Labour Induction – What Are My Options?

You’re nearing the end of your pregnancy and perhaps you’re hearing the words ‘labour induction’. 

Perhaps at your last appointment your midwife or obstetrician mentioned induction of labour as an option if you haven’t had your baby in the next few weeks. They may have offered to perform a stretch and sweep to ‘help’ things along. 

Or you’re experiencing some complications and induction of labour has been recommended as a safer option for you and your baby. 

Whatever the reason, thinking about having an induction can be challenging. You may have heard induction is more painful than natural labour, or that it doesn’t always work and ends in a c-section. 

The best way to deal with your concerns and fears is to be informed about induction of labour and empower yourself to be prepared for labour. 

How is labour induction done?

In Australia, around 25% of women are induced. How induction is performed depends on several things. 

If it’s decided an induction is necessary, you doctor or midwife will do an internal examination to see if your cervix is ready for labour. This can help your doctor decide what method of induction is best for you. 

When your cervix is softening and ripening, you have a much better chance of induction being successful.

Membrane sweep

This involves your midwife or doctor inserting two fingers into your cervix and making a circular motion. This encourages a hormone called prostaglandin to be released. 

Artificial rupture of membranes 

This can only be done when your waters don’t naturally break. A small hook-like instrument is inserted through your vagina to make a hole in the amniotic sac. This brings your baby’s head down onto the cervix to encourage labour to begin; although most women also need medical induction as well. 

Synthetic oxytocin (Syntocinon)

This is an artificial version of the hormone responsible for contractions. You are given this through a drip in your arm. When contractions begin, the amount of Syntocinon is adjusted to make sure you have regular contractions. 

Prostaglandin (Prostin)

Another synthetic version of a hormone that softens the cervix to prepare for labour. It is inserted into the vagina as a gel or pessary. Quite often the gel is used when the cervix isn’t ready yet, before having your waters broken or Syntocinon to bring on contractions.

Balloon catheter

This is a small tube attached to a balloon which is inserted into the cervix, then inflated with saline. The balloon catheter puts pressure on your cervix to encourage it to open. You may also need to have your waters broken or Syntocinon to bring on contractions.  

Why is labour induced?

Most of the time, healthy women have healthy pregnancies and go into labour without any need for intervention. 

Sometimes, there are complications that mean the well-being of you or your baby is at risk. In these situations, it might be decided it’s better for your baby to be born sooner rather than later. 

Medical reasons to be induced are:

  • Preterm or pre-labour rupture of the membranes
  • Health complications for the mother, such as preeclampsia, high blood pressure, diabetes or kidney problems.
  • Concerns about the baby’s health, including poor growth, heart rate changes, or fewer movements. 

There is also an increasing number of care providers who recommend induction for women aged 35 years and older, to reduce the risk of stillbirth. It’s important to know maternal age alone isn’t an isolated risk factor. 

Being overdue is a very common reason for induction, but it isn’t considered a clinical reason unless you are over 41 weeks pregnant. Often, care providers will start talking about induction when you reach 39 weeks even if there’s no medical urgency for birth. 

Induction is also commonly recommended for mamas who are 35 years or older. This is because there’s evidence showing a higher risk of stillbirth at the end of pregnancy in women of this age group. It’s important to know the risk is still very small and has gotten lower in the past few decades. It’s also lower in healthy women and those who have already given birth before.  

Being overdue or considered an older mum can be stressful, particularly if you’re hoping for a natural and positive birth experience. 

It’s impossible to predict when a baby will be born. At best we guess with a due date, based on pregnancy lasting an average of 280 days or 40 weeks. Many women are also choosing to have babies later in life, or experience fertility issues which delay pregnancy until their late thirties. 

How long is labour after induction?

Labour induction is as unique as your pregnancy experience and the truth is there’s no way to know exactly how long labour will take after induction.

It depends on a number of factors all working together to answer the question of how long your induction will take, starting with the method used for induction and how ready your body is for labour to begin.

The consistency, dilation and position of your cervix is the most reliable way to get an idea of how long labour induction will take. This is why before you’re induced, your care provider will assess your cervix.

If your cervix has already begun to dilate before you’re induced, there’s a good chance labour will go faster than if you weren’t dilated at all. In the same way, how thin or ‘effaced’ your cervix is can indicate how successful induction will be. A thin cervix is considered to be ‘ripe’ or ready for labour.

If this is a second or subsequent birth, then chances are your induction is more likely to go quicker than if it is a first baby. Our bodies are marvellous things and seem to recognise what to do after having already birthed.

Is induced labour more painful?

Again, this depends a great deal on each woman but generally induced labour is harder to manage, and the use of epidural pain relief is higher than labour that has begun on its own.

This is because medically inducing labour overrides the natural process of hormone production that allows your body to produce its own painkillers. Induced contractions are also harder and faster much more quickly.

Natural labour induction preparation

Some care providers will offer to perform one or more stretch and sweeps in the week of your due date to ‘encourage’ things along and avoid a medical induction later. 

However you have other options to naturally prepare your body for labour. 

One of these is something known as labour induction massage. Massage is a safe and beautiful way to bring your mind-body awareness into play. Labour induction massage can encourage your body and baby into labour. 

Labour requires several things before it will begin. Your baby needs to be ready for life outside the womb, and positioned optimally for birth. Massage encourages your muscles to release tension that may be preventing your baby from moving into an ideal position.

By stimulating certain acupressure points on your body, labour induction massage can encourage your baby to apply pressure to the cervix and strengthen contractions. 

Your body is also a key part of the process, and that also involves your mental and emotional state. Massage encourages you to let go of fears and inner tension, to work on a positive mindset and open up to the incredible power within your body as it moves into the final stage of pregnancy – labour. 

Natural labour induction massage may encompass many therapies, such as osteotherapy, meditation, stretching, body movements and Rebezo. Ideally you will begin induction massage treatment close to or after your due date.

However, priming your mind and body for labour can begin earlier, as these therapies encourage an open and relaxed state of mind and body and can only benefit you and your baby. 

If you are pregnant and would like to know more about how natural labour induction massage may benefit you, contact Nurtured Birth here

Author: Sam McCulloch, Wordsmith at Nurtured Birth