Induction along with elective C-section is becoming extremely common these days. There are medical reasons to get labor induced like high blood pressure, Gestational diabetes, baby’s restricted growth. Induction, whether elective or prescribed always holds some disadvantages. Let’s have a look at some of the risks associated with Induction of labor.
What is induction of labor?
Almost 20-30% of pregnancies are induced each year, a number that has significantly increased just like C-section. For your body to naturally go into labor, a set of hormones called oxytocin and endorphins have to release. By the end of pregnancy, production of estrogen is on the rise while production of progesterone decreases. This combination of hormones helps the body to easily detect and sensitize to the production of oxytocin.
Spontaneous labor involves complex processes and involves an exquisite coordination of your brain, body, and uterus. Oxytocin is responsible to control the production of yet another hormone called prostaglandins. Prostaglandins are the hormones that are responsible for the contractions of the uterus. Prostaglandins are the same hormones that are responsible for menstrual cramps.
Some of the crucial developments happen in the baby during the last few weeks of gestation. This includes the development of lungs, learning the skills for swallowing and sucking. Baby’s body also actively receives nutrients from the mother’s body like Iron, Fat and antibodies. Antibodies play a crucial role in fighting infections after the baby is born. Fat is important for brain development, which speeds up by the end of pregnancy. Once the baby and your body is ready, contractions start on their own. Well, not always.
This is where induction steps in. Some complications can interfere with this natural body process. Induction involves artificially stimulating your body to produce contractions, dilate and open the cervix and streamline the hormones carefully. Since the process can get complicated, it’s necessary to have you constantly monitored.
How is it done?
Inducing labor can be done by 3 methods:
Pitocin is a medicine that imitates oxytocin in your body and kick starts contractions. Pitocin is introduced into your body using an IV in your arm. Depending on how your contractions grow, the nurse will reduce, increase or stop the Pitocin altogether. Keep in mind that Pitocin induction can’t be done unless your cervix is prepared for childbirth, which means that your cervix is “open, thin and low” and not “closed, thick and high”.
Artificial Rupture of Membranes:
If your baby is head down, the cervix is dilated and your health seems in a good condition to give birth, this option might be the best choice for you to induce labor. In this method, a special hook is inserted into your vagina to rupture and create a hole in the amniotic sac causing it to break. This method requires you to go into a labor in a strict time limit, like an hour or two. If you don’t go into labor during that time, the doctor will use another method of induction to initiate contractions.
Stripping the Membranes:
This is yet another method that works well if your cervix is dilated and prepared for labor. In this method, your doctor will insert his gloved finger inside your cervix to separate the amniotic from the lower part of the uterus. This can initiate the release of hormones that can kick start contractions. You will be sent home to wait for contractions to start. This method doesn’t require constant monitoring.
This process is used when the cervix hasn’t dilated at all. In this process, tiny deflated balloons are inserted into the vagina which is then inflated with water. This inflation helps your cervix to expand and dilate. This can set things moving and produce prostaglandins and oxytocin in your body.
What are the most common reasons for induction of labor?
You are way past your due date: Only 5% of the babies are actually born on their due dates. Your doctor will estimate whether or not it’s high time that you go into labor. Having a baby way after your date can cause complications such as having a bigger baby, placenta not able to provide appropriate nutrients, increased chances of stillbirth etc.
Oligohydramnios is a condition when your amniotic fluid is too low. Amniotic fluid is what the baby floats in while inside your uterus. It has a variety of functions like protecting the baby from infections, transferring the nutrients etc. If amniotic fluid is low at any point of time, it can cause serious health risks to the baby. Induction remains the only safer choice to opt for.
Premature Rupture of Membranes or water breaking: One your water breaks, the amniotic sac is broken from one end, which can increase the risk of infection to your baby and your uterus as well. It’s crucial that you go into labor within 24-48 hours of rupture of membranes.
Intrauterine Growth Restriction: The growth and well-being of your baby depend on a lot of factors like your health, genes, previous medical history etc. If the growth of the baby becomes restricted due to any of these conditions, there is a high chance that you will be medically induced.
Suspected Large Baby: Having a chubby baby is a dream of all the mothers. But, having a baby that’s much larger to classify as chubby is not good. Having a big baby can cause shoulder dystocia, a condition where the baby’s shoulders are stuck while coming out of the vagina.
Complications such as Placenta Previa, Preeclampsia, Gestational Diabetes etc. can make induction necessary in case mother’s or the baby’s health is at risk.
What are the risks associated with Induction of labor and why you should avoid elective induction of labor?
Here are 7 risks associated with Induction of labor.
#1 Increased Risk of Fetal Distress
Induction of labor often uses synthetic substances and powerful drugs, which very intensively participate to replace the body’s natural process. This artificial stimulation can cause the contractions to become strong and lengthy. This can cause variations in baby’s heart rate and oxygen levels. Mother and the baby both need constant monitoring after induction is done.
#2 Increased Risk of Shoulder Dystocia
If the labor is induced because you are way past your due date or your baby is too big, then baby’s shoulders can get stuck while coming out. Since, the cervix also doesn’t dilate and opens naturally, getting a baby out can be tricky.
#3 Increased Risk of baby being admitted to the NICU
This risk is higher if the induction is elective and not done for medical reasons. Since the baby is not yet prepared there are high chances that he many not be able to adjust well to the life outside of the womb.
#4 Increased risk of Jaundice
When a baby is born via induction, he many not be able to guard himself well by the bacteria lingering around him. This is because he might not have received the antibodies at the end of gestation to increase immunity.
#5 Increased risk of Forceps or Vacuum extraction at birth
Labor induction can cause the baby to move inside in the womb to unfavorable positions. This can lead to doctors resorting to assisted birth to pull the baby out of the vagina.
Some process of induction of labor like inserting fingers, tubes, mechanical dilation can risk chances of infection in your body. Any foreign substances that are introduced can infect both mother and the baby.
#7 Bleeding after delivery
When normal labor ends, the same hormones which were released naturally goes down to contract the uterus to prevent and minimize postpartum bleeding. But, when contractions are done artificially, there are high chances that the uterine contractions that contract the uterus and slows down postpartum bleeding might not occur in a proper manner.
There have been a few studies that have, in fact, suggested that elective induction of labor can reduce the chances of C-section and meconium stained amniotic fluid. (1) Even then the negatives still outweigh the benefits. In times of trouble, trust your maternal instincts. They do work very well.
How was your induction story like? Tell us in the Comments section below.