By the time you reach your due date, you might feel like you’re ready to just Get. This. Baby. Out! We don’t blame you. Pregnancy, and especially the later stages isn’t always pleasant - many women feel huge and bothered, and just want to meet baby already, and everyone you see tells you; “You look like you’re ready to pop!” (Thanks, for the heads up, I know!)
In most pregnancies labour should start naturally anywhere between 37 and 42 weeks. If you’ve reached week 41 and there is still no sign of bub, your doctor might start to discuss the option of having a medical induction. Induction means taking medical steps to encourage labour to begin. Though most labours begin naturally, and usually your body will know when it’s ready, sometimes you may need a little help to get started.
Why you might need an induction
So the anticipation has built, your due date arrives….and nothing. It can feel unfair (and most likely frustrating!) when your pregnancy goes into extra time, but it’s important to remember that only about five percent of women give birth on their exact due date. That being said, you can’t be pregnant forever (thank goodness!). Most doctors will allow you to go over your due date by a few days with some hospital policies allowing inductions up to 10 to 14 days after the due date. Inductions normally take place when your doctor believes that it’s safer for your baby to be born than continue with the pregnancy.
Approximately 20% of women are induced. It’s not just mums who are overdue that might need an induction. If you have specific health concerns, like diabetes or high blood pressure, or your doctor thinks your water has broken but your contractions haven’t begun, you may be induced early.
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If your doctor suggests an induction, there are several ways it can be done;
- Sweeping of the membranes: Before your obstetrician recommends a formal method of induction, they will try a ‘stretch and sweep’ of your membrane. This can be done in a doctor’s office as opposed to a hospital. The obstetrician will give you a vaginal examination and use their finger to gently separate the membranes (or bag of waters) from the cervix and uterine wall. This can sometimes stimulate labour. The process can be painful though, and can cause some bleeding.
- Prostaglandin is a natural hormone that prepares your body for labour. A synthetic version is inserted into your vagina to help your cervix open and begin the labour process. Once you are given prostaglandin your baby’s heart rate will need to be monitored in hospital. It may take a few doses of prostaglandin before your cervix will soften and open.
- Cervical ripening balloon catheter: Not every woman can have prostaglandin to help induce labour. For example, if you have had a previous caesarean or an allergic reaction to prostaglandins. If you can’t have prostaglandins, your obstetrician may recommend a cervical ripening balloon catheter. This device is a thin tube with a balloon on the end. It is inserted into your cervix where the balloon is inflated with sterile saline. The balloon catheter applies pressure to the cervix which should help soften and open it and prepare your body for labour. Once the balloon catheter has been inserted, you’ll need to stay in the hospital. It usually stays inserted for about 15 hours, or until it falls out. Your waters may still have to be broken artificially, and you might be given oxytocin to bring on contractions.
- Artificial rupture of the membranes (breaking your waters): Your doctor can use a small tool to make a hole in the sac of amniotic fluid that sits around your baby, which, like when waters break naturally, may trigger labour within hours. Membrane rupture can only occur once your cervix is dilated a few centimetres. Sometimes releasing the waters is enough to bring on labour but many women also require oxytocin.
- Oxytocin: This hormone causes contractions. A synthetic version of the oxytocin called syntocinon is administered via a drip. Once your contractions start, the rate of the drip is adjusted until contractions become strong and regular. Once the infusion starts your baby’s heart rate will be monitored. The syntocinon infusion will continue for a little while after the birth.
Risks with inducing labour
There are some risks associated with inducing labour, including a higher chance you will need to have forceps, a vacuum or a cesarean birth. It’s important to weigh up the risks of being induced with the risks of waiting for labour to come on naturally. Speak to your midwife or obstetrician and work out what’s right for you.
How to naturally induce labour
Childbirth is a natural process, and many mums want to have the least amount of medical intervention possible. If you’re at 41 weeks, it may be okay to try a natural inducement methods you’ve heard of. Just remember to check with your doctor first to make sure it’s safe. Try taking a walk, having sex or even hitting up your local Thai place for a spicy curry if you like! None of those methods are scientifically proven to work, but mums everywhere will swear to their effectiveness. Besides, sometimes it can just feel good to be doing something to move the process along.
Not all natural inducement methods are harmless though - some could cause real damage to you and your baby’s health. Stay clear from any herbal remedies purporting to bring on labour.
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It’s a waiting game
Even though you probably feel like you have a watermelon in there, if you’re under 41 weeks it is unlikely you will be induced if there unless there is a risk to you or your unborn baby. It’s definitely not safe to try anything to bring on labour until you’re past 41 weeks and your doctor advises you to do so.
If you’re overdue, keep in mind that heaps of mums have inductions and still have wonderful labour experiences! Pregnancy is full of surprises, so you might actually appreciate knowing exactly when you’re going to give birth.