Induction of labour
Labour is the process by which delivery happens.
Induction of labour is a process where labour has not started on its own and certain procedures and medicines are used to start the labour process to bring about a vaginal delivery.
Common reasons for Induction of labour
- When the pregnancy goes beyond 40 weeks. It is important to be sure of the date and size of pregnancy. The sonography in early pregnancy (at 6 to 8 weeks) is ideal to estimate the due date.
- The bag of waters may break spontaneously. Labour usually starts within a few hours. If it does not start, then induction may be required.
- There may be medical reasons to start labour before the due date.
Prerequisite for induction of labour.
It is important to ensure
- There is no immediate reason to avoid a vaginal delivery and do a caesarean section (e.g. like a malposition of baby, or HIV positive mother).
- The foetus is fine and is not compromised in any way to undergo the process of labour.
- The cervix is favourable for induction (e.g. A short soft partially open and effaced cervix v/s a long posterior tubular cervix).
Process of Induction
The substance called Prostaglandins are responsible for starting natural labour. Therefore, for induction of labour, drugs containing prostaglandins are used to start the process. They are available as tablets, gel and a ribbon-like delivery system. The patient is administered either of them depending on the situation of the cervix.
The situation is reviewed after 4 to 6 hours to see if labour has started or not.
Once the contractions start then the process is monitored as in any other labour. In case the contractions do not start then the doctor will use their expertise to decide about a second dose and the way ahead.
Under certain circumstances it may be required to stop the process and do a caesarean section. They are
- Failure to start labour.
- Failure to progress.
- Foetal distress: – the heartbeat of the foetus slows down.
Close Monitoring and timely action is required for a successful induction of labour and vaginal delivery.