Written by Caroline Meyer
You were given an approximate due date. You planned everything around it. The date comes and goes and you don’t go into labour. Everything else seems fine, but you really just want your little one to enter the world already! Remember that due dates are not exact. As long as baby’s movements remain strong and regular and there are no abrupt changes, all is well for a little while longer. If you have concerns, you should consult your midwife or doctor to make sure everything is fine. Unless there are issues such as the placenta no longer supplying the baby with adequate nutrition and oxygen, you might want to just wait a bit longer to see if nature takes its course.
Once you are overdue, your care giver may do more regular testing and, in some cases, may recommend a caesarean section or an induction of labour. Tests can include an ultrasound to check on the baby as well as the amniotic fluid index. These tests can help to get information on whether it is safe to wait or if labour should be induced. There are many tips and tricks out there on how to bring on labour, but there is no research to show that any of these ideas actually work. While there is no harm in doing some light exercise, having intimate relations with your partner or eating a little spicy food, don’t be too disappointed when this doesn’t result in speeding up the process of bringing baby into the world.
What Is an Induction?
An induction is when you are given certain medications or specific tools and techniques are used to make labour start. Almost 25% of Australian women are induced and this normally takes place in a hospital. Your care giver may recommend inductions when:
- You have high blood pressure or pre-eclampsia
- Your baby’s heart rate is not stable
- Your baby is not developing properly
- Your waters have broken but no contractions
- You are more than 41 weeks pregnant
- There are other health concerns
Your midwife or doctor will discuss the need for an induction with you so you are able to decide knowing the benefits and the risks involved to you and your baby. Induction techniques may also be used even when you are in labour if the labour is progressing slowly in order to speed it up. You can also choose not to have this occur if you prefer. You can weigh all the positives and negatives and then decide for yourself. Most pregnancies do not go past 42 weeks. The risks after this period are increased, but fortunately this is quite rare. If you choose not to be induced, you can discuss with your healthcare provider what options are open to you. They can advise on what they recommend based on the risks to you and your little one, but the ultimate decision in this is still up to you.
An induction would usually start with a vaginal exam to check and see whether or not the cervix is prepared for labour. This can be a little uncomfortable but it is over fairly quickly. If the cervix is not yet ready, you are likely to be given medication to soften the cervix and allow it to open in preparation for birth. There are also other techniques and procedures that may be done to soften the cervix and allow for dilation. These procedures can include oxytocin, prostaglandins, using a balloon catheter to artificially ripen the cervix, rupture of the membranes (breaking the waters) and a membrane sweep. You doctor may use one or a combination of these techniques. Most women feel fine having been induced before giving labour but some may feel a little disappointed that their labour did not start naturally. If you are feeling unhappy after your baby’s birth due to being induced (or any other reason for that matter) reach out to someone and discuss it. Often just talking to your partner or a family member can help, but if you feel the need, consult a health care professional.
Some of the risks involved in induced labour include a higher blood loss after birth, requiring more pain relief, the potential for extra assistance such as a vacuum or forceps for delivery, more equipment is needed to monitor you during birth which also restricts movement, higher risk of needing a caesarean and on occasion, the induction may not work and you would need to consider other alternatives. You are also limited to where you can give birth in most instances as water births would not be practical with all the monitoring equipment.
If you are over term and had a birth plan mapped out, discuss your options with your midwife or doctor in order to try and get the birth experience closer to what you had envisioned even if you may need to be induced. Your health and that of your baby is vital and you may need to set aside some of the ideas you had for the birth in order to reduce risks to you and your unborn child.