When it comes to childbirth, every woman's experience is unique. For some, labour starts naturally, while for others, medical intervention can be necessary.
Induction rates are increasing and I'm hearing more and more stories of induction being offered as as early as 38/39weeks, therefore, I wanted to create this blog post to explain the risks and benefits of induction, so that you can decide if it’s right for you and your baby.
So, what is Induction?
Induction is the process of artificially starting labour.
It may be recommended for reasons such as:
Being overdue (usually past 41 weeks).
Waters breaking without contractions starting.
Concerns about the baby's or mother's health.
NHS Offered Induction Procedures
The NHS currently offers several procedures which may help to start the labour process.
Stretch and Sweeps (Membrane Sweep)
Procedure: A midwife or a doctor inserts a finger into the cervix to gently separate the amniotic sac from the cervix.
Purpose: To release hormones that may start labour.
Stretch and Sweeps A Closure Look - Is it induction, is it not?
Stretch and sweeps are often debated: some see it as a form of induction, while others do not as there is no medication involved.
As mentioned earlier, stretch and sweeps, also known as membrane sweeps, are a form of induction where a midwife or doctor gently separates the membranes of the amniotic sac from the cervix, with the hope of releasing hormones that may start labour.
What does this “look” like?
Imagine making an opening in an orange, inserting a finger along the inside edge of the peel and with a sweeping motion, separating the orange (membranes) around the circumference away from the peel (cervix).
Below is a video demonstrating this process:
BHRUT Maternity Services
This simple procedure can naturally encourage labour without medication, blurring the lines between natural onset and medical induction.
Prostaglandin
Procedure: A tablet, gel, or pessary containing prostaglandin is inserted into the vagina.
Purpose: To soften and dilate the cervix, encouraging contractions.
Artificial Rupture of Membranes (ARM)
Procedure: A small hook-like instrument is used to break the waters (amniotic sac).
Purpose: To release hormones that may start contractions.
Oxytocin Drip
Procedure: A synthetic hormone (oxytocin) is administered via an IV drip.
Purpose: To stimulate contractions if labour hasn’t started or isn’t progressing after other methods.
Balloon Catheter
Procedure: A small balloon is inserted into the cervix and inflated to help it dilate.
Purpose: To mechanically open the cervix.
Benefits of Induction
Health of Mother and Baby:
Reduced Risks: Induction can be vital if continuing the pregnancy poses risks to the mother or baby, such as preeclampsia or infection.
Overdue Pregnancies: For pregnancies going beyond 41 weeks, induction may prevent complications associated with being overdue, such as stillbirth.
Risks of Induction
Increased Interventions:
Higher Chances of Assisted Delivery: Induction, especially if the cervix isn't ready, can lead to the need for further interventions such as forceps or vacuum delivery.
Caesarean Section: There's a slightly higher chance of needing a C-section if induction doesn't progress.
Physical Discomfort:
Painful Contractions: Induced labour can be more intense and painful, often requiring additional pain relief like an epidural.
Potential for Complications:
Uterine Hyperstimulation: Overly strong or frequent contractions can distress the baby and may require emergency interventions.
Infection: Procedures like stretch and sweeps carry a small risk of introducing infection.
Making an Informed Choice
Deciding whether to agree to an induction is a personal choice and should be made after discussing all options available to you, which includes the option of doing nothing.
Induction is not a mandatory procedure, it’s a choice you get to make.
B.R.A.I.N.S is a useful tool to use when making decisions:
Benefits - What are the benefits to you and your baby?
Risks - What are the risks?
Alternatives - Are there any alternatives?
Intuition - What does your gut instinct tell you?
Nothing - What if you wait and do nothing?
Smile - Smile & laugh, get the oxytocin flowing to help you with start labour naturally!
Final Thoughts
Induction of labour can be a critical intervention when medically necessary, the NHS outlines that induction is particularly beneficial when there are health concerns for the mother or baby, such as preeclampsia or post-term pregnancy. However, it is still essential to approach induction with caution and not as a routine procedure.
Induction should not be offered based solely on the baby's size and should not be routinely offered before 41 weeks in the absence of a medical reason.
The NHS supports this, recommending that full-term pregnancies often benefit from allowing labour to start naturally, as long as both the mother and baby are healthy. This approach respects the natural timeline of pregnancy and reduces the likelihood of complications associated with early induction.
For further information, I have listed out a few helpful links below for your own continued research and reading:
Sources:
When faced with decisions such as whether induction is the right path for you, remember your B.R.A.I.N.S - this is just one of the many tools I teach in my 1:1 classes and workshops alongside so much more to help you feel prepared for pregnancy and labour.
Check out my courses page and FAQs for more information or send me a message and we can have a chat.
Rox
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