Induce Labor - Part II

What are some of the techniques used to induce labor?

This depends in large part on the condition of your cervix at the time. If your cervix hasn't started to soften, efface (thin out), or dilate (open up), it's considered "unripe" – or not yet ready for labor.

In that case, your practitioner would use either hormones or "mechanical" methods to ripen your cervix before the induction. This tends to shorten the length of labor, and sometimes these procedures end up jump-starting your labor as well.

If your labor doesn't start, you'll get an IV infusion of oxytocin. This drug (often referred to by the brand name Pitocin) is a synthetic form of the hormone that your body naturally produces during spontaneous labor.

Some of the methods used to ripen the cervix and induce labor are:

Using prostaglandins. Typically, if you need to be induced but your cervix is not yet dilated or thinned out, you'll be admitted to the hospital and your caregiver will start the induction by inserting medication that contains prostaglandins into your vagina. This medication helps to ripen the cervix and, as mentioned above, sometimes stimulates enough contractions so that you don't need oxytocin.

Using a Foley catheter. Instead of using medication to ripen your cervix, your practitioner may insert a catheter with a very small uninflated balloon at the end into your cervix. When the balloon is inflated with water, it puts pressure on your cervix, stimulating the release of prostaglandins, which cause the cervix to open and soften. When your cervix begins to dilate, the balloon falls out and the catheter is removed.

Stripping or sweeping the membranes. If your cervix is already somewhat dilated and there's no urgent reason to induce, your practitioner can insert her finger through the cervix and manually separate your amniotic sac from the lower part of your uterus. This causes the release of prostaglandins, which may help further ripen your cervix and possibly get contractions going.

In most cases, this procedure is done during an office visit. You're then sent home to wait for labor to start, usually within the next few days. Many moms-to-be find this procedure uncomfortable or even painful, although the discomfort is short-lived.

Rupturing the membranes. If you're at least a few centimeters dilated, your practitioner can insert a small, plastic hooked instrument through the cervix to break your amniotic sac. This procedure (called amniotomy) causes no more discomfort than a vaginal exam.

If your cervix is very ripe and ready for labor, there's a small chance that rupturing the membranes alone will be enough to get your contractions going. If that doesn't happen, your practitioner will give you oxytocin through an IV.

Once your water has broken, most practitioners will want you to deliver within 12 to 24 hours because the risk of infection for you and your baby increases over time.

Using oxytocin (Pitocin). Your practitioner may give you oxytocin through an IV pump to start or augment your contractions. She can adjust the amount you need according to how your labor progresses.

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