inductions: what to expect. how you can prepare. why they are used.
Last year, in 2017-18, NHS (National Health Services) data shows that labor started naturally for 52% of babies delivered in hospital, and this was down from 69% in 2007-08. (BBC News - Health, 2018) In 2014, 23% of all pregnancies involved some sort of induction. This means that almost 1 out of 4 women will experience an induction. (Debby Amis, 2014) With numbers that high it is important to know what all an induction can entail, how to prepare for inductions and what questions you might want to be ready to ask your provider.
In a nutshell, an induction of childbirth is the artificial start of labor “through medical interventions or other methods”. The American College of Obstetricians and Gynecologists (ACOG) recommends that inductions only be used “when it is more risky for the baby to remain inside the mother’s uterus than to be born”. So, what constitutes as an “ok” reason for induction and what is considered an elective induction?
Medical reasons that may warrant an induction include, hypertension, preeclampsia, cholestasis, decline in fetal growth, infection in the uterus and rupture of the amniotic sac without labor starting. (Mayo Clinic, 2017) If you were to face any of these conditions, your provider may monitor you and decide if an induction is right for you and determine when they’d like to proceed with beginning the induction process.
Some inductions fall into the “elective” category. These inductions may occur if a woman has passed her 40 week due-date, lives far away from her provider and elects to be induced to ensure care during labor, if a mom is having twins or multiples or if a family feels like they need to be induced due to scheduling/work/care concerns.
Unless the induction is an emergency, parents have a bit of time between learning about their induction and actually going into the hospital to be admitted. There is a lot that new parents can do in this time to get ready for their new and revised birth journey. No matter if you are heading into an induction electively or out of medical necessity, there are a few ways your partner and yourself can get prepared for what lies ahead of you. Here are some tips that I’ve learned from supporting families going through inductions:
1. Get to know the stages of induction and what that means for your body! Inductions happen in stages. Typically they begin with cervical ripeners, progress to pitocin and could end up breaking your waters. Research the kinds of cervical ripeners that your provider uses and also ASK how long they will allow the induction process to continue until they consider surgical birth. About 25% of first time mamas who are induced end with a cesarean birth. (Mayo Clinic, 2017)
2. Prepare yourself for a marathon. You may anticipate childbirth to be long but inductions can be even longer. Prepare yourself mentally that this process could be a couple days. You can also get ready physically by having some things on hand to keep your mind off of this possibly long process. I’d suggest bringing games, cards, adult coloring books, movies and books (both to listen to and to read) into your hospital room.
3. Call on extra support. If your induction takes multiple days, fresh faces will be your saving grace. Having someone new is not only a distraction but can lift your spirits and keep your head in the game. Hiring a doula for your induction may be a huge benefit to you and your partner as well so you have extra support when inductions become long and when you are facing a lot of decisions.
4. Focus on the fact that you will meet your baby at the end of all of this! This seems obvious but it is worthwhile to keep reminding yourself that the prize of this induction process is a cute squishy baby!
5. Tell your friends and family that you are going in for an induction and then ask them to leave you alone! Inductions can be long or they can be speedy. It is difficult to have people constantly asking if the baby has come yet and that might bring down the morale. Ask your tribe for support and prayers but be very clear that you will notify them when baby is here!
6. Bring extra-yummy snacks and drinks!! Hospital food isn’t the worst but after a couple days, you’ll be hankering for a delicious sandwich or ice cream.
You also may want to ask your provider a few questions before your induction process:
How long will you try inducing with cervical ripeners before starting Pitocin or other medications? Can the cervical ripening process last for more than 24 hours in your practice?
Will I be able to use sleep-aides during the cervical ripening process? (Hospitals are anything but relaxing. Sometimes, in order to get rest you may need a Benadryl or something stronger to rest)
How many times would you try Pitocin before you would begin looking at a surgical birth? Often, if your body doesn’t react to Pitocin your provider may suggest you take a “pitocin-vacation” for a number of hours and then start you on it again at a low dose.
At what stage do you typically rupture the membranes (break your water) in an induction? Why?
Typically, how many of your inductions result in c-sections?
An induction, obviously, will change the way your birth journey unfolds. You may try interventions that you never thought you’d have to consider and you may have to readjust some goals. An induction does NOT mean, however, that you can no longer participate in your birth. Research, ask questions, pad your support team with people who can help educate and guide you. My hope is that you will always play the most active-role in your birth possible and that these guidelines might make an induction more pleasant and even fun!
BBC News - Health. (2018, October 28). Rise in Women Having Induced Labours, NHS Figures Show. Retrieved April 7, 2019, from BBC: www.bbc.com/news/health-45978623
Debby Amis, R. B. (2014). Healthy Birth Practice #1: Let Birth Begin on it's Own. The Journal of Perinatal Education .
Mayo Clinic. (2017, September 11). Labor Induction. Retrieved April 7, 2019, from Mayo Clinic - Patient Care & Health Information: www.mayoclinic.org/tests-procedures/labor-induction/about/pac-20385141