So you went in to your OB or midwife for a routine appointment or late pregnancy ultrasound and they have suggested that you be induced immediately. What are your options? What do you do?
First obtain as much information about why they are inducing you and how they plan to perform the induction. Then consider the following options
Do nothing.
You always have the option to do nothing and wait for labor to begin on it’s own.
Non-invasive, non-medical options
Having sex introduces prostaglandins (agents which ripen the cervix) into the vagina and the cervix from the male’s semen. Having an orgasm releases oxytocin which stimulates contractions. Unless your OB or midwife has advised you not to have sex, intercourse and/or orgasm can help stimulate labor or help to ripen the cervix.
Nipple stimulation – nipple stimulation, by hand, oral or with a breast pump produces oxytocin which may stimulate contractions
Stripping your membranes – during this procedure you care provider will introduce one or two fingers into your cervix and separate the bag of waters from the cervix. This produces irritation to the cervix and may stimulate contractions or the production of prostaglandins which will ripen the cervix. Many women describe this process as quite uncomfortable. There may be cramping and mild bleeding or discharge for a few days following this. It may help to ripen the cervix or start labor.
Methods to prepare the body for a medical induction
Acupressure – There are several acupressure points that can be stimulated to promote the start of labor, regulate contractions or prepare the body to “take” to a medical induction
Evening Primrose Oil – Can be taken either orally or vaginally. Take 3 capsules a day orally. In addition or instead, insert 2-4 capsules directly into the vagina, near the cervix.
Homeopathics – Caulophyllum and/or Cimicifuga 30C
Mediation/visualizations to prepare your baby/your body for a coming medical induction
Non-pharmaceutical induction methods
*Inducing labor should ALWAYS be done under the guidance of a trained health professional. Please do not use herbs or natural remedies to induce labor on your own without first consulting an herbalist, midwife or OB*
Acupuncture – An acupuncturist can stimulate points which may promote the start of labor
Homeopathic – Caulophyllum and Cimicifuga 200C or 1M doses to induce labor
Herbal – Cotton root bark, Blue Cohosh and Black Cohosh can be given to induce labor. 10-20 drops in water every 1-3 hours. Or 20 drops Blue Cohosh every 30 minutes for 2 doses followed by 20 drops of Cotton Root Bark up to every 15 minutes for 3-6 hours. Risks: Blue Cohosh is known to lower blood pressure, cause nausea and may elevate fetal heart tones. Use under guidance of an herbalist or midwife.
Medical Inductions
Artificial Rupture of Membranes - Sometimes either before or during a hospital induction (or a slowly progressing labor) your OB or midwife may want to “break you water”. To do so he or she will guide a small hook through your vagina and puncture the membranes that enclose your baby and the amniotic fluid that supports him/her. Without the cushion of amniotic fluid, the baby’s drops right onto the cervix and applies extra pressure which may help the cervix dilate more effectively. Risks: Infection, the risks of infection increase further with repeated vaginal exams, the use of an internal fetal monitor, or a positive group B strep status. If the baby’s head was not perfectly positioned prior to rupturing your membranes, your baby ay have a harder time maneuvering his/her descent. Once done, it cannot be “undone” if your baby does not tolerate it well.
Cervidil, Prepidil (Proastaglandin E2) – Prostaglandins (usually derived from pig semen) are inserted vaginally to help ripen the cervix and produce contractions. Often used prior to a Pitocin induction. Risks: May produce hyperstimulation of the uterus, increase the likelihood of a cesarean or cause fetal distress. Dosage can not be reduced once given.
Cytotec (Misoprostal) – An off label use of an ulcer medication. Pill is inserted vaginally or taken orally. Produces prostaglandins and stimulates contractions. A cheaper and faster alternative to cervadil Risks: Off label use which the manufacturers do not support. FDA warns its risks include profound fetal distress, uterine rupture, amniotic fluid embolism, hypertonic contractions and increased risk of cesarean. Dosage is hard to control and cannot be reduced once given. Often produces intense, tumultuous labors.
Pitocin – Synthetic oxytocin given via an IV to produce contractions. Very effective at producing effective contractions. However contractions are much more painful usually leading to an epidural. Risks: Uterine hyperstimulation, fetal distress and increased risk of a cesarean. Baby is more more likely to develop jaundice and have low APGAR scores at 5 minutes.
Anytime a baby is forced to be born before he or she is ready and labor has begun on it’s own there are inherent risks. These risks must always be weighed against the assumed benefit of the baby being born and risks of prolonging pregnancy. Even non invasive measure possess the capability of a baby being born before he or she is ready. Even non-pharmacological induction methods have risks. If you are being induced for medical reasons it may be prudent to consider the methods mentioned to prepare your body for the induction. Sometimes even such a simple act as communicating with your baby about what is coming can produce a more effective and smoother induction.