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by Bucciarelli A

Definition

The birth process may need to be started by your care team. Both medicine and procedures may be needed.

Reasons for Procedure

Labor may need to be induced if it is unhealthy for the baby to stay in the womb any longer. Babies can become too large for a safe birth. It can also become hard for them to get enough oxygen. Labor may be started:

  • For pregnancy that is 2 or more weeks past the due date
  • For pregnancy with twins that has reached due date

Labor may also need to be started if there are health risks for mom or baby such as:

  • Water breaks and contractions do not begin
  • High blood pressure or diabetes in the mother
  • Infection in the uterus
  • The baby is not growing properly
  • Low amniotic fluid level
  • Rh incompatibility—mother and baby have different red blood cell Rh types which makes the mother's immune system attack baby's blood cells

Possible Complications

Once labor starts, complications are the same as labor that starts on its own.

Medicine that is used to start labor can lead to:

  • Stalled labor—medicine does not trigger labor. A C-section may be needed.
  • Strong contractions—medicine may make contractions too strong. This is rare. However, it can lead to fetal distress and uterine rupture.

Be sure to discuss these risks with your doctor.

What to Expect

Prior to Procedure

Not all labor inductions are planned. If it is, do not eat too much before going to the hospital. It is okay to have clear fluids.

Labor can make it hard for food to leave your stomach. This can cause a problem if you need a c-section.

Description of the Procedure

Cervical Ripening

The cervix will need to soften, thin, and open. This may need to be started with medicine such as:

  • Gel that is applied to the cervix
  • Suppository put in the vagina
  • Pill taken by mouth

It can take a few days to ripen.

Other steps to help prepare the cervix include:

  • Strip the membranes—separate your cervix from the tissues around the baby’s head
  • Expand a small medical balloon in the cervix
  • Place a type of sponge-like seaweed into the cervix
Changes in the Cervix During Pregnancy
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Contractions

A medicine called oxytocin can start contractions. It acts like a hormone your body makes during active labor. The medicine will be changed to strengthen or weaken the contractions. The birth process will then be the same as when labor begins on its own.

Immediately After Procedure

If everything goes well, you will deliver a healthy baby.

How Long Will It Take?

It can be hours to several days (rare) until the delivery. If your cervix is not ripe, labor and delivery could take 2 to 3 days. It could take longer for first-time mothers and for pre-term babies.

How Much Will It Hurt?

Labor causes severe pain. Talk to your doctor about ways to manage the pain.

Average Hospital Stay

The usual length of stay is 1 to 3 days. Your doctor may choose to keep you longer if you have any problems.

Postoperative Care

Birth is a very physical process. Allow time to rest. Ask for help for daily tasks.

Call Your Doctor

Contact your doctor if your recovery is not progressing as expected or you develop complications such as:

  • An unexplained fever of 100.4 degrees Farenheit (38 degrees Celsius) or above in the first 2 weeks
  • Soaking more than 1 sanitary napkin an hour or if the bleeding level increases
  • Wounds that become red, swollen, or drain pus
  • New pain, swelling, or tenderness in your legs
  • Hot-to-the-touch, significantly reddened, sore breasts
  • Any cracking or bleeding from the nipple or areola (the dark-colored area of the breast)
  • Foul-smelling vaginal discharge
  • Painful urination or a sudden urge to urinate, inability to control urination
  • Increasing pain in the vaginal area
  • Cough or chest pain, nausea, or vomiting
  • Depression, hallucinations, suicidal thoughts, or any thoughts of harming your baby

In case of an emergency, call for medical help right away.

RESOURCES

American Congress of Obstetricians and Gynecologists  http://www.acog.org 

Women's Health—US Department of Health and Human Services  http://www.womenshealth.gov 

CANADIAN RESOURCES

Health Canada  http://www.hc-sc.gc.ca 

Women's Health Matters  http://www.womenshealthmatters.ca 

References

Harman JH, Kim A. Current trends in cervical ripening and labor induction. Am Fam Physician. 1999;60:477-484.

Induction of Labor. The American Congress of Obstetricians and Gynecologists, Practice Bulletin No. 107. August 2009.

Facts about labor induction. Am Fam Physician. 1999 Aug 1;60(2):484. Available at: http://www.aafp.org/afp/990800ap/990800a.html. Accessed December 28, 2016.

Longer hospital stays for childbirth. National Center for Health Statistics website. Available at http://www.cdc.gov/nchs/data/hestat/hospbirth/hospbirth.htm. Updated February 3, 2010. Accessed December 28, 2016.

Morey SS. ACOG develops guidelines for induction of labor. Am Fam Physician. 2000 Jul 15;62(2):445. Available at: http://www.aafp.org/afp/20000715/practice.html. Accessed December 28, 2016.

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