the method used, and the readiness of the cervix. Some may give birth within hours of induction, and some may take longer than one day.

Recent studies indicate that inducing labour at 39 weeks in women aged 40 years or older may decrease the risk of stillbirth. However, it is essential to consult your physician to determine the most appropriate approach for your pregnancy and delivery preferences.

Risks Associated with Labour Induction

The safety of inducing labour largely depends on the specific circumstances and the methods used. While labour induction is generally a safe intervention, there are some common risks associated with labour induction, such as uterine hyperstimulation, foetal distress, infection, and a slight increased risk of caesarean section delivery.

However, induction is typically considered before a caesarean section since it is less invasive and associated with fewer complications. However, the choice between induction and C-section depends on various factors, including the mother’s and baby’s health.

Discuss any concerns with your healthcare provider, as they will weigh the potential risks against the benefits for both you and your baby.

Tips for Inducing Labour Naturally

If you are interested in natural methods to encourage labour, consult your healthcare provider to ensure they are safe and appropriate for your situation. Some natural ways that may be considered include:

• Swimming: Swimming is an exercise that can strengthen the body to cope with the labour process.
• Gym ball exercises: Gentle exercises on a gym ball can help position the baby for labour, alleviate labour pain discomfort, and encouraging better well-being for mother and baby for spontaneous vaginal delivery.
• Expressing colostrum: Gentle breast stimulation to express colostrum (early breast milk) may stimulate contractions. However, this should only be done under the guidance of a healthcare professional.
• Nipple stimulation: Gentle nipple stimulation can stimulate the release of oxytocin, a hormone responsible for initiating contractions. However, it is important to proceed with caution to avoid overstimulation.

Make an Appointment at Gleneagles Hospitals

If you have any questions or concerns about labour induction, consult your healthcare team to make informed decisions about your pregnancy and delivery.

Get in touch with us to book an appointment today to consult with our Obstetrics and Gynaecology specialists, or find out more about our Obstetrics and Gynaecology Services at your nearest Gleneagles Hospital.