5 Important Questions to Ask About Labor Induction
The rate of labor induction in the United States has doubled in the last thirty years. Approximately 1 in 4 women are induced.
You’ve probably heard mentions of induction from family and friends. And you may be questioning if induction will be necessary for you.
So, here’s the most important thing to remember about induction:
The more you know, the more you are in control.
Educating yourself on induction methods, and when induction is necessary will help you make well-informed decisions concerning your birth.
Sometimes, induction is necessary…
While at other times it may be avoided altogether.
When it comes to birth, we can’t control everything. But we can educate ourselves.
Knowledge is power!
So, let’s talk more about labor induction.
What is The Bishop Score?
Towards the end of your pregnancy your care provider may start talking to you about induction. If so, you can ask them about your Bishop score. The Bishop score can be a helpful tool you can use to advocate for yourself.
Developed by and named after Dr. Edward Bishop in the 1960s, your Bishop score indicates whether or not you are a good candidate for labor induction.
Your score will range anywhere from 0 to 13. A higher score generally suggests that your cervix is more favorable for labor, meaning that induction is more likely to proceed smoothly. A lower score might indicate that your body isn’t quite ready yet, potentially leading to a more challenging induction process.
Your care provider uses the following factors to calculate your score:
- Cervical dilation. Measured in centimeters, this tells you how much your cervix has opened.
- Cervix position. Your cervix will move forward as your baby travels farther down.
- Cervix consistency. Is your cervix soft or firm? (The softer the cervix, the closer you are to labor).
- Cervical effacement. How thin is your cervix? A thinning effect happens as labor continues.
- Baby’s station. How far has the baby moved down your pelvis? -5 means they are not engaged in your pelvis yet and are still floating, and +5 means they are crowning and almost out!
Keeping each of these factors in mind, your doctor will determine your Bishop score.
Here’s how the Bishop scoring works:
5 or below: induction is likely not a good idea yet. Your labor hasn’t progressed enough.
6 to 7: induction may or may not be right for you.
8 or above: labor will most likely start on its own soon, and induction is more likely to succeed.
In order to obtain this information, you would need to be okay with having a cervical check. So keep this in mind as your pregnancy progresses.
Understanding your Bishop score can be empowering when discussing induction options with your healthcare provider. If your healthcare provider recommends induction, knowing your score can help you advocate for your preferences. For example, if your Bishop score is low, you might discuss the possibility of waiting a little longer, if it’s safe to do so, or exploring alternative methods to help your body prepare for labor. On the other hand, a higher score might give you more confidence in proceeding with an induction.
By being informed about your Bishop score, you can engage in a more collaborative conversation with your healthcare provider, ensuring that your voice is heard and your choices are respected as you navigate this important phase of your pregnancy journey.
If your labor doesn’t start spontaneously before 42 weeks, then there are risks involved in both waiting for labor to start and in having your labor medically induced. Your healthcare provider should be able to provide you with all the evidence you need to weigh the risks and benefits and make an informed decision about what is right for you and your baby.
What Labor Induction method should be used?
Different circumstances may require different techniques.
There are several reasons why your doctor may recommend induction:
- Labor isn’t advancing and you may need or want assistance to augment progress
- Preeclampsia
- Gestational diabetes.
- Your water breaks, but your body does not go into labor with contractions.
- You are well past your due date (past 41 weeks of pregnancy)
- Your amniotic fluid is low
- You have an infection in the uterus
- You have a history of stillbirth or other childbirth risks in your past
- You request an “elective induction,” which means you plan your induction ahead of time with approval and in coordination with your care provider.
Sometimes, you may only need one intervention to get labor started and progressing.
Other times there is a combination of methods used.
It depends on how far your labor has progressed, what your body is doing, and how you personally feel about it.
Here are a few methods your doctor may try:
- Membrane Sweep. With a gloved hand, your care provider will attempt to separate your membranes from your uterus. This may allow the release of natural prostaglandins, causing the cervix to soften.
- Prostaglandins. These hormones already exist naturally in the body to ripen the cervix. Your doctor may give you synthetic prostaglandins to encourage the cervix to soften. These are typically provided in vaginal tablets, gels, or suppositories. The two most common prostaglandins used for labor induction are: Cytotec and Cervidil.
- Balloon catheter. A balloon catheter, also known as a Foley balloon, is used for induction by gently inserting it into the cervix and then inflating the balloon with sterile saline. The pressure from the inflated balloon helps the cervix to dilate and encourages the release of natural prostaglandins. This method is often used when the cervix is not yet favorable for labor but needs a little help to get things started.
- Pitocin. Your body naturally produces oxytocin which helps to start and keep labor going. The synthetic equivalent, Pitocin, can be given to you through an IV to either augment your contractions or to help get them started.
- Amniotomy. With a plastic hook or other surgical instrument, your doctor will break your water (amniotic sac.) This is usually done to help augment your labor when it has already started, but it can also be done to get labor started.
What Are the Risks of Induction?
With any birth intervention there is always an element of risk. Your body has a learning curve ahead of it while undergoing any induction method. Your body may react in a variety of ways to a foreign object or external medication.
So, let’s break down a few risks you could encounter when being induced for labor:
- Infection. Any outside object inserted inside your body increases the risk of introducing bacteria.
- Increased likelihood of C-section. Any intervention increases the likelihood of more interventions (like C-sections). Sometimes, it can be a domino effect.
- Uterine rupture. Lengthy exposure to oxytocin (Pitocin) may cause too much stress on the uterine wall. This is very rare but serious.
- It won’t work. Sometimes, induction doesn’t work and your body does not make progress. When that happens your care provider will usually recommend a c-section after a period of time.
- Uterine atony. Sometimes inducing labor causes your uterus to not contract after giving birth which is necessary to bring it back down to normal size and heal. While rare, this can cause a postpartum hemorrhage.
Keeping these risks in mind will help you make decisions about your birth going forward.
Sometimes induction is necessary, but not always.
But, if you want to avoid getting induced, here are a few tips to help.
What Are Tips for Promoting Labor and Preventing Induction?
Some people might happily welcome the idea of inducing labor, especially when they are feeling overwhelmed and tired of being pregnant. On the other hand, others might prefer to avoid it. If you are hoping to avoid induction, keeping yourself and your baby as healthy as can be is important. Eating nutritious foods, staying hydrated, doing light exercise and keeping up with your prenatal care are things you can do to remain healthy.
Let’s walk through a few ways you might be able to kick-start labor at home…
- Tip #1 – Nipple Stimulation. Nipple stimulation can increase oxytocin levels. It’s not a perfect science, but it may help.
- Tip #2 – Eat a Few Dates. Start snacking on these at 36 weeks! They are an excellent snack, and may also ripen your cervix.
- Tip #3 – Acupuncture. This involves small needle insertion at certain pressure points on your body. There is some data to suggest this may induce labor.
- Tip #4 – Do The Deed. Having sex releases oxytocin, the love hormone. Increased levels of oxytocin can send your body into labor.
- Tip #5 – Light Exercise. Go on a light walk, bounce gently on a birth ball, do yoga… nothing too vigorous.
Read more about going past your due date and ways to kick-start labor on our blog Past Your Due Date? 7 Things to Know.
How Can a Doula Help You?
In the delivery room, it’s helpful to have someone in your corner who is also a knowledgeable professional.
Research shows that…
Hiring a birth doula can put your mind at ease.
Having the support of a professional doula during labor allows for a more satisfying birth experience!
Our doulas will…
- Discuss your options with you
- Know your birth plan
- Offer emotional and physical support
- Reduce fear, stress, and anxiety
- Instill strength
Allow us to take this journey with you…
We’ve traveled it many times… and we’re prepared to take on the hills and valleys with you every step of the way.
Schedule a call with us here.
We can’t wait to hear from you!
Also check out this article for more info: All About Labor Induction
