Stimulation of uterine contractions during pregnancy before labor begins is called labor indiction. It is done to achieve a vaginal birth and can also be recommended when there’s a concern for the mother’s or the baby’s health. To determine the necessity of labor induction, the healthcare provider evaluates several factors such as the mother’s health; the baby’s health; the baby’s gestational age, weight, and size. They also consider the baby’s position in the uterus and the state of the mother’s cervix.
Here are the reasons why labor induction is performed during pregnancy:
- It can be performed if there is a premature rupture of membranes and the water has broken, but the labor hasn’t begun.
- Labor induction can also be performed in case of a post-term pregnancy when the mother is approaching two weeks beyond the due date and the labor hasn’t been started naturally.
- An infection in the uterus called chorioamnionitis can also delay labor resulting in the need for labor induction.
- Fetal growth restriction where the estimated weight of the baby is less than 10 percent of what is expected at gestational age also results in delayed labor which in turn requires labor induction.
- Labor pain can also be delayed due to oligohydramnios. A condition in which there is not enough amniotic fluid surrounding the baby. In the case of oligohydramnios, labor induction may be required.
- It can also be required due to placental abruption where the placenta peels away from the inner wall of the uterus before the delivery.
- Certain medical conditions such as kidney disease or obesity can also lead to delay in labor and there is a need for labor induction.
Depending on the circumstances mentioned above, following are some procedures of labor induction:
- Rupture the amniotic sac– It is a technique called amniotomy where the healthcare provider creates a small opening in the amniotic sac using a plastic hook. The pregnant mother might feel a warm gush of fluid when the sac opens, which is called as water breaking. Amniotomy is performed only if the cervix is partially thinned and dilated and the baby’s head is deep inside the fluid.
- Cervix ripening– Synthetic prostaglandins are typically placed inside the vagina to soften the cervix. After using prostaglandin, the mother’s and her baby’s heart rate will be monitored. In some cases, a small tube, a catheter with an inflatable saline-filled balloon will be inserted in the cervix. Resting saline-filled balloon against the walls of the cervix also helps in ripening the balloon.
- Intravenous medications– The healthcare provider might intravenously administer a synthetic version of oxytocin, a hormone that helps in the contraction of the uterus. It is more effective in speeding up the labor.
Labor induction needs to be strictly performed under the guidance of a healthcare professional as it involves risks such as:
- Lower heart rate– The medications used in labor induction might cause excessive contractions, which can diminish the baby’s oxygen supply lowering the mother’s heart rate.
- Infection– Some methods of labor induction like rupturing the amniotic sac can increase the risk of infection for both the baby and the mother.
- Bleeding after delivery– It also increases the risk of improper uterine interaction after the mother gives birth, which can lead to serious bleeding after delivery.