reasons for inducing labour
Labour & birth

4 reasons for inducing labour

Paula Barry, Practice Development Co-ordinator at the Coombe Women & Infants University Hospital explains some of the reasons for induction of labour.

Sometimes labour needs to be started artificially; this is called induction of labour. The following are some of the reasons why you may be offered induction, but you should ask your hospital what their policy is.

Reasons for inducing labour

1.  If your waters have broken, but labour hasn’t started. If you don’t go into labour within a day or so, there is an increased risk that you or your baby could develop an infection. So you’ll probably be offered an induction 24 hours after your waters break.

2. If you have diabetes. Each mother is assessed individually. If your baby is growing normally, in some hospitals you are offered an induction after 38 weeks of pregnancy.

3. If you have a chronic or acute condition, such as preeclampsia or kidney disease, that threatens your wellbeing, or the health of your baby.

4. If your pregnancy is overdue.

Methods of induction

There are a few methods your doctor can use to try to get your labour started. Some may need to be repeated, or you may need to try more than one before your labour begins. There are three main methods used to induce labour:

  • Propess/Prostaglandin
  • Amniotomy
  • Syntocinon drip

Propess/Prostaglandin

Propess and Prostaglandin are drugs to help soften, or ripen, the neck of the womb. This may stimulate contractions. Your midwife or doctor will insert a tablet, pessary or gel containing one or other of these drugs into your vagina. While you wait for prostaglandins to work you can usually go for a walk around. However, in some hospitals, this is not an option. How you are given prostaglandin depends on whether this is your first or second baby. If this is your first baby, you may need further help to assist induction.

Amniotomy

When your cervix is open enough, your waters will be broken using a small plastic instrument, somewhat like a crochet hook. This is known as artificial rupture of the membranes (ARM).

Syntocinon

Oxytocin is a hormone that is released by your body when you start labour naturally yourself. It causes contractions, which open your cervix and push the baby out. If your labour is being induced you may be offered a synthetic (man‑made) form of oxytocin known as syntocinon. It is given intravenously (into a vein) as a drip in your arm.

reasons for inducing labour

The contractions brought on by syntocinon encourage dilatation of the cervix – you may ask for an epidural for pain relief if required. Syntocinon may cause your uterus to become overstimulated or hyperstimulated. You will be given medication to slow your contractions if stopping syntocinon isn’t enough. There are other methods of pain relief, which can be used before an epidural should this happen to you.

Possible interventions

Your baby’s heartbeat is monitored closely using a cardiotocography machine (CTG machine), which is a monitor with two small discs placed on your abdomen, as some babies may not tolerate medications used to induce labour. If it is still not possible to break your waters or you are on the syntocinon drip but your cervix is not opening you may be offered a Caesarean section, as induction of labour has not worked for you (depending on the reason for the induction).

The risk of you requiring a Caesarean section, or other medical interventions with induction of labour is higher than when labour is spontaneous. If you have concerns, discuss them with your doctor/midwife.

More like this:

Outlining your birth preferences
All you need to know about water birth
Everything you need to know about labour positions

ASK JESSICA

Q. I’m would like to start an exercise programme that will benefit my emotional health as much as my physical health, but I don’t know which type of class would be best. Should I consider choosing from yoga, pilates, tai chi, or could you recommend a class, please?

A It’s great that you have decided to get into exercise. The benefits to you are going to be great. You’ll sleep better, have more energy, better skin, reduced stressed, not to mention all the amazing physical benefits of your clothes fitting better, and looking healthy, trim and toned! My advice to you would be to try them all. Even if some don’t offer pay-as-you-go sessions, if you get in touch directly with the instructor, they will almost always let you try it out first to see if it’s for you. All of the above things that you mentioned are great for mental health, so it really will be a personal preference as to which you go for. On top of the classes you mention, all forms of exercise will give you great mental rewards so consider the not so obvious interval training sessions, bootcamp, and circuits too, as you will also feel on top of the world after a class like that.

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.