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It is sometimes necessary to start labour artificially. This is known as induction of labour or, if your waters have already broken, stimulation of labour. Induction of labour is usually easier if you have had one or more babies before by normal delivery, and if your cervix (neck of your womb) is already ripe.

Why your labour might be induced

  • If you are beyond 41, or in some cases, 42 weeks pregnant (known as "post dates" pregnancy).
  • If your doctors are concerned that your baby's growth h as slowed down or stopped; your baby is not moving well; there is a reduced amount of amniotic fluid; or the placenta is no longer nourishing your baby (placental insufficiency).
  • If you have reached 40 weeks and you have a medical condition that means that an early delivery would be in your interest.
  • If you are at 40 weeks, and you have a viral personal reason to have your baby delivered .
  • If your baby has a condition, such as "hole in the heart ", that needs surgery, it is in your baby's interests to be delivered during working hours when the necessary expertise is readily available.
  • If you develop pre-eclampsia, your doctors may decide, for your and for your baby's safety, that your labour should be induced. This may be as much as a few weeks before your baby is due.
  • If you have another medical condition, for example, diabetes or kidney disease.

The procedure for inducing labour 
Your obstetrician will check that your baby is "head down" in your womb, and has engaged low in your pelvis, then will ascertain if your cervix is ripe. You will be asked to return to the hospital at a certain time to have your labour induced. When you come in, your baby's heartbeat will be monitored for about half an hour on a CTG machine to check that he or she is not in distress. You will then be induced by one of the following methods:

 

Prostaglandin (vaginal gel or tablets orally) 
This substance is found naturally in your womb lining and one of its functions is to stimulate uterine contractions so that labour can begin . If your cervix is firmly closed, your midwife or doctor may put a gel or a tablet containing synthetic prostaglandin into your vagina, which helps to ripen your cervix. This procedure may be repeated several rimes in one day, or even continued the next day, until you go into labour or your cervix has opened enough for your waters to be broken.

 

Artificial rupture of the membranes (ARM)
If your cervix is sufficiently ripe, this can be an effective way of inducing labour. Your doctor or midwife will give you an internal examination, then use a long, thin plastic hook to brush against the delicate membranes, which is usually enough ro break them.

Syntocinon
This is a synthetic substance fed into your arm via a drip to increase the strength and regularity of your contractions. It is similar to oxytocin , the hormone produced by the pituitary gland, which causes the womb to contract, stimulating labour. This method is often combined with the artificial rupture of your membranes (see above). It is very safe, bur if too much syntocinon is given it can cause your womb to contract too much; it can also make your contractions very painful (and sometimes causes double contractions).

Why inductions are not more common
Although inductions are usually successful, labour is not induced more frequently or on demand because there is a risk that you will not go into labour; if the induction fails, then you will need a Caesarean. You are also more likely to need an assisted delivery with forceps or ventouse. An induced labour is less likely to be successful if your cervix is completely closed and your baby's head has not properly engaged in your pelvis.

What to consider
An induced labour may be more painful and rake longer than one that starts naturally. You may need to have an epidural; this means that you will be prepared if you later need a Caesarean, or even an assisted delivery with forceps or a ventouse cup.

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