Induced labour is labour that is brought on by various means before it starts spontaneously. Induction is undertaken when the risk to the foetus of remaining in the uterus is greater than the risk of hastening its delivery. Several methods can be used.
Surgical rupture of the membranes
Forceps or a small hook may be inserted through the cervix to grasp and make a tear in the membranes so that the amniotic fluid (waters) can begin to drain. This allows the head to make closer contact with the cervix.
The procedure is painless. Labour usually begins within a few hours. If not, other intervention is necessary; there’s increased risk of infection if the baby isn’t born within 24 hours of the membranes rupturing.
Syntocinon drip Oxytocin is the pituitary hormone that naturally stimulates the contractions of labour. Syntocinon, a synthetic copy of oxytocin, is added to intravenous fluid, which is given into an arm vein. The rate of the drip is gradually increased until labour begins. Contractions are often stronger, longer and more painful than in spontaneous labour: pain relief is usually needed.
Prostaglandin pessaries These are inserted into the vagina where the effect of the prostaglandin close to the cervix triggers uterine contractions.
The main risk of induced labour is that if the maturity of the pregnancy is miscalculated, delivery may be before the foetus is ready, leading to problems of pre-term birth. Other risks are that artificially stimulated contractions of the uterus may be more painful, may not dilate the cervix properly or may separate the placenta too early.
Reasons for inducing labour ma pregnancy-induced hypertension other illnesses in the mother, abnormalities of the placenta, post-maturity (pregnancy longer than 40 weeks) and some foetal conditions. If you’re advised to have labour induced, the reason should be explained to you.
Induction is entirely justified when done on grounds of safety. However recent study at a large maternity lira Sydney found that around 12 per cent of labours were induced among women having a first delivery. This rate is higher than could be accounted for by accepted sons for induction. Some have questioned whether the convenience of birth attendants or parents contributes to this high rate, though it could be a valid choice as long as safety is assured, the circumstances are favourable and the woman and her doctor understand the reasons.
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