Induction of labor: everything you need to know

You can’t wait for your little miracle to finally come into the world, but the birth does not announce itself? If your baby doesn’t want to go into labor on its own, induction of labor occurs. In this article, we will tell you how this happens, which aids are used, and which medications are used in the process.

Most women want a gentle birth in a hospital or birthing center. A few weeks before the expected date of birth (ET), the hospital bag is packed, the birth plan is worked out, and one registers at the hospital for birth. And when the delivery date is getting closer and closer, you expect the contractions that announce that your little miracle is finally coming into the world. And what happens if nothing happens?

What is an induction of labor?

Not every baby wants to come into the world on the calculated date. Some are in a hurry and come earlier (premature birth), others like to take their time.

"My son was in no hurry at all. On the day of the due date, the CTG could not record a single contraction. No miracle. I did not have contractions either. I went into labor two days after my due date. If he had come even later, I too would have had an induction of labor."

Julia, mama of Paul

During induction of labor, the expectant mother is administered medications that induce labor. The more advanced your pregnancy, the more stressful it will be for you. However, it won’t get any easier for your baby either, because it is growing steadily and the placenta will eventually be unable to supply it properly. When the placenta is too old to feed your baby, no one knows for sure. That’s why a birth is induced between the 7th week of pregnancy and the 7th month of pregnancy. and 14. Induction recommended for the first day after the estimated due date.

Why is a birth induced?

There can be various reasons for the induction of birth. Most gynecologists will look at your baby’s growth, assess the CTG, and then weigh with you when an induction is advisable for you and the baby. Of course it is also important how you feel. But also, if the expectant mother is older than 40 years, this can be a reason to induce the birth. In addition, there are new studies that show that children born after 38 weeks are more likely to be born after 38 weeks. The babies born during the first week of pregnancy often have a birth weight of more than 4 weeks.reach 000 grams.

"That’s how it was for me too: our son was born by cesarean section at 40+2 and weighed a handsome 4.030 gram."

Julia, mom of Paul

The larger and heavier the baby is at birth, the greater the risk of perineal rupture, for more severe postpartum hemorrhage, or delayed birth outcomes. High BMI of the mother can also be a reason for induction of labor, or smoking during pregnancy.

However, there are now also many women who want the induction of labor of their own volition; a so-called. Desired induction of labor. Here’s what midwife Katharina has to say about it:

"Wishing induction with medication is not a good idea. Because birth begins when you and the baby are ready for delivery. If there is a medical reason, your baby is not well cared for in the womb, it will help with induction. Then the birth will also begin. If the reason for induction is that the birth date would fit well, or you just still want your baby to be born, then the medications will either not work, or they will cause unnecessary severe pain."

Katharina, midwife and mother

Your desire for the baby promotes the start of the birth. What else you can do, you will learn further down in the article.

But a high-risk pregnancy can also be a good reason for induction of labor. There are several reasons that lead to a high-risk pregnancy:

  • Premature rupture of the membranes
  • Too much or too little amniotic fluid
  • a relatively large child
  • Gestational diabetes
  • Poisoning during pregnancy (pre-eclampsia or HELLP syndrome)
  • etc.

When is the induction of labor?

There is no precise indication of when a birth is induced. The induction of labor is always done according to the personal circumstances and the health condition of the mother and the child. It can be said, however, that every gynecologist should give an expectant mother a thorough check-up from the 42nd week of pregnancy. You will be sent to the hospital for induction of labor during the first week of pregnancy. Because no one wants to risk birth complications because of missing the due date.

What happens during induction of labor?

If the gynecologist or the expectant mother has decided to induce the birth, the pregnant woman is admitted as an inpatient. For you this means: pack your hospital bag, pack your birth plan and go to the hospital. Together with the hospital team, you will choose a Method of induction of labor begins: Mechanically or with medication. Over the last few years, both procedures have improved significantly, so the risks have decreased.

Which method you choose depends on you, but you should take into account the advice of the doctor. The doctor will be able to assess whether a previous caesarean section, your state of health or the condition of your child can affect the induction of labor. And he knows which drug has the highest success rate in your case. In any case, you must be prepared for the fact that the birth will not begin immediately. A drug induction can take hours. Often even a few days.

Medicinal induction of labor

One way to start the birth is the so called. contraceptive drip. You will receive an infusion containing the active ingredient oxytocin. This hormone causes contractions in the uterus and thus labor pains. A special side effect: Your body also releases the hormone oxytocin when you are holding your baby and this promotes milk production. If you get a contraceptive drip to induce labor, it also strengthens the mother-baby bond and can speed up milk let-down after birth. The contraceptive drip can only work if your uterus is already ready for birth. When the cervix is already soft. Ideally, the cervix is shortened and the cervix is already opened a few centimeters. Then a contraceptive drip can give the little push that you and your baby still need. Once labor is regular, the contraceptive drip is turned off again.

An alternative to the contraceptive drip is the active ingredient Prostaglandins, which is administered via a gel or tablet. The tablet is also better known as "Cyclotec". However, Cytotec must only be dosed very carefully. Because – unlike the contraceptive drip – the effect is difficult to assess. The effect cannot simply be turned off again.

"Cytotec" is a medication that is not approved for labor induction. It should only be used if careful consideration has been given to the benefits but also the possible side effects for you and your baby. And then it must be used carefully, i.e. low dosage."

Prostaglandins cause the cervix to soften and open up. This promotes labor. Unfortunately, the problem lies in the dosage: neither the gel nor the tablet (which is crumbled and dissolved in water) can be dosed correctly. Before you decide to induce labor with prostaglandins, you should weigh all the pros and cons well.

Mechanical induction of labor

If you decide not to induce labor with drugs, doctors and midwives will try to induce labor mechanically. The cervix is mechanically stimulated so that the body itself releases prostaglandins, causing the cervix to open. Of course, a combination of both methods is also possible.

One option is to induce labor mechanically Egg solution. The outer shell of the amniotic sac is carefully loosened with a finger. Normally, this procedure is not particularly unpleasant, as long as the doctor or midwife is very careful. There may be some vaginal bleeding afterwards, but this is usually harmless. There are studies that show that an egg drop ensures that less or no oxytocic drugs are needed during the rest of the birth.

Another possibility is the Balloon catheter. A small catheter is inserted through the vagina into the cervix, with one or two small balloons at the tip. The balloons are filled with saline and are meant to stretch the cervix. This dilation can be uncomfortable, and in some women even painful. By dilating the cervix, the body itself is supposed to release the necessary hormones for the cervix to mature. The balloon catheter causes the contractions to become less severe later on. Induction of labor with a balloon catheter is also possible if you have previously had a cesarean section.

In some cases, the birth is already in progress, but the contractions are not strong enough to deliver the baby. In these cases Amniotomy performed. The amniotic sac is opened. The midwife inserts a small instrument through the already open cervix and uses it to puncture the amniotic sac. This procedure is painless, but is not recommended as a means of inducing childbirth. By opening the amniotic sac, the water cushion in front of the head is gone. The hard baby head presses directly on the cervix. This triggers contractions and speeds up the birth.

How long does it take for labor to begin??

The induction of labor can take different lengths of time. Just like natural birth, neither doctors nor midwives can predict how long it will take for labor to begin. Some midwives report that the duration of induction of labor with prostaglandins is longer Labor drip with round three hours lies. But even here there can be individual differences. In the case of ovipolar separation, it can take up to 48 hours for the birth to begin. When using Cyclotec The duration of the induction of labor varies greatly, so that it is not possible to give exact figures. If you decide to induce the birth with a Balloon catheter, you have to count with at least 24 hours.

What are the risks of inducing childbirth?

Of course, the induction of labor is also associated with risks. These risks must always be lower than the risk for you and your baby if you stay pregnant longer. The use of prostaglandins is particularly risky. Because they are difficult to dose. Therefore, they can cause labor pains and even a rupture in the uterus. They often lead to very strong and painful contractions so that an increased Use of painkillers is necessary. In addition, the risk of Emergency cesarean section or the Use of a suction cup or forceps Increase.

What I can do myself to induce labor?

If you notice that the due date is getting closer or you have already passed it, you can also do a few things at home, can ensure that the birth begins:

You need the hormone prostaglandin and oxytocin for the induction of labor. Both hormones are produced by your body and the body of your baby. You can influence your production through diet. You can influence your insulin level in the blood through your food. If the is high, it inhibits the formation of prostaglandin. Therefore, before the birth, try to arrange your diet in such a way that it prepares you well for the birth. You need a lot of protein, good fats and few carbohydrates. By the way, you not only promote the beginning of the birth, you also reduce the pain.

The contractions are supported by the pressure of your baby’s head on the cervix. You can influence this through your movement. Extensive walks in the fresh air, promote the beginning of birth. By the way, they also have an influence on your sugar balance. walking has not only the mechanical effect, but also influence on the right hormone production.

If you want to increase this pressure, it helps if you take time to circle your pelvis. You gently rock your child towards birth. Supporting you can also go into the deep squat position. You can find out how to do this in my childbirth preparation course.

A very well known and long used remedy in birth medicine is the Castor cocktail, better known as labor cocktail. Castor oil is mixed with apricot juice and almond paste. However, you should talk to your midwife beforehand to clarify whether it is possible for you to induce labor with it. Because castor can cause violent diarrhea. But also to the same labor storms as an induction with prostaglandins. The castor cocktail is not a harmless drug. Especially not if you take a prescription with alcohol. Alcohol does increase the effect of castor oil. But alcohol is also harmful to your baby’s brain for induction of labor.

Some gynecologists advise sexual intercourse to promote labor. Also Stimulation of the nipples Is supposed to get the birth going. there are hormones (prostaglandins) in the semen that are supposed to trigger the contraction of the uterus. In addition, oxytocin is released during a woman’s orgasm. You cannot persuade the child to give birth when the baby is not yet ready. But you can be sure of the fun factor. And that promotes a good birth in any case.

You are still looking for a birth preparation course? Our midwife Katharina will show you in her Online childbirth preparation course in over 30 video lessons on how to best prepare yourself and your partner for birth.

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