After nine long and tiring months, you’re more than ready for your bundle of joy to make its way into the world. You’ve anxiously waited for the moment your water breaks, and you have to rush to the hospital. You’ve even dreamed of holding your little one for the first time.
But before you can search for your eyes and your partner’s smile on your baby’s precious face, you have to first get through labor. As with everything in a pregnancy, there’s always room for unpredictability. You may need to medically induce labor with the help of your provider.
There are some conditions when a doctor or midwife recommends a medical induction. First, they will evaluate the health of you and your baby. They will consider your baby’s gestational age, the weight and size of your baby, your baby’s position, as well as the status of your cervix. After weighing the benefits and risks, you and your care provider will determine if a medical induction is the next best step. According to the Mayo Clinic, these are the medical reasons why you may be induced:
Here’s what you need to know about the available options and that may be recommended to get your body in labor mode.
Also referred to as artificial rupture of membranes (AROM), or most popularly, “breaking the water.” An amniotomy is a fast procedure in which your doctor will deliberately rupture the amniotic sac.
The process is completed while you are in bed in the labor and delivery room. Your provider will use a small surgical hook, called an amnihook, that is inserted into the vagina and through the cervix to puncture the membranes within the amniotic sac. This will release the amniotic fluid as well as natural hormones that can stimulate contractions. There aren’t any nerve endings in the amniotic sac, so this is a painless procedure. It feels like a cervical exam and then a release of warm fluid. Once the procedure is completed, moms-to-be typically go into labor within a few hours. However, this is not guaranteed.
For pregnant mommas who are either at the end or near the end of their pregnancy, Cervidil is an option physicians may recommend to help ripen (a.k.a. soften) and dilate the cervix. The vaginal insert is infused with a synthetic version of prostaglandin—a hormone-like substance naturally occurring in the body and responsible for the cramps you feel during your period. Through the use of prostaglandins, the muscles of the cervix are relaxed, and labor can begin.
Similar in shape and size to a tampon, Cervidil is inserted into the vagina by your healthcare provider. It will remain in place until you no longer need it or after 12 – 24 hours. You’ll notice a long tape that’s attached to the insert. But it’s important to not tug on or remove it, as it’s necessary for when your doctor has to take it out. (Here is a video to see how it is administered.)
Cytotec is given to pregnant women whose cervix is long, closed, or unripened. It helps to soften the cervix so that it can properly dilate and produce uterine contractions.
Cytotec is provided in pill form and ingested orally with water. Another option is to have the pill inserted into the end of your vaginal canal (called a vaginal Cytotec). The pill will dissolve quickly and is longer-acting than the oral form.
A foley balloon (or foley bulb) is a small balloon-like instrument attached to the end of a catheter and used to open the cervix and help it reach effacement (cervix is stretched and becomes thinner).
The uninflated balloon is inserted into the cervix through the catheter and filled with saline solution to inflate the device. The foley bulb will apply pressure to the cervix to help dilate it. Once the cervix has dilated (usually about 4-5 centimeters), the foley balloon will fall out.
Membrane stripping, or membrane sweeping, is a procedure that’s completed when you’re either full term (39 to 41 weeks of gestation) or partially dilated to help induce labor.
Membrane sweeping can be completed during your regular physician visit when you’re close to or past your due date. Your doctor will insert a finger into the vagina and up through the cervix to manually move and separate the thin membranes connected to the amniotic sac. When the membranes are stripped, the body can release prostaglandins to help produce contractions and prep the cervix for delivery.
To help kick-start contractions, your physician may recommend the use of Pitocin. This is one of the most common methods to medically induce labor. The medication, a commonly used drug in labor, is the artificial variation of oxytocin—a natural hormone produced to help the uterus contract and is also released when a woman’s body is ready for childbirth.
Pitocin is administered intravenously in your arm while you’re settled in the labor and delivery suite. Your nurse will slowly increase the dosage to start your contractions. It is removed when you’re experiencing contractions that are two to three minutes apart.
Whether your body can induce labor naturally or you need to medically induce labor, all that matters is being able to hold your new baby in your arms. But knowing your options before you begin the process will help you and your provider make the best choice when and if needed.