Induced labor can be elective or due to a medical emergency. It is recommended that it should not be performed before 39 weeks of gestation. Induced labor is commonly used for medical conditions that endanger the mother or baby. It can be achieved through the use of hormones or by breaking the water bag. The response to induced labor varies greatly among women.
Induced labor occurs when a doctor or midwife artificially initiates a pregnant woman into labor. An induced labor may be elective to fit the mother’s schedule, which is becoming more common, or performed in response to a medical emergency. While induced labor is not necessarily a dangerous practice, the American College of Obstetricians and Gynecologists recommend that induced labor should not be performed electively before 39 weeks of gestation.
Any number of medical conditions may require induced labor. Complications that endanger a woman’s health, including preeclampsia, high blood pressure, heart disease, bleeding or gestational diabetes, are some of the most common reasons for inducing labor. If the baby is in danger because it cannot get adequate oxygen or nutrients, or is small for its gestational age, labor may be induced.
Induced labor should occur if the amniotic sac has ruptured, but labor has not started naturally within 24 to 48 hours. Occasionally, the mother will develop chorioamnionitis, which is a uterine infection. For others, labor is induced when the pregnancy exceeds 42 weeks, although some doctors take pity on a woman who has reached 40 or 41 weeks with no signs of labor in sight.
Induced labor is most often achieved by administering one or two main drugs used for this purpose. Pitocin or Syntocinon, which are brand names for oxytocin, is given through an intravenous (IV) drip. Oxytocin is a naturally produced hormone that stimulates contractions associated with labor. When this hormone is given artificially, it can hasten labor, but it can also make labor progress faster than pain management can work or be administered.
Prostaglandin is another hormone that is administered artificially in the form of a vaginal suppository. It is usually inserted in the evening to stimulate labor in the morning. The advantage of this type of forced labor is that the women are not tied to an IV.
The second way labor is induced, without the use of artificial hormones, is by breaking the water bag. This is called artificial rupture of membranes (AROM). If all goes to plan, when the bursa ruptures, prostaglandin production naturally increases, stimulating contractions. AROM is performed by brushing a small hook, inserted into the vagina, just inside the cervix, on the sac.
AROM allows the doctor to monitor the baby through the canal and examine the amniotic fluid. One drawback is that it can cause a prolapsed cord, where the cord drains first, with fluid. If labor and delivery do not occur within 24 to 48 hours, the infection can set in.
While inducing labor is generally very predictable, how a woman responds to it varies greatly. Some women go into labor and experience a delivery quickly with few or no complications. Others are more resistant to the surgery and labor takes longer to go on.
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