Labor induction: when and who can do it?

Have you ever heard of labor induction? Labor induction is a procedure to smooth the process of childbirth.

Induction is very important to do if there is a risk of endangering the mother and the fetus during delivery. This procedure, also known as labor induction, is performed with the aim of stimulating the uterine muscles to make labor easier.

Before you can undergo labor induction, of course there are a number of things you need to know as initial preparation. Actually, what is labor induction and what do you need to know?

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Labor induction is the process of launching a birth

Childbirth is a moment that has been eagerly awaited when the gestational age is approaching the date of birth of the baby.

Long beforehand, delivery preparation and delivery equipment should not be missed to be provided.

On the eve of birth, pregnant women may feel unbearable heartburn.

But sometimes, some mothers don't show signs of giving birth even though the time has come.

At this time, the doctor may perform labor induction or delivery. The question is, what is the procedure of giving birth or labor by induction?

Induction of labor or delivery is a process that is especially carried out when a pregnant woman gives birth in a hospital instead of giving birth at home.

The meaning of labor induction is the process of stimulating the contraction of the uterine muscles so that the mother can give birth normally through the vaginal route.

With this meaning, induction of childbirth aims to facilitate the birth process when it is deemed to endanger the lives of both the mother and the baby.

If signs of labor do not start on their own, labor induction may be done to stimulate the baby to be born quickly.

The condition of pregnancy can be the reason why labor induction is carried out, especially regarding the health condition of the mother or baby.

How long does the induction reaction take to give birth?

The length of time the labor induction process takes place during pregnancy can vary for each mother.

How long the labor induction reaction process to delivery is determined by the condition of the mother's own body.

Typically, mothers who have had a previous spontaneous labor respond more quickly to induction than mothers who have never experienced spontaneous labor.

If the condition of the mother's cervix (cervix) is immature, in the sense that it is still hard, long, and closed, the process of induction of labor may take 1-2 days until the time of delivery.

However, if the cervix is ​​already soft, the induction process can certainly be faster, even it only takes a few hours for delivery.

In addition, the induction method chosen also determines how long the labor induction process lasts until the time of delivery.

The following is the length of time the labor induction process is based on the method chosen:

• About 6-8 hours when using prostaglandin gel and 12-24 hours when using suppositories
• About 6-12 hours when using oxytocin (pitocin)
• About 24 hours when using a Foley catheter

What are the conditions for labor induction to be done?

According to the American College of Obstetricians and Gynecologists (ACOG), labor induction is only performed when the baby is at more risk of remaining in the womb.

Yes, labor induction is not always necessary because there are various conditions that require you to induce labor.

Doctors usually choose labor induction or delivery procedures as the first alternative before recommending the type of delivery by cesarean section.

The doctor will first detect health problems that are considered for induction of labor.

This condition can be detected since pregnancy. So, pregnant women have enough time to make preparations before undergoing labor induction or childbirth.

Some of the factors that determine whether a mother needs induction of labor are the following:

• Maternal health
• Baby health
• Your gestational age and size of your baby
• Position of the fetus in the uterus
• Cervical conditions

Reasons for induction of labor should be done

Some of the conditions or conditions that make labor induction necessary are:

• Your pregnancy is past the due date which should be almost 2 weeks and you are showing no signs of giving birth. A gestation that is longer than 42 weeks puts you at greater risk for various problems, such as stillbirths.
• Premature rupture of the membranes without labor contractions for 24 hours. Induction is needed to reduce the risk of infection in your uterus or baby.
• The fetus does not move or push outward even though it is old enough to be born.
• There are complications of pregnancy. For example, preeclampsia (high blood pressure during pregnancy), diabetes, disorders of the placenta, or infection of the amniotic fluid.
• Stunted fetal growth.
• There is an infection of the uterus (chorioamnionitis).
• The baby in the womb has stopped growing.
• Little or insufficient amniotic fluid surrounds the baby (oligohydramnios).
• The placenta starts to deteriorate.
• The mother has placental abruption.
• The mother has a history of stillbirths in previous pregnancies.
• The mother has a medical condition that is risky for both herself and the baby. Take for example high cholesterol, hypertension, preeclampsia, gestational diabetes, kidney disease to excess body weight.

In addition, the doctor also looks at the age of your pregnancy and whether your baby is ready to be born or not.

If the baby is very premature, the doctor may not do labor induction.

Another reason, namely to provide comfort to pregnant women so that they do not feel too much pain while waiting for delivery. However, generally this is not recommended.

Who is not recommended to induce labor?

Launching from the Mayo Clinic page, labor induction is not a method that can be done by all pregnant women.

Some of the conditions or conditions that prevent the mother from doing labor induction are as follows:

• Had previous caesarean section with classic incisions.
• Position of the placenta blocking the cervix or cervix (placenta previa).
• The position of the baby will be born with the lower body first, or in a sideways position.
• Pregnant women have active genital herpes.
• The baby's umbilical cord enters the vagina before delivery (umbilical cord prolapse).

If you have had a previous cesarean section and labor was induced, your doctor may avoid giving certain drugs.

This aims to reduce the risk of uterine or uterine rupture.

How is induction delivered?

Induction of childbirth or labor can be done in various ways, such as giving drugs or other methods to stimulate childbirth.

In what way labor induction is performed depends on the readiness of the mother's body for childbirth.

If the condition of the mother's cervix has not started to soften, thin, or open, it means that the mother's body is not ready to give birth.

In these conditions, pregnant women may be given childbirth stimulants.

This is to make the cervix ready for delivery before starting labor induction.

However, before labor induction begins, your doctor will usually ask you to do a biophysical profile test or non-stress test (NST) test.

These medical tests are performed to determine the condition and response of the baby.

Some of the methods used in labor induction are as follows:

1. Using prostaglandin drugs

To make the cervix thin or open, your doctor may insert a prostaglandin induction drug into your vagina.

This labor induction drug acts like a prostaglandin hormone so that it can help ripen the cervix for delivery.

Sometimes, this medication can also stimulate real labor contractions instead of false contractions.

2. Using the drug oxytocin (pitocin)

Pitocin is actually a synthetic version of the hormone oxytocin that is produced naturally in the body.

Pitocin is used to dilate the cervix and stimulate or increase uterine contractions.

Oxytocin itself is a hormone that the body produces naturally to trigger the uterus to contract.

Oxytocin is used to stimulate or increase your contractions. The doctor will give pythosin through intravenous fluids in low doses.

This additional supply of oxytocin will speed up the birth of the baby by triggering the fetal exit reflex and making it easier for it to pass down the birth canal.

The amount of oxytocin needed will be tailored to your needs.

3. Using the drug Misoprostol

Misoprostol is a labor induction drug that acts like a natural prostaglandin hormone as a stimulant for immediate delivery.

Misoprostol works to make the cervix thin or open while stimulating labor contractions.

This medicine can also be given as a first aid step when the cervix has severe tearing or bleeding after delivery.

Misoprostol in labor induction procedures is given by the doctor by inserting a drug into the vagina or given to you to drink directly.

However, misoprostol given vaginally is more effective at ripening the cervix and speeding up the delivery of the baby than taken orally.

4. Using a Foley catheter

Apart from drugs, labor induction can also be done with tools. Your doctor may insert a catheter with a special balloon into the end of your cervix.

This balloon will be filled with water so that it presses on your cervix, which then stimulates the release of prostaglandin hormones in the body. This causes the cervix to soften and open.

5. Wiping the lining of the cervix

If the cervix has opened slightly, the mother may no longer need to use drugs or catheters to stimulate cervical ripening.

Mother only needs a little stimulation.

The doctor may insert a finger into your cervix and manually separate the amniotic sac from your uterus.

This causes the prostaglandin hormone to be released by the body, causing the cervix to mature and possibly contractions.

6.Solution of the amniotic sac (amniotomy)

When your cervix has opened a few centimeters and your baby's head has moved into your pelvis.

However, you will have to wait another long time for labor to be ready.

Your doctor may break your amniotic sac with a small instrument. A ruptured amniotic sac can make you feel contractions to give birth.

Are there any risks or dangers from induction of labor?

Most labor induction goes smoothly without side effects for both mother and baby.

It's just that, there are still possible side effects that follow after you undergo induction.

When labor induction doesn't work, you may need another method of induction or have to have a caesarean section.

In addition, labor induction can also take a long time, especially if your cervix is ​​not ready.

This may make you feel uncomfortable and anxious.

Some of the risks or dangers that can occur when you induce labor or give birth, namely:

1. The baby's heart rate is low

Low heart rate in babies can occur because the drugs used during labor induction or delivery to stimulate contractions actually cause the contractions to appear too strong.

In fact, the onset of contractions can also be too frequent for quite a long time.

This reduces the oxygen supply to your baby, resulting in a low heart rate.

2. Uterine rupture or uterine tear

In rare cases, uterine rupture can occur due to the prostaglandin and oxytocin drugs used during labor induction.

A caesarean section may be needed at this time to prevent more dangerous complications.

3. Problems with the baby's umbilical cord

Labor induction increases the risk or danger of umbilical cord prolapse, in which the umbilical cord precedes the fetus during birth or delivery so that the supply of oxygen to the fetus is interrupted.

4. Bleeding after childbirth

Labor induction can also increase the risk of your uterine muscles having bad contractions after childbirth (uterine atony).

This causes serious bleeding after delivery.

5. Risk of causing infection

Labor induction or delivery is a procedure that can carry risks.

The risk or danger of infection to the mother and baby increases with induction of labor.

While in the mother's stomach, the baby is protected by amniotic fluid. That is why, if after the mother's amniotic fluid breaks but the baby does not come out, the baby is susceptible to infection in the womb.

This is because nothing else can protect the baby from exposure to the outside environment so that the germs that cause infection are easier to enter.

6. The risk of health problems in babies

Generally, labor induction is performed earlier than the estimated day of birth (HPL). This condition can bring dangerous side effects to labor induction in the form of health problems in the baby.

Babies can have difficulty breathing and the liver is not mature enough to do its job. As a result, this condition actually increases the level of bilirubin in the baby's blood.

As a result, the skin and eyes of the baby turn yellow or what is known as jaundice.

This condition can still be treated until it is cured, but your little one will have to spend more time in the hospital.

7. Increase the risk of giving birth to a cesarean section

The induction process will stimulate the uterus to contract so that the amniotic fluid breaks. Unfortunately, not all mothers are able to go through this process smoothly.

Yes, there are mothers who still find it difficult to give birth normally so that a caesarean section must be replaced.

Caesarean section in labor induction is also often chosen when the position of the baby is not possible to be born normally because it can be bad for the baby.

8. Induction failure

Failure to induce labor can occur because the uterus does not open enough.

Normal delivery cannot be done so pregnant women need to undergo a cesarean section.

Apart from its advantages, induction of childbirth does have a number of risks.

However, if your doctor recommends it, the benefits you can outweigh the risks.

Induction of labor that is done properly can actually save the mother and the fetus during childbirth if it is considered to be at risk of causing harm.

Despite all the dangers above, the induction of labor or delivery tends to outweigh the risks.

That is why induction of labor or delivery is a procedure that still needs to be done for certain conditions.

It is better to talk to your doctor about preparing for the birth of your baby so that anything bad during childbirth can be anticipated.

What conditions must be prepared before labor induction?

The success of labor induction is determined by medical factors and your readiness before undergoing it. Medical factors include health conditions and the opening of the uterus.

In order to support a successful induction, you can make the following preparations:

1. Understand all the options available

Labor induction can be performed using a variety of techniques. For example, the amniotomy technique involves breaking the amniotic fluid to speed up labor.

The first preparation you need to do before labor induction is to consult a doctor about this.

Ask why the doctor suggested induction, the technique to use, and any other information you may need.

2. Knowing the condition of your uterus

Before deciding to undergo induction, you must first know what the condition of your uterus is like.

The reason is, induction is easier to do when your uterus is ready for labor.

Usually the doctor will inform you about this when you consult.

The elements that you need to pay attention to include the width of the opening, the length of measurement, and the softness of your uterine muscles or not.

In addition, also understand how low the position of the fetus in your uterus and whether there is a possibility of breech.

3. Know the expected day of birth

Labor induction is a process that will run more easily when you are nearing your due date (HPL).

So, try to consult your doctor about the date of birth as you prepare for labor induction.

The uterus will be better prepared for labor the closer you are to your due date.

If you don't know your due date or if you haven't reached 39 weeks of gestation, your risk of delivery usually becomes higher.

What will be done if labor induction is unsuccessful?

Before doing induction there are several things that need to be considered. The doctor will do a cervical assessment. The success of labor induction depends on the pelvic score.

Another thing to consider before deciding whether labor induction is necessary or not is the mother's vital signs.

Take for example blood pressure, pulse, respiration and temperature, fetal heart rate, excessive uterine contraction abnormalities, and bleeding or not.

Induction of childbirth or birth is a process that is not always successful.

If you have this, your obstetrician or midwife will first observe the condition of the mother and baby.

That is why induction must be carried out under the close supervision of the treating doctor.

Labor induction is a procedure that can be declared a failure if the mother is unable to reach the desired target contractions.

The doctor who handles labor will pay attention to the response of the uterus to the contraction drug that has been given.

If the mother is not strong or experiences excessive pain, the induction can be stopped.

It is likely that the doctor will offer another method of induction of labor or a caesarean section if that does not work.

A cesarean delivery is required when labor induction isn't working, especially if you've never had a birth before and your cervix isn't ready for delivery.

The mother will be given the opportunity in advance to discuss this situation with the obstetrician who handles childbirth.