I is for Induction
Whether you found this article in searching for ways to move baby along or you are concerned about the induction process with your medical care provider, you may be feeling like the pressure is on! Here's all the information you'll need to navigate this birth with minimal intervention and confidence. We'll start by taking a look at how to naturally get labor to begin, as well as a few things to avoid.
It's worth mentioning that less than 5% of births happen on your estimated due date, and many holistic providers would consider it to be your "due month". Another study mentions that labor may be triggered by a cascade of birth hormones in the body after a protein called surfactant, which strengthens babies airways at delivery, is released within the womb. This may be a sign that our bodies and babies know what's best, and letting nature take its course is sometimes the best option for both the mother and babies health.
If you are feeling pressured into induction, discuss these concerns openly with your care provider. Ask questions, request information and resources, and inquire about the option to avoid induction altogether or come in for additional ultrasounds or fetal heartrate checks to ease their concerns. If you encounter resistance at any point, you can always look into other practices, midwives, or doctors, research home birth and hospital birth, and also consider hiring a Birth Doula to support you throughout the process.
Exercise- We aren't looking to burn calories, but to help move baby into the best position possible. Moving baby down is the goal, so doing squats, sitting on a birth ball, or taking light walks can be effective exercise.
Sex/Intimacy/Cuddling on the couch- Anything that brings on Oxytocin, the love hormone, will help labor to begin. This includes cuddling with family pets, watching sappy love movies, and listening to your favorite music. If you feel up to it, indulging in some intimacy with your partner can be very helpful.
Rest- Your body uses as much energy during labor as during a full marathon. Prepare and nourish your body in the weeks leading up to your due date with health proteins, full fats, and fruits and vegetables.
Red Raspberry Leaf Tea, Medjool Dates- These are both proven to reduce the length of labor, increase uterine strength, and are safe for pregnancy with no side effects. The recommended amounts for labor preparation are 2-3 glasses of tea a day, and up to 6 dates a day beginning at 36 weeks.
Yoga- Benefits of prenatal yoga practice include breathing practice, moving meditation, and stress reduction, among many others. If you haven't practiced before, seek out a Restorative or Slow Flow class to be gentle on your body.
Alignment- Regular chiropractic adjustments not only help with good posture, but encourage baby to be in the best alignment in your pelvis as a result. It's a great idea to get an adjustment during postpartum recovery, as well as throughout your pregnancy leading up to birth. Spinning Babies is another great resource for specific movements related to optimal fetal positioning.
Acupressure/Acupuncture- This is an ancient and highly effective practice which can be non invasive with Acupressure. Your Doula or Midwife can usually teach you these techniques to use at home beginning at 38 weeks. Check with your care provider to see if this is an option for you! Local resources are linked here.
Things to Consider
Bumby Car Rides- It's not necessary to go for a long drive just to encourage labor to begin. It's more comfortable and more effective to gently bounce on a birth ball.
Spicy Food- Usually causes bouts of intestinal cramping, which can cause labor to begin. Not the most easy way to start things off! Your body needs hydration and good food to fuel itself through labor and delivery.
Black/Blue Cohosh- This herb can be very dangerous and shouldn't be consumed to induce labor. We don't have enough evidence to be sure, but the information we have suggests that risks include birth defects, and toxic effects on both the mother and the baby.
Castor Oil- As with spicy foods, this causes intestinal distress which causes labor to begin. The same contraindications exist as spicy food, with the added concerns of Meconium in the womb, decreased breastmilk production, and dehydration.
Evening Primrose Oil- There have been almost no studies or research done on the effectiveness of this natural induction method, until further research is done it isn't advisable as an option.
Excessive Activity- There is no proof that walking for hours can move things along, so it's best to use the above steps for healthy and gentle exercise instead of marathon walks or cleaning your home all night.
Induction- This is my personal and professional opinion. Sometimes induction is effective as an alternative to cesarean birth with a medical care provider, but in most cases causes a lot of physical distress for mom and baby. I've seen a lot of mothers struggle to deal with the pain of induction, usually right on their baby's estimated due dates or before for non-emergency reasons. Your body needs time to work its own magic. Trust in it! Feel free to contact me if you have questions on this.
The Medical Induction Process
Most women aren't aware of the exact process for inducing labor, or that they have a few options for induction methods! Usually mothers going in for induction are given a date and time to arrive, and they don't know what else to expect. When you arrive at the hospital, they will usually ask you to dress in a gown, review your medical history, and begin monitoring you for your vital signs, contractions, and fetal heart rates.
When you are administered any type of medication, they will require you to be monitored on a schedule and in some cases, consistently. You have the option to ask what monitoring is necessary and when attached monitors can be removed, as well as the right to decline any procedure you aren't comfortable with.
You have a few options for comfort from the beginning:
Decline to change into the hospital gown, wear your own labor gown!
Decline constant fluid intake, choosing a Heparin IV lock for mobility.
Request a mobile monitor. so that you can be upright and active while monitored.
Alter your labor environment with music and lighting, to keep yourself relaxed.
Sweeping of Membranes
This is an in-office procedure that can be slightly uncomfortable, but the process is quick and you will go home while labor progresses. Your midwife or obstetrician may take a finger or two to gently stretch the cervix opening and strip the protective membranes. After this is done, the cervix may begin to thin and dilate naturally, avoiding other interventions. There is some debate about whether this is very effective, and it isn’t without risks. Some moms experience their water breaking prematurely as a side effect of the procedure.
Cervix Ripening Agents
Your cervix has a few adjustments to make in labor, so if you arrive to the hospital and are not dilated at all, they may offer this option. Although the cervix needs to dilate, it also tilts forward and thins during early labor. It isn’t advisable to rush this process.
There are a few different medications and options available for this purpose, such as Cervidil and Cytotec. As with any medication, there can be risks and side effects with these. Please see the linked article for details.
This is a low risk option with minimal side effects that would be done on induction day in the hospital, after cervical ripening agents but before moving on to Pitocin. A Foley bulb catheter can be inserted into the cervix and ballooned up to aid in dilation by putting constant, gentle pressure on the cervix.. This sometimes gives the cervix the message that things are changing, and can begin the labor process naturally. You are asked to pull on the catheter tube until it falls out, and then you will be checked by your provider for progress.
AROM (artificial rupture of membranes)
Rupturing the membranes of the amniotic sac interrupts the natural barrier that babies have for protection and fluid, and removes the cushion that amniotic fluid provides. The benefit in this is that your babies' head will likely be pressing more firmly on your cervix so to make contractions stronger and encourage dilation. This is usually offered as an option if you are progressing and dilating well but your contractions don’t feel like they are increasing in intensity.
The risks are more serious than the previous methods mentioned, including prolapsed cord, decreased fetal heart rate, and increased risk of infection. Most providers will also begin a 12 hour limit on your induction after your water is broken due to these risks, be sure to ask what options you will have after this procedure.
Pitocin is the artifical form of the hormone Oxytocin, and is the most common form of medical induction. This medication can be very helpful for a mom to get into a more effective contraction pattern, and in some cases the dosage can be lowered or turned off completely as labor progresses. This medication does bring on strong contractions, in some cases they are too strong, ineffective, or it can cause other adverse side effects. In cases of a longer induction, I have seen mothers decide to get an epidural to cope with the strength of the induced contractions. Read more information on epidurals and that process here.
In a recent study, it was shown that there is a possible link between Pitocin and Postpartum Depression. It's important to look at the evidence available and make the best decision possible for your baby and your health when considering this option. Discuss any concerns you have about Pitocin and any possible alternatives with your care provider!
This information isn't meant to scare you away from induction, advise against medical advice in an emergency, or to advocate any birth methods that would be unsafe. In presenting the options, research, and information that is available, I hope to make it easier for you to make clear and confident decisions in your birth process.