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Updated 01 September 2016

Induced labour

Everything you need to know about induced labour, when it is used and how.

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What is an induced labour? It is the artificial starting of labour should it fail to start naturally, or your doctor decides that you need to deliver the baby early.

A technique is used to accelerate labour if the contractions are weak and progress is slow.

Induction is usually planned in advance and you will generally be admitted to hospital the night before the induction.

How is labour induced?
There are three commonly used techniques:

  • Prostaglandin gel - this gel contains prostaglandins (various hormones), which have an effect on the pregnant uterus. They may induce labour if inserted into the vagina, often in the evening so that you will have gone into labour by the morning. This method is often preferred because no drips are needed and you can move around freely.
  • Artificial rupture of the membranes (ARM) – this method is only used near to the normal date at which your baby is due (term) since there is a risk of infection once the waters have broken and the baby must be delivered within 24 hours. If ARM fails to induce labour then some other method, usually an oxytocin drip, will be used as well. ARM is carried out using a tool that looks like a small crochet hook. This is inserted vaginally, through the cervix (mouth of the womb) and a small opening is made in the amniotic sac so that the waters can escape. This is painless. Labour usually starts soon after ARM because the baby’s head is pushing on the cervix, which makes the uterus contract. ARM will also be performed if an electrode is attached to the top of the baby’s head to monitor its heartbeat.
  • Oxytocin-induced labour – Oxytocin is a natural hormone produced by the pituitary gland and will stimulate labour when used in a synthetic form. It is used to start labour and to keep it going. It can be given in several ways, one of which is a small tablet placed under your tongue. It is also given by a drip. This has the advantage that it can be turned down or stopped if your contractions become strong too fast for the cervix to expand sufficiently for the birth. The needle will not be removed until after the baby is born because the uterus needs to continue to contract after the birth to prevent bleeding. This type of induction is used in only a small percentage of deliveries since the contractions may be strong enough to compromise the baby’s blood and oxygen supply during birth.

Why is labour induced?
When babies don’t arrive when they are expected it can lead to anxiety both on the part of the mother and the doctor. There are fears that the placenta may be becoming inadequate to support the baby who may outgrow its food supply.

However, very few babies are truly overdue, since medical convention calculates the date of pregnancy from the first day of the last missed period rather than from the date of conception.

Most doctors will allow about seven days latitude. After this time you will be examined for signs of a prolonged pregnancy and the doctor will check that the baby is still fine in the uterus. If there are any signs that the baby is in distress, you will be induced.

(Mandy Borrain, Health24)

 
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