In most of the cases, labor occurs naturally, but there are certain cases in which help may be needed to initiate labor. Artificial initiation of labor is referred to as induced labor.
Need for induction of labor
- Labor is induced if the delivery date is overdue and pregnancy has proceeded beyond 40 weeks.
- Induced labor is preferred if labor does not start naturally within 24 hours after the water has broken.
- For women with chronic conditions like pre-eclampsia and kidney disease, labor is induced for the well-being of both mother and baby
- Demand of parents to have the baby born on a particular date is another reason for inducing labor
- If the mother has diabetes and is on insulin, labor is generally induced after 38 weeks of pregnancy.
How is labor induced?
As the name indicates, the membranes that surround the fetus is gently separated from the cervix. This action stimulates the production of prostaglandin. A membrane sweep is suggested for a full-term woman during their 40th-week visit.
Prostaglandin, a hormone-like compound, plays an important role in uterine contractions. During induced labor, prostaglandin in the form of gel, tablet or pessary is inserted into the vagina. If labor does not start with this, another tablet would be inserted after six hours.
Artificial rupture of membrane
Artificial rupture of membrane or breaking of waters is done during an internal examination. The doctor will make a small break in the membrane surrounding the baby. It is a lesser recommended way for induction of labor as it does not always work. It is used when the cervix is soft and labor is about to begin.
Syntocinon is an artificial form of the hormone oxytocin. It is usually given after the waters are broken. A low dose is given initially and then increased gradually. Syntocinon is given intravenously and the rate of flow is adjusted once contractions begin.
The doctor may assess the readiness for labor by checking the condition and position of cervix, and also the position of baby’s head in the pelvis. This assessment is called Bishop Score, and a score <6 indicates that the cervix is unripe for labor. The doctor may then opt for using other interventions or to have a cesarean section.