Should I get induced? What are my options for induction?

Disclaimer: Please remember this is intended for educational purposes only and all individual healthcare decisions should be made with your healthcare provider.

"I don't want to be induced" is a common sentiment I hear women express during the third trimester. What are some reasons that you might need to be induced and why do people want to avoid induction? And if you do need to be induced... what are your options? I'm glad you're here. Let's dive in!

Mama Bear, we all know you want what's best for your baby. You probably know that studies show that full term is considered 39 weeks, and that can get confusing because sometimes that get's misinterpreted as "babies should be born by 39 weeks". On the contrary, 37-39 weeks is considered "Early Term". 39-41/42 weeks is considered full term, and depending on who you talk to, 41/42 weeks+ is considered late term. The truth is, due dates are an estimate, not an exact science, and some babies take longer to finish developing than others. For that reason, I always encourage healthy pregnant women to aim for a spontaneous labor if possible. Spontaneous labor means your baby has signaled your body that it's time to be born for one reason or another. Inducing labor without a medical reason can be very risky. But even if there is a totally legitimate reason for induction, many mothers find themselves dreading induction. Why is that?

Induced labor can be a long, strenuous, intense process. There are many different ways to induce labor, but one medication that seems quite common is pitocin (synthetic oxytocin). Pitocin can cause very intense, challenging, painful contractions, and can have negative side effects on mom and baby. These are common reasons laboring women often prefer to avoid pitocin at all costs. But is that possible when requiring a medical induction? Are there any options other than pitocin for induction? YES!

Your provider will assess your cervix to determine how "ripe" it is (ie. ready for induction based off dilation, effacement, and position). This will help determine the induction path that is "best". However, frequently, doctors may begin inducing with a cervical ripener like cervidil or cytotec. Sometimes they will "sweep your membranes" (more on that later), and sometimes they will use a foley balloon or cook's catheter. The goal is that these methods on their own, or together, will put your body into labor, once contractions begin, they may suggest using pitocin to increase intensity, duration, frequency, and efficacy of contractions. But overall, induction tends to be a longer process than a spontaneous labor. Read below for more information on various labor induction options! Discuss these options with your provider to help you build your birth plan! If you need extra help building your birth plan, don't forget Jaimie Zaki has helped countless women create empowering birth plans using the RoadMap concept, and is here to help you too!

Membrane Sweep

Sweeping your membranes is an invasive procedure requiring your provider to "sweep" their finger between your cervix and amniotic sac to cause a separation that could, in theory, encourage labor to begin. Does it work? The science isn't settled on this one. It seems to be a pretty hit or miss approach that depends on a variety of individual factors. Benefits:

- Can be done in outpatient setting, no need to be admitted to hospital

- Does not require medications

- If it works, it could eliminate the need for a medical induction Risks: - Very uncomfortable (note- just like any cervical check, you could bleed some after) - Potential for introducing infection

- Potential for accidentally breaking bag of waters, which could increase risk of infection

Cervical Ripeners

Two of the popular cervical ripeners are Cytotec and Cervidil. I linked some informative web pages about these medications to prevent from the misperception of me providing you with medical advice. I highly recommend learning as much as you can about the benefits and risks of these medications. Talk to your healthcare provider about the medications and which option you prefer to ensure it is available for you if needed. Not all hospitals use both of these medications, so they may opt for one over the other and it is imperative you ensure you are comfortable with that. If they do not provide the option you prefer, talk to your healthcare provider about how the medication you prefer can be utilized instead. **Cervical ripeners are considered especially risky for VBAC patients, refer to the ACOG Practice Bulletin on VBAC and discuss with your doctor or midwife.

Mechanical Dilators

For a totally bias discussion of the difference between a Foley Balloon and Cook's Catheter approach to mechanical induction you can read this article.

If you want some suggestions on how to avoid Pitocin during your induction, hop on over to youtube for this great video!

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Jaimie Zaki, owner of Little Bear Services, LLC is a Birth Photographer, Labor Doula, & IBCLC serving families in South Jersey and Central New Jersey. Mother of three, military wife, and lover of coffee, Jaimie enthusiastically supports hospital and home births in Burlington County, Camden County, Mercer County, Atlantic County, Ocean County in New Jersey. If you reside outside of this service area, there are online courses and virtual support packages available! Jaimie is excited to serve your family! Learn more about Jaimie and the services she offers!

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