Induced birth: what it is, when it is indicated and when to avoid it

Induced labor is a medical procedure to stimulate uterine contractions or prepare the cervix late in pregnancy. It is recommended by the obstetrician when labor does not begin naturally or when there are situations that could put the life of the woman or baby at risk, such as gestational diabetes, pre-eclampsia or fetal growth restriction.

Medical induction of labor is normally carried out from 37 weeks of gestation, but there are home methods that can facilitate the process of starting labor at the end of pregnancy, such as having sexual intercourse, if the woman feels comfortable doing so. or stimulate the nipples, for example.

Although there are several indications for inducing labor, all of them must be carefully evaluated by the doctor, because sometimes it may be safer to opt for a cesarean section instead of trying to stimulate the start of labor. See how a cesarean section is performed and when it is recommended.

When is it recommended to induce labor?

Induction of labor must always be indicated by the obstetrician, which generally happens in the following situations:

• Pregnancy that goes beyond 41 weeks without contractions starting spontaneously;
• Rupture of the amniotic fluid bag without the onset of contractions within 24 hours;
• Infection in the uterus, called chorioamnionitis;
• Gestational diabetes;
• Pre-eclampsia, which is the worsening of high blood pressure during pregnancy;
• High blood pressure before pregnancy or that developed before 20 weeks of gestation;
• Gestational hypertension, which develops after 20 weeks of pregnancy;
• Health problems such as kidney or lung disease;
• Rh factor incompatibility;
• Thrombophilia;
• Fetal growth restriction, in which the baby stops growing at the expected rate, due to having a lower weight than expected for gestational age;
• Decrease in the amount of amniotic fluid, even after trying to hydrate.

Furthermore, induction of labor can also be carried out in some cases due to logistical factors, such as the hospital being very far from the area of ​​residence or not having a companion if labor begins spontaneously.

How labor is induced in the hospital

Labor induction is performed by the obstetrician at the hospital, who may use one or more techniques together, depending on the maturity of the cervix or the stage of labor.

The main techniques for inducing labor performed in the hospital are:

• Use of oxytocin applied directly to the vein: is the hormone that stimulates uterine contractions. This form of labor induction is more effective in speeding up labor that has already begun;
• Amniotic sac rupture: is done when the cervix is ​​partially dilated;
• Placing a probe or special catheter in the cervix: contains an inflatable balloon filled with saline to stimulate the ripening of the cervix;
• Use of synthetic prostaglandins: are placed inside the vagina to thin or soften the cervix. They cannot be used in pregnant women who have undergone any type of uterine surgery, including cesarean section;
• Membrane detachment: It is done during vaginal examination, when the cervix is ​​minimally dilated.

These four methods are effective and should only be carried out in the hospital, where the woman and baby can be well monitored by a team of doctors and equipment, which may be necessary if there is a need to interrupt the induction or perform an emergency procedure.

How long does induction take?

After the labor induction process begins, the time for labor to begin will depend on how mature the cervix was before induction, the technique used by the doctor, and how the woman’s body responds to the chosen induction technique. .

Is induced labor more painful?

Typically induced labor hurts more than labor that begins spontaneously, especially when synthetic oxytocin is used, but this can be resolved with epidural anesthesia.

Those who want a birth with fewer interventions and without epidural anesthesia can control pain through correct breathing and vertical positions, such as squatting, for example. Find out how to ease the pain of labor.

What to do to start labor naturally

Other ways to facilitate the start of labor naturally and which can be carried out with the knowledge and guidance of the obstetrician are:

• Exercise, such as going for a long walk
• Nipple stimulation, as it helps promote the production of oxytocin, causing the uterus to contract, inducing or increasing the quality of contractions;
• Sexual intercourse, without a condom, to facilitate the softening of the cervix;
• Masturbation, as in the final stage of pregnancy it helps in the release of oxytocin, favoring contractions and labor;
• Activation of affective memories, such as going to a place you really like, eating your favorite food or using a perfume that brings back good memories;
• Acupuncture sessions.

Furthermore, drinking raspberry tea can also help prepare the uterus for birth, helping labor to progress at a good pace and not be as painful. See how to prepare raspberry tea to induce labor.

When it can be dangerous to induce labor

Labor induction is not indicated and should therefore not be performed when:

• Fetal distress;
• More than 2 previous cesarean sections, due to the presence of scars on the uterus;
• Pregnancy with twins or more babies;
• Baby is in a sitting position or has not turned upside down;
• Active genital herpes in women;
• Complete or partial placenta previa. Understand what placenta previa is;
• Vasa previa, which consists of the proximity of the umbilical cord blood vessels to the internal orifice of the uterine cervix;
• Baby’s heartbeat decreased;
• Baby is very big, weighing more than 4,200kg;
• Positive serology for HIV in women.

However, the decision to induce labor should always be discussed with the doctor, taking into account several factors that assess the risk and benefit of induction.

Possible complications

Some complications may occur during labor induction, such as a failure in the induction process, which may require a cesarean section, an increased risk of infections when the amniotic sac rupture technique is used, or a decrease in the baby’s heartbeat due to the use of medicines to induce labor, which can cause excessive contractions, and as a consequence reduce the amount of oxygen for the baby.

Although rare, induction of labor can also cause uterine rupture, which is the uterus tearing into the scar from a previous cesarean section or uterine surgery, but it can also occur in women who have never had uterine surgery before.