Inducing labor greatly increases risks for you and for your baby. Induction leads to what's called a “cascade of interventions” – meaning that one intervention leads to another, which leads to another, which leads to another (and so forth). There are a very few instances when inducing labor is the best option.
Researchers are not sure exactly what decides that labor should begin. Some research has shown that it may be the baby's brain that is responsible for naturally inducing labor. No matter how it starts, it's a complex interplay between your body and your baby's body.
Each and every day is valuable to your baby and to your body. Your baby grows and develops more for birth every day during late pregnancy. He or she is putting on more fat and his or her lungs are developing more with the passing time. Your baby's brain has a huge growth spurt in the last few weeks of pregnancy!
Your body also prepares for labor every day in late pregnancy. You could even be dilating a few centimeters without being in labor!
Methods of Inducing Labor Chemically and/or Forcefully
Forceful “Natural” Induction
Breaking the Water
Modern obstetrics makes breaking the water (called amniotomy) seem like a simple, routine procedure. But having your water broken changes the course of your labor – and it places a time limit on your labor. You may have as little as twelve hours to have your baby!
Having your water broken to “speed up labor” doesn't work. Studies show that amniotomy speeds up labor by only 30-45 minutes. Sometimes it does help get a sluggish labor moving, but getting moving and drinking plenty of fluids has been shown to work the same.
As a method of inducing labor, 70-80% of women will start labor within about 24 hours. The rate of uterine infection is much higher for that 20-30% of women who do not.
In fact, it increases the risk of uterine infection to all women. If yours is broken say “no” to vaginal exams – each exam increases your risk of infection.
Breaking your water removes the cushion of water surrounding your baby's head. Both you and your baby will feel more pressure, and many researchers believe that it's safer for you and your baby to have an intact bag of waters during labor.
There's a risk of cord prolapse when water is broken. This means that your baby's umbilical cord falls between his or her head and your pelvis/cervix. This is a life-threatening situation that requires an emergency cesarean section.
Sweeping the Membranes
When someone “sweeps your membranes,” it means that a finger is run lightly along the inside of the cervix to separate baby's amniotic sac from the wall of your uterus. Women are told this will start labor, but it frequently doesn't work.
There's a chance of infection from sweeping (or “stripping“) your membranes.
Inducing Labor Chemically Requires Intervention
Agreeing to induction is agreeing to a host of interventions. A chemically induced labor is very different from a natural labor.
Labor that's induced with synthetic oxytocin (Pitocin) is unnaturally strong. Contractions are stronger and peak more quickly. Your uterus stays tense even between contractions – the stress on your baby never stops (as it does during normal labor).
Continuous monitoring is required due to the high-stress situation. This is called electronic fetal monitoring (EFM) and it leaves you stuck in bed, unable to move and work with your baby. The EFM printout tends to be very open to misinterpretation and directly increases your risk of cesarean section.
Your baby is more likely to pass meconium (the first stool) in the womb, opening up the possibility of aspiration (meaning it gets into his or her lungs). Your baby also has a higher chance of jaundice.
A cesarean section gives your baby a much higher chance of being born with breathing difficulties because there has been no pressure on the chest to help squeeze fluids out of the lungs.
You must have an IV when inducing labor. This is painful, limits your mobility, and can cause an excess of fluid in your body.
Having Pitocin also changes the immediate postpartum period. Your body doesn't release all the hormones it should (because the Pitocin interrupted your normal hormone release pattern). You're missing the hormones that make you and your baby alert and aware.
Your baby is less responsive which prevents him or her from behaviors that benefit both of you. Newborns make movements that stimulate your body and they latch on and nurse shortly after birth. This gets hormones surging in your body that help you to recover from birth.
Prostaglandins are produced by the body and help to soften and “ripen” your cervix. The synthetic forms are usually in a gel, a caplet, or a tampon-like applicator, and are used to get labor started.
In the United States, two brands of synthetic prostaglandin are approved for inducing labor (Prepidil and Cervidil). Another drug, called Cytotec, is a “favorite” for labor induction. This drug has never been approved for this use – in fact the manufacturer warns against using it when inducing labor!!!!
There have been disastrous outcomes associated with Cytotec (Misoprostal) used for inducing labor – including uterine rupture, baby death, and maternal death. The manufacturer warns that Cytotec can “cause abortion.” The drug is made to help with ulcers, not labor.
Prostaglandin induction also causes hard uterine contractions that are stressful on you and the baby. Your baby is more likely to pass meconium in the womb and more likely to be jaundiced. There is a higher incidence of fetal distress.
A NICU (neonatal intensive care unit) visit isn't unusual for a baby whose mother was induced. In fact, chemically inducing labor brings with it a new term – iatrogenic prematurity – meaning “doctor caused” premature birth. The term was created because of the rising rate of induction and the correlating rise in premature births.
Doctors can't know exactly when a baby should be born… and some pregnancies normally go past 40 weeks. Don't let a doctor pressure you into inducing a labor that you and your baby are not ready for.
“Forced Labor.” Mother Jones Magazine. http://www.motherjones.com/politics/2001/01/forced-labor (Covering the Cytotec scandal)
Photo by koadmunkee