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  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52

Labour Induction

inductionIn order for any at-home labour induction technique to work, your body needs to be ready for the labour process. Many women experience Braxton Hicks contractions. These “warm-up” contractions prepare your body for the actual labour. Your cervix also needs to soften, thin and dilate for the process of labour to get started. This is known as a favourable cervix. As hormones called prostaglandins are released, your cervix starts to “ripen”. 

Although some DIY labour induction methods may have an impact, most of the common labour- inducing theories are old wives tales that are ineffective and in some cases, potentially dangerous to the well being of both mother and baby. It is therefore essential to consult your health care provider before attempting to jump start labour, to bear in mind that your due date is merely an estimate, and you don’t want labour beginning before your baby is mature.

What is labour induction & when is it necessary?

Induction of labour is any process that initiates labour before it spontaneously begins. Medically, an induction is done if a continuing pregnancy posses a danger to the mother or her unborn child. This includes when:

•    The foetus is not thriving-due to inadequate nutrition, postmaturity (being in the uterus 10 days-2 weeks beyond the estimated due date), low levels of amniotic fluid or other reasons-but is mature enough to do well outside the uterus.
•    Tests suggest that the placenta is no longer functioning optimally and the uterus is no longer a healthy home for the foetus.
•    The membranes rupture in a full term pregnancy and labour fails to begin within 24 hours thereafter.
•    The amniotic fluid is infected.
•    A pregnancy has gone 2 or more weeks after a due date that is considered to be accurate.
•    The mother is diabetic and the placenta deteriorates prematurely or there is concern that her baby will be very large and therefore difficult to deliver, if carried to full term.
•    The mother has preeclampsia that cannot be controlled by bed rest and medication, and delivery is essential for the safety of the mother and/ baby.
•    The mother has a chronic or acute illness that threatens the well being of herself or her unborn child, if the pregnancy continues.
•    The foetus is afflicted with severe Rh disease.
•    You have a history of rapid deliveries or live far from the hospital.

Why the concern after 2 weeks?

The longer your pregnancy continues, the larger your baby will be and this may complicate a vaginal delivery. In some cases, an ageing placenta may affect a baby’s ability to thrive in the womb. An overdue baby is also more likely to inhale meconium (fecal waste) during childbirth. This can result in breathing difficulties or a lung infection after birth.

Inducing labour medically:

High risk patients are generally induced in a hospital very close to or before their due date. In low risk patients, 42 weeks is the absolute cut-off. After this time the risk of stillbirth doubles.

Your doctor or midwife will begin the induction process with the administration of prostaglandins. In a painless procedure, these hormones (either in the form of a vaginal gel or vaginal suppository) are placed near the cervix. These hormones soften the cervix and prepare it for labour. The advantage of this is method that you are free to move around the labour room.

If prostaglandins are insufficient to stimulate labour, Pitocin or Syntocinon, synthetic forms of the hormone oxytocin are used. This hormone can be given through an IV at low doses to stimulate uterine contractions. Oxytocin can effectively initiate and speed up the pace of the labour process if necessary. However, it needs to be discontinued if a woman’s uterus is extremely sensitive to the drug, and her contractions become too powerful and too close together.

Your health care provider may suggest the artificial rupturing of your amniotic membrane (AROM). A thin, sterile, plastic hook is brushed against the membranes just inside your cervix. As the amniotic sac breaks, a gush of warm amniotic fluid is released through the vagina. The production of the hormone prostaglandin increases, which usually causes contractions to strengthen. Because the baby’s head generally moves down towards the cervix during this process, it is possible to monitor their heart through direct access to their scalp. AROM may shorten the labour process and allows the amniotic fluid to be examined for the presence of meconium, which may be a sign of foetal distress. Possible complications of this procedure include; a prolapsed cord, infection if there is too much time between the rupture and the birth, or breech delivery. Some women also find this procedure to be painful, so many practitioners prefer inducing labour with medication once the cervix is ripe.

As your due date approaches, you are probably getting progressively more excited about finally meeting your unborn child. Bear in mind that labour, delivery and having a newborn can be overwhelming, difficult and tiring. In most cases, it is best to wait until nature is ready, willing or able to start the labour process; instead of searching for methods to start this process sooner. Under certain circumstances, elective inductions are recommended but unnecessary interventions pose unnecessary risks. According to the American College of Obstetricians and Gynaecologists (ACOG), “labour should only be induced only when it is more risky for the baby to remain inside the mother’s uterus than to be born”. Trust your health care provider to make the best decision in your case.