The thought of having an induction may seem overwhelming and daunting. The unknown around how your induction will be performed and what risks are involved can be frightening. Understanding the types of induction, the risks and benefits, and your rights as a mother will help you feel more prepared and empowered if the topic of induction comes up for you.
Firstly, an induction of labour is the “artificial initiation of labour before its spontaneous onset to deliver the feto-placental unit. The goal of induction is to achieve a successful vaginal delivery that is as natural as possible”.
Why You Would Need an Induction –
There are several reasons as to why your health care professional may recommend a labour induction and these are categorised into medical or elective. A medical reason for labour is if there are concerns for pregnancy complications and/or your health or your baby’s health.
If there are no clear medical reasons for the induction of labour, then this would be considered an elective induction. An elective induction may be chosen by you and your doctor or midwife due to reasons other than an issue with the pregnancy or health.
The Types of Induction
Inductions are performed as per initiation by a medical professional and are by way of:
• Prostaglandin – to encourage cervical ripening and encourage the onset of contractions
• Oxytocin –placed on a drip to help induce labour
• Balloon catheter - a balloon is inserted into your cervix and the balloon is then inflated with water which is used to apply pressure to your cervix. It helps to open it, preparing it for the next phase of labour.
• Breaking the waters (aka stretch and sweep) - a clinician will insert their index finger into the opening of the cervix or neck of your womb and use a circular movement to try to separate the membranes of the amniotic sac from your cervix.
In most cases, women will need a combination of these as part of their induction process.
The Growing Rates
The numbers of women having inductions are on the rise, and the Listening to Mothers survey reported that almost 50% of the women surveyed had their labours induced (Declercq, Sakala, Corry, Applebaum, & Risher, 2002). From these numbers, 44% indicated they were induced because they were full-term and close to their due date whilst 18% noted they were induced because their health care provider was concerned that they were overdue. (https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/)
The growing number of inductions is linked to a “woman’s lack of knowledge on the risks, benefits and appropriate use of labour induction”. Additionally, women are not provided enough accurate information on when it is optimal and safest for their baby to be born. Education is key to make an informed choice around your induction.
This leads me to my next point.
The Risks and Benefits Involved
Whilst inductions are typically encouraged when there are health concerns or a long pregnancy, it is not a decision that should be made lightly. An induction of labour can have some serious risks and it is your right as a mother to understand these risks and make an informed choice around a looming induction.
Some risks can include a premature birth, a reduced heart rate in your baby, infections, umbilical cord issues, stronger contractions, uterine rupture, or even an unsuccessful induction which may lead to the increased potential of a c-section.
Although there are clear risks of an induction, there are also risks associated with continuing on with your pregnancy when an induction has been recommended. An induction may be necessary to ensure the health and safety of both you and your baby so if your induction is medically required, you should understand your rights and the process.
Unless you or your baby’s health is at risk, waiting for labour to come on its own is the best decision. You will reduce the risk of complications from an induced labour by waiting for the labour to commence naturally. You should weigh up all the benefits versus the risks with your doctor before you decide to have an induction. If you feel pressured to proceeding with an elective induction, you should consider seeking a second opinion.
Know Your Rights
As a mother, there are no obligations around what you must or must not do regarding an induction. It is believed that not enough women have accurate information around the safety of induction and it is encouraged that you have the knowledge around induction and then provided the opportunity to make an informed choice about your treatment, along with the right to refuse.
If you are presented with the possibility of induction, don’t be afraid to ask questions to help you further understand the process and potential outcome, such as:
· Why is the induction recommended?
· What might happen if I don’t have the induction?
· What process will be involved?
· What are the risks?
· How will it affect me and my baby?
The discussions of induction can be sudden and unexpected and this may cause confusion and a pause in thoughts. Additionally, having the courage and confidence to say ‘no’ to an induction can be hard. So, if you haven’t considered enlisting the support and help of a Doula, you should add this to the top of your list. A doula who is certified and educated will coach you on the benefits of waiting for labour to starts on its own and cover the risks of proceeding with an induction that is not medically required. In addition, the support and education of a Doula will help you progress through your induction process with confidence, encouragement and be your voice if you are concerned or confused.
Your Doula will encourage you to ask the right questions about your induction, support you and empower you, help you to breathe correctly and stay relaxed, provide comfort and even discuss positive outcomes from induction labours.
If you are feeling lost, confused or looking for further support, consider connecting with a Doula to ensure the best birth outcome for you and your family.
My name is Shereen Nielsen and I am a Birth and Postpartum Doula and a certified infant and child Sleep Consultant. I am also a lecturer and mentor for students on their journey towards becoming a Sleep Consultant, through my on-line internationally recognised sleep consultants course.
If you would like more information about my services please contact me:
Saying No To Induction: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595289/
Evidence on Inducing for Dates: https://evidencebasedbirth.com/evidence-on-inducing-labor-for-going-past-your-due-date/