What to expect in a Medical Induction

There are two common reasons for a doctor to perform a medical induction:

1. The baby has some sort of problem - if the doctor thinks the baby may be very large, the mother has problems or you have had a high risk pregnancy, the doctor may choose to induce you.
2. The baby is postdate - if you've gone past your due date, the doctor will usually begin preparation for a medical induction. Postdate means you are past your EDD (estimated due date - 40 weeks) while overdue means you are past 42 weeks.

There are several ways to induce labour medically. They will use varying degrees of induction. If the first, less invasive type doesn't work, they will continue onto the next type. Be aware however, doctors may not use all the forms of induction listed, depending on medical history and which doctor you use.

Stretch & Sweep - This is a technique where the doctor or midwife sweeps a gloved finger across the opening of the cervix (if you are dialated) attempting to disturb the uterus into having contractions.

• If it's going to work it will work within: 2-24 hours.

Prostglandin gel - A gel inserted around the outside of the cervix if you are not dialated. Usually done twice in an 8-16 hour period. You may need to stay lying down once you've had it inserted.

• If it's going to work it will work within: 8-16 hours.

Cervical balloon - This is a balloon inserted into the cervix that presses against the amniotic sac, attempting to disturb the uterus into having contractions.

• If it's going to work it will work within: 1-4 hours.

Breaking waters - This method uses an amniotic hook to break the waters. This will help bring the baby down into the cervix and induce contractions.

• If it's going to work it will work within: Immediately or within a short time.

Pitocin drip - This is the manmade version of the hormone that starts labour (oxytocin). It may cause more painful contractions than normal, since it is released in regulated doses unlike your body, which releases oxytocin as you need it.

• If it's going to work it will work within: Generally a doctor will not allow you to be in labour with this drip for more than 24 hours.

Cytotec - If your doctor wants to use this for a live baby induction, refuse. Despite evidence that it can cause uterine rupture and severe complications, some doctors still use it. It's given as a pill. 

Caesarian - If it's impossible to induce labour using any of the above methods, there are complications OR labour has stalled a doctor may choose to perform a caesarian. This is major abdominal surgery so you will be in pain for up to 6 weeks after surgery.

• If it's going to work it will work within: This is the final option for baby delivery.

When will a medical induction happen?

A medical induction is generally scheduled for:

• 36-39 Weeks for mothers and babies with complications.
• 40-42 Weeks for overdue babies. Many hospitals induce at ten days postdate (41+3)

Do I have to have a medical induction?

No. Your doctor will strongly recommend it, especially if you have complications or are nearing the 42 week mark, but they cannot force you to. They will need your signed or verbal consent to do a medical induction. 70% of first time pregnancies go overdue and some women naturally have longer or shorter pregnancies than others.

What are the risks of not having a medical induction?

Anywhere from 38-42 weeks is a normal time for baby to arrive. However, once baby passes 42 weeks, there is a higher chance of the following:

• Passing meconium - This is baby's first poo and, if baby is distressed in the womb, may pass it before delivery. It is more likely when baby is past 42 weeks because the baby's bowels are more mature. If it gets in baby's nose and mouth, baby can have respiratory complications.
• Stillbirth - Some extremely overdue babies are stillborn. However this is quite often related to other medical problems, not specifically due to the gestation time.

Does a medical induction hurt more than a normal delivery?

If your waters are broken too early or you are on a pitocin drip, contractions can often be more forceful and painful than if you began labour pains naturally. Women who are induced medically are more likely to require medical pain relief.

Is it true that if I get induced, I'll end up with a caesarian?

Many people worry that if they are induced, they'll end up with a caesarian. The chances of a caesarian with medical induction do increase, however unless the labour is not progressing (and mother is getting exhausted) or baby is in danger (usually passing meconium in the womb or with the cord wrapped around the neck), a caesarian won't be needed. If your doctor asks if you want a caesarian, without a good reason (and him wanting to go home isn't a good reason) you don't have to agree.
Many overdue women begin labour as soon as their waters are broken - baby often needs just that little extra nudge.