INDUCTION OF LABOR
Fred Creutzmann MD - Carrollton, Tx 972-394-7277 or www.DrCmd.comThe induction of labor is a medical intervention that is generally done for medical and not social reasons. There are several ways to induce a woman's labor. Just breaking the water in some women will be enough to get contractions going. This is called an amniotomy and requires the cervix to be open enough to reach the bag of water. If the cervix is closed and thick (we call this a "green" or unripe cervix) a medication called prostagandin can he applied to the cervix to "ripen" it, this also frequently starts the patient into labor as well.
The most common type of induction is with pitocin. This hormone is put out by the pituitary and is one of the hormones involved in the natural onset of labor. To induce labor, doses far in excess of the hormones natural levels are used. The dose of pitocin is and gradually creased over time.
The reason we don't just pick a birthday when the pregnancy test is positive is that, like most things in medicine we have only partial control and Mother Nature has the rest. To attempt a delivery when the cervix is not ready increases the likelihood of failure and the need for a cesarean. Once the water is broken at term the baby needs to be delivered in a reasonable time frame. The use of protaglandin to ripen the cervix can lead to prolonged strong contractions that can injure the baby and also lead to a cesarean. Pitocin can also lead to very powerful contractions, but unlike prostaglandin, which is applied in a single dose, pitocin is given through an, I.V. and can be turned off if the baby is thought to be in danger.
Modern induction is safe, but there are risks. These risks are worth facing if one is trying to deal with other risks. A balance must be found. Reasons for induction include: risks to the mother, such as toxemia, or risks to the baby, like poor growth in the womb. Labor can be induced a little early to affect a delivery before the baby gets too big. If a woman's last labor was very rapid, and she lives far from the hospital, an induction may avoid the husband doing the delivery in the car. There are some less pressing indications for induction, these may include: having the husband present for the delivery, multiple episodes of false labor, or significant discomforts of pregnancy. To induce labor for is a decision that is between you and your doctor, but the risk/benefit ratio needs to be discussed before Mother Nature is nudged in any direction.