Discover the induction options available to you, both inside and outside of a hospital setting. Understand when and why an induction might be ...
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Discover the induction options available to you, both inside and outside of a hospital setting. Understand when and why an induction might be offered to you and how to discuss it with your care provider. You’ve got this. P RO G R A M Pregnancy & Postpartum TO P I C Labor & Birth MOD U L E Inductions The information contained in this guide is for informational purposes only and is not intended to be medical advice. It also is not a substitute for regular medical care. Please consult with your care provider about your care options and for any medical advice. You should never disregard medical advice or delay in seeking medical advice or care because of any content presented as part of this guide. Reliance on the information presented in this guide is solely at your own risk. 2021
PROGRAM PREGNANCY & POSTPARTUM
TOPIC LABOR & BIRTH
MODULE INDUCTIONS
Insights
Inductions are typically not a swift process. In fact, an induction is typically what I like to
call “a long game.” Depending on the type of medication or procedure utilized, it usually
can take anywhere from 12 to 72 hours between the start of an induction and the birth of
your baby.
The induction options that might be available to you are going to depend on how far along
you are in your pregnancy, where your baby is located in your pelvis, and the state of your
cervix. What I’ve learned over the years is that it’s key to understand the options that are
available in order to take out the guesswork and help make your induction process feel
empowered. In case that’s the direction your birth experience moves in, let’s unpack the
basics.
Key Points To Remember
Takeaways
Induction refers to interventions or strategies to induce labor. There are a variety of reasons why your
healthcare provider may suggest an induction, including going 2 weeks beyond your due date, your
water broke but labor has not started, or there is a significant health risk for you or your baby.
Common outside of birthing environment induction techniques include acupuncture, chiropractics,
and sex.
Common within birthing environment induction techniques include labor-inducing medications,
stripping of the membranes, breaking of the waters, and the use of a foley bulb.
Speak with your healthcare provider about safety risks associated with inductions and any questions
or concerns you may have.
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A Framework
For Understanding Landscape
This Experience
An induction is a way of inducing, or bringing on, labor.
Kickstarting the process, if you will. Your care provider may
suggest using a selected method to get labor going, often
wanting to stimulate contractions. If the idea of having an
induction creates some worry or anxiety for you, it can be
helpful to understand the different inductions available and
why your care provider might suggest each one.
Induction methods can range depending on the birth environment you are birthing in, and
what methods might be used will be determined by your health, your baby’s health, and
the desire to keep you safe. In U.S. hospitals, inductions and medical inductions are used to
stimulate your uterus to begin contractions, or to stimulate the cervix to begin softening and
thinning. You could be offered an induction for a couple of key reasons:
• Going beyond your due date by around 2 weeks
• Your water has broken but labor has not started yet
• There’s an infection, other medical condition, or concerns around the health of
the birthing person or the baby
• Because you choose to have one (Data from a 2018 study found that a non-medically-
indicated induction of labor at 39 weeks (sometimes referred to as an “elective” induction) did not
increase the risk of cesarean birth or NICU admissions for people in their first birth.1)
Each person’s body and pregnancy is Your health care provider will use the Bishop Score to determine whether they should
unique. Be sure to check in with your recommend induction, and how likely it is that an induction will result in a vaginal birth.
care provider to see which inductions Your healthcare provider will assess your Bishop Score by doing a cervical exam to
would be safest for you.
assess effacement, dilation, consistency, and position of the cervix, as well as your baby’s
pelvic station.
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MODULE INDUCTIONS
C OMMON I ND U CT ION T ECHNIQ U ES
Used Outside The Birthing Environment:
AC U P UN CT URE CHIROPR ACT ICS SEX
Traditional Chinese Medicine Some chiropractors specialize Sex can be thought of as a way
practice that is utilized to in working with pregnant to induce labor because human
induce labor by inserting tiny people. They use a method of semen naturally contains a high
needles into your body. relaxing the ligaments around concentration of prostaglandins.
the uterus and pelvis in late Prostaglandins are known to
stage pregnancy. ripen the cervix, getting it ready
for labor. So, sex might help get
your labor going.
C OMMON I ND U CT ION T ECHNIQ U ES
Used In The Birthing Environment:
Some of the following induction methods are only used in hospital-based inductions, while
others can also be utilized in a birth center or a home birth if you’re working with a midwife.
Ask your care provider which induction techniques may be available to you in your chosen
birthing environment.
L A B OR-I ND U CING MEDICAT IONS
• Prostaglandin medication: used for “ripening the cervix.”
• Pitocin: a synthetic version of oxytocin that is given through an IV and left in (and possibly
increased) until your contractions begin.
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“STRI PPI NG MEMB R ANES”
• If your cervix is partially dilated, your care provider would sweep their finger over the thin
membranes that connect the amniotic sac to the wall of your uterus in an effort to cause
contractions.
“BRE A KI NG YO U R WAT ER”
• Or clinically, rupturing membranes. Only if you are partially dilated, your care provider will
make a small hole in the amniotic sac using an instrument to speed up or induce labor.
F OL E Y BUL B I ND U CT ION
• A procedure where your care provider will insert a catheter into your cervix. Once inside
your womb, your doctor inflates a little balloon on one side of the catheter. The inflated part
will put pressure on your cervix for dilation.
I ND U CTI ON TECHNIQ U ES
Clarity and Risks
Sometimes inductions are the safer option, whereas other times waiting for spontaneous
labor may be a safer option for you. Speak with your healthcare provider about any risks
that may apply so you can make the decision that feels right for you and your birth.
Questions you can ask your healthcare provider:
• Can you explain the medical reason for me to have this induction?
• Can you spend some time explaining the risks of this induction to me, both for myself
and my baby?
• Can we talk through the exact induction or inductions you would recommend for me?
This would be an important time to share if there is any part of the specific intervention
that triggers anxiety or fear for you. You can talk through what different options exist
and how you might need to be supported during an induction.
• What would happen if I chose not to have this induction? What would it look like for me
in terms of wait time for labor and protocols to follow?
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How You Can Take
Care Of Yourself Self Care
Physically, Emotionally,
& Spiritually Inside
Of This Experience
• Consider for a moment all the different decisions you have made up until this point in
your pregnancy; what did you need to know to help you feel safe in those decisions?
Considering this can help inform what steps you need to take in making a decision.
• If you do have an induction, talk with your support person like a partner, doula, or
friend to help you process information, make decisions, and explore ways to keep you
comfortable during the process.
• Explore different sensory integration techniques that may be supportive to you during
an induction. Use the Sensory Integration In Pregnancy & Birth guide to explore
different strategies.
• Try the “Release Breath” practice:
Using the release breath can help you relax and shut out
distractions. It’s a combination of long forced exhalations
through the nose, followed by deep passive inhalations
through the nose.
1 When you feel a contraction start to build during labor, immediately
start to gently blow all of the air out of your lungs, through your nose.
Blow until you think you can’t blow anymore.
2 Then, let a deep inhale float back in through your nose in response.
3 Let that inhale travel all the way up to the top of your head.
4 And then once again, gently begin to blow all of the air out of your
lungs, through your nose until you think you can’t exhale anymore.
5 Let another deep restorative inhale flow back in through your nose,
right up to the top of your head.
6 Repeat that breath pattern as many times as you’d like.
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Things You Might Need
To Feel Prepared For Needs
This Experience
I can find support through...
Alone time Alone (together) time Conversation with care provider
Asking for clarification Journaling Processing induction options
Getting to bed early A meal A snack Movement
Sensory break Gadget time
Get:
A Pen
& Paper
Do:
Write Down
Your Needs.
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Resources To Explore, If You
Want To Keep Learning About
This Experience
Deep Dive
Nurture by Erica Chidi
Evidence Based Birth (www.evidencebasedbirth.com)
Mayo Clinic (www.mayoclinic.org)
Where We Found Our Information
On This Experience
References
1
The American College of Obstetricians and Gynecologists. (2018,
August). Clinical Guidance for Integration of the Findings
of The ARRIVE Trial: Labor Induction Versus Expectant
Management in Low-Risk Nulliparous Women. acog.org/clinical/
clinical-guidance/practice-advisory/articles/2018/08/clinical-
guidance-for-integration-of-the-findings-of-the-arrive-trial
Dekker, R., PhD, RN. (2020, February 27). Evidence on: Inducing
for due dates. Retrieved February 03, 2021, from https://
evidencebasedbirth.com/evidence-on-inducing-labor-for-
going-past-your-due-date/
Foley Bulb Induction. (2017, December 10). Retrieved February 03,
2021, from https://www.healthline.com/health/pregnancy/foley-
bulb-induction
Induction of Labor at 39 Weeks. (2020, May 1). Retrieved February
03, 2021, from https://www.acog.org/womens-health/faqs/
induction-of-labor-at-39-weeks
Labor and delivery, postpartum care. (2020, May 13). Retrieved
February 03, 2021, from https://www.mayoclinic.org/healthy-
lifestyle/labor-and-delivery/in-depth/inducing-labor/art-
20047557
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