 | ||
|
| |    Induction of Labor by Elisa Ross, MD reviewed by Marjorie Greenfield, M.D. In certain situations, your obstetrician or other healthcare practitioner may judge that it's in your or the baby's best interest for delivery to take place before natural labor has begun. As long as there is no reason to choose a cesarean delivery, she may recommend an induction of labor that, if all goes well, will result in the vaginal birth of a healthy infant. The general principles of labor induction are similar to the path that natural labor takes. At first, the cervix may dilate and efface only slowly despite regular contractions. Then after a while, usually around four centimeters' dilation, the progress is quicker. This active phase of labor and the pushing phase that follows are usually similar to natural labor. Amniotomy The method chosen to induce labor depends on the readiness of the cervix. If the cervix is already around four centimeters dilated and is already thinned out (or effaced), it may be enough for the practitioner to just break the bag of water. Many times, that will give the uterus the chemical signals needed to start labor and no further help is needed. Pitocin If the cervix is not quite so ready or if the uterus does not respond to the breaking of the water, a medication called Pitocin is used to get the uterus to contract. It is exactly like the natural labor-causing substance that is usually produced by the mother's own body. Pitocin is given in very small doses through an IV (intravenous line or catheter). Every half hour or so, the nurse or doctor gauges the uterus's response to the current dose of Pitocin, and makes an adjustment. Medical agents for cervical ripening If the cervix is showing little sign of being ready, a so-called ripening agent (which makes the cervix softer, slightly dilated, and effaced) may be recommended before using Pitocin. The purpose of ripening the cervix before starting the contractions is to shorten the time needed for intense labor. Usually, if dilation has already begun, the contractions will be more successful in accomplishing labor and birth. A good analogy is a child's party balloon: When you first start to blow into it, it barely inflates at all, even if you blow very hard. However, once a certain size has been reached (about four centimeters), every breath makes a big difference. It's like that with contractions and cervices: Early on, lots of contractions are needed to get any dilation, but, coincidentally, around four centimeters, the contractions make a bigger change. The medications used to help ripen the cervix are all chemically related to the hormone prostaglandin E, which is naturally made by the body in other circumstances. It can take the form of a clear gel, suppository, or tablet and be placed next to or inside the cervix, or given by mouth. Physical methods for cervical ripening Just as you might stretch out a balloon to make it easier to inflate, doctors will sometimes employ physical methods to ripen a cervix. One method involves inserting thin sticks of dried, sterilized seaweed (yes, really!) called laminaria or compressed foam into the cervix. Over the course of several hours, the sticks absorb moisture from the vagina and slowly expand, dilating the cervix. Another method is to insert a rubber balloon on the end of a tube (a Foley catheter) through the cervix. The balloon is inflated with water. Apparently, the pressure on the inside of the cervix gives the signal for dilation. Both of these methods also result in softening of the cervix. After ripening Occasionally, the mere dilating of the cervix prompts the uterus to contract and labor ensues on its own. Most of the time, though, Pitocin is given through the IV when the cervix seems ready. Once labor is active, it usually progresses just like natural labor.
| |  | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| About Us |
Contact Us |
Our Partners Privacy Policy | Ethics | Advertising Policy | Terms of Service © Copyright 2004 The Dr. Spock Company. All Rights Reserved. THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. The information drSpock.com
provides is for educational purposes only and is not a substitute for
professional medical advice. Always seek the advice of your health care
professional if you have a specific health concern. Mention or advertisement
of any product, service, or brand does not constitute endorsement, guarantee,
or recommendation by The Dr. Spock Company. Please read our full
Terms of Service. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
