Induction of labour is a common procedure today. About 10-15% of women will either request or need to have an induction of labour. Inducing a labour effectively means taking someone not in labour and by whatever means assisting them to establish labour. It is not a guarantee of vaginal delivery.
Common reasons for induction include:
- The pregnancy has gone longer than 41 weeks.
- The mother has health issues like high blood pressure, pre eclampsia, gestational diabetes or pre-existing Type 1 or Type 2 diabetes.
- There are concerns that the baby may be compromised or unwell in the uterus.
- The waters have broken, and natural labour has not occurred with 24 hours of the waters breaking, or if there is observed to be some of baby’s poo (meconium) in the fluid after the waters break.
The induction process varies based on the requirements at the time and the state of the cervix (open/closed, firm/stretchy).
ARM: Artificially rupture the membranes by using a small plastic hook to gently make a hole in the membranes in front of the baby through the cervix (the neck of the uterus). This may be enough to start labour but if it does not then an IV drip is placed in the hand, and a hormone infusion called SYNTOCINON is commenced to stimulate the uterus to contract.
Should the neck of the womb be closed, or too firm or too long for the membranes to be reached, then the induction will be done using either CERVADIL or MISODEL. A small strip of material containg either a prostaglandin or misoprostol is placed in the vagina, behind the cervix, and left overnight. This usually causes the cervix to soften, shorten, and dilate, allowing an ARM the next morning.
It is important to remember that induction of labour is not without its risks, and will be undertaken only when appropriate and with your consent and understanding. Dr Price and Dr Friebe will discuss the risks and possible problems with induction of labour before undertaking this with any patient.