There’s a lot of scheduling and planning when it comes to having a baby. There’s the baby shower, figuring out childcare (no matter what option you chooses), and the OB-GYN appointments, scans, tests. But what about scheduling the actual labor itself? How do you know if you’ll have to schedule your labor, too? Are there early signs you’re going to be induced?
According to Dr. Sherry Ross, OB-GYN and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California, and author of She-Ology, early signs you’ll probably need to be induced include being diagnosed with high blood pressure, gestational diabetes, or your baby isn’t growing the way he or she should. In most cases, “Medically indicated inductions should occur after 34 weeks ideally unless it’s a matter of life and death for mom or baby,” she explains in an email interview with Romper. Additionally, the Mayo Clinic noted these other signs you’ll need to be induced: you have an infection in your uterus, your water has broken but you haven’t gone into labor yet, your placenta “peels away from the inner wall of the uterus before delivery,” or you have kidney disease or are obese.
What about an elective induction? Ross says, “Elective inductions can also be considered for a nonmedical reason at 39 weeks if the cervix is favorable for induction. An example of elective induction is if a previous delivery happened quickly and there are concerns the woman would not make it to the hospital when she goes into labor,” she says. However, you’ll have to have an “inducible” or “favorable” cervix, according to Ross. “A cervix is favorable when it’s thinned out and dilated before the induction begins. Labor tends to go more quickly and is more likely to be a vaginal birth with a favorable cervix,” she explains. If your cervix is “unfavorable,” the process of being induced may take a couple of days or end up in a cesarean section.
How does being induced work exactly? You’ll be given a “Bishop Score,” which will access the thinning, dilation, and softness of your cervix, and also where your baby’s head is located at the time, explains Ross. The Bishop Score will determine if you need medication to soften the cervix before starting the medication to start contractions.
According to the Mayo Clinic, the induction procedure, depending on your circumstances, could include using synthetic prostaglandins to ripen your cervix. These prostaglandins are placed inside your vagina. “After prostaglandin use, your contractions and your baby's heart rate will be monitored. In other cases, a small tube (catheter) with an inflatable balloon on the end is inserted into the cervix. Filling the balloon with saline and resting it against the inside of the cervix helps ripen the cervix,” the Mayo Clinic noted.
The Mayo Clinic also mentioned using intravenous medication such as Pitocin, which is a synthetic version of oxytocin, which will cause your uterus to contract, effectively “speeding up labor.” Your doctor may also rupture your amniotic sac with a plastic hook, which will start labor, but your doctor will only do this if you’re cervix is partially dilated and “your baby’s head is deep in the pelvis.” Depending on your circumstance, some doctors will do all three of these things to induce your labor.
As soon as you start showing some signs of high blood pressure, diabetes, or your baby isn’t growing as they should, your doctor may begin discussing the possibility of scheduling an induction with you for further down the line. If you have signs indicating it is medically necessary to be induced, unless it’s life threatening to you and baby, you won’t be induced until at least 34 weeks. And if you’re ready to evict that baby, even with scheduled inductions, most doctors recommend waiting until you are at least 39 weeks along. That way the baby should be finished “cooking” long enough for there not to be complications.
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