How labor is induced. Induction of labor: features, methods, consequences. Reasons for inducing labor

Childbirth is a natural process determined by human nature. However, no one is immune from pathologies and complications, so in some cases it is difficult to do without medical intervention. Doctors often stimulate labor activity: what it is and how dangerous it is for the baby and mother is of interest to all women in labor.

You should then decide as soon as possible whether the oocytes should be frozen. Thanks to modern freezing techniques, it is now possible to preserve eggs to achieve pregnancy after therapy and a certain waiting period. It is a condition that reduces fertility frequently and in different ways.

Inflammatory substances in the immediate vicinity of endometrial implants affect the quality of oocytes and the ability of the endometrium to accept embryos. Surgical removal of endometrial lesions always results in loss of healthy tissue. If there are mechanical obstacles to the transportation of sperm and eggs. . Mechanical fertility problems associated with endometriosis can be treated through in vitro fertilization.

This concept refers to the artificial induction of labor and its activation if the natural process cannot, for some reason, take its course.

Indications for induction of labor

The doctor may suggest this procedure if there are indications for induction of labor that pose a risk to the further continuation of the pregnancy. These include:

However, the loss of ovarian tissue cannot be reversed. The earlier the disease develops, the longer it persists and the more radical the treatment required, the less likely it is that the woman will conceive naturally. Often the diagnosis of an illness occurs at a time when family planning has not yet been done.

Fertility preservation, fertility reserve

Appropriate measures can be taken to help the woman maintain her ability to have a child once the disease has been overcome. Depending on the woman's age, the timing of therapy, existing partnership, and other factors may vary. Sometimes it is enough to keep the ovaries in a functional state, so they are not heavily attacked by chemotherapy. There are surgical procedures in which the ovaries are moved inside the body to better protect them from radiation therapy.

  • post-term: pregnancy exceeds 41 weeks;
  • absence of contractions within 24 hours after the water breaks;
  • chronic or acute diseases: kidney failure, diabetes, preeclampsia, heart problems;
  • multiple pregnancy(read about the features of such births);

There are also unforeseen situations when a pregnant woman herself insists on labor with stimulation, but the decision in each such case remains only with the doctor. For the safety of mother and child, the possibility of natural labor should be used, since drugs that stimulate it can lead to complications and side effects. Therefore, it is often said that this procedure is harmful. Is this true?

Or the ovarian tissue is removed, hoping that it may later produce eggs or that the tissue will resume its function after reimplantation. However, the most in a simple way Fertility maintenance is freezing the storage of egg cells. Since still widespread in Germany, only fertilized oocytes are well preserved. This means that this type of fertility reserve only makes sense if the woman has a regular partner with whom she also wants to have a child in the future.

Only an unfertilized egg can be frozen and preserved with very good survival rate. Thus, women who do not yet have a partner, or are unsure whether they want to have a child with their current partner, can retain unfertilized oocytes for many years.

Why is stimulation dangerous?


Many women’s fears are exaggerated, since few people know specifically why induction of labor is dangerous and what consequences it can have for mother and baby. In most cases, it passes without complications and saves the situation. Negative points include:

At the end of pregnancy, pregnancy becomes increasingly difficult for a woman. She longs for the calculated date of birth and, of course, hopes for a few days that the baby will arrive a few days early. Unfortunately, it rarely goes according to plan, and so it is not uncommon when the calculated date of birth is there, but the baby still does not move to vacate its two-room apartment in mom's belly.

Initiation of labor by natural stimulating labor. If a pregnant woman suffers from serious medical conditions, has gestational diabetes, or the unborn child is at risk of deficiency, it may be appropriate to initiate labor by naturally inducing contractions. This works in different ways and should be discussed with your doctor or midwife. Not all methods work for all women.

  • painful contractions that are felt much more strongly by a woman than during natural childbirth, - therefore the question often arises about the use of epidural anesthesia ( full list indications for it);
  • an uncomfortable position complicating the birth process: stimulant drugs are often administered through an IV, which forces the woman to lie primarily on her back, severely limiting her movements;
  • in rare cases, but it still happens sometimes, the procedure causes oxygen starvation of the fetus with all the ensuing consequences.

As for everything else, correctly chosen drugs to stimulate labor and a timely decision by the doctor to carry out the procedure most often save the lives of the mother and baby, and do not cripple their health. At the same time, all the pros and cons are weighed, which may be different in each individual case.

Using herbs to stimulate contractions

When the eipole is separated, the cervix is ​​stimulated and the outer membrane of the amniotic sac is released from the uterine wall. This very unpleasant and even painful method is definitely effective and can only be performed by a gynecologist or midwife. Even acupuncture can be extremely helpful in birth conditions and induce contractions. Midwives who experience homeopathy can also put together a globular therapy tailored to the woman to get things started. Another option is a foot reflexology massage, which should be performed by a midwife or massage therapist.

The answer to the question whether induction of labor is harmful is rhetorical. This is an artificial intervention in a natural process, and therefore it is undoubtedly harmful. But according to available indications, this method is necessary. It happens that stimulation turns out to be useless, the mother’s body does not respond to it. In such cases, the last chance is only a caesarean section.

Additional therapeutic measures

If certain pressure points in a pregnant woman are stimulated, this can stimulate labor activity. Like the previously mentioned options for promotion, all of these should only be used in consultation with a doctor or midwife, and in relation to what is called an oil tampon. Here the tampon is soaked in clove oil and then inserted vaginally. The cervix becomes softer and more fertile.

If one does not belong to the group of pregnant women who can be instructed by a doctor or obstetric methods of induction of birth, then there is an opportunity to take small home remedies and become active. In principle, however, it is said that all work incentives are only effective when the child is ready for birth. Ultimately, the baby always provides the initial signal for birth. However, there are a few things Ms. can do to possibly shorten the wait.

Methods of stimulating labor

Many women associate this procedure with painful and dangerous methods, again only because most do not know how to induce labor. It all depends on what stage labor is at, whether it exists at all. After analyzing the condition of the pregnant woman and the child, the question of which method of stimulation will be useful in a particular case is decided.

Never use castor oil or alcohol. This should be clearly condemned by colloquial "work cocktails". The compositions of these different mixtures often contain castor oil and a high percentage of alcohol. You can never tell how such toxins affect a child, and the dangers are too great. From this, you should definitely keep your fingers crossed and prefer to contact your gynecologist or his midwife for gentle ways to encourage labor.

Onset of labor with artificial stimulation

Warm, not too hot baths can at best stimulate the initial signal for delivery. Basically, this only helps to distinguish real labor from false ones. False labor is less in warm water or even disappears completely. However, an adverse reaction can also lead to sagging blood circulation, and therefore you should not be at home alone if you want to try this experiment.

  • Detachment of amniotic membranes

The technique is used in post-term pregnancy. The doctor peels off the amniotic sac manually, and this triggers the onset of contractions. The difficulty is that the procedure often does not work due to various reasons (inexperience of the doctor, thick walls of the shell, etc.). Therefore, it has to be done several times or resort to other methods. The risk to the health of the mother and baby is minimal, there is no pain.

Movement and activity can be helpful. Walking, climbing stairs, some belly dancing or gymnastics exercises bring the baby into a better position and with moderate exercise, gentle labor can be promoted or even initiate birth. Again, it is advisable for the escort to be helpful in walking if these activities actually bring the desired success.

When the nipple is stimulated, the nipples are massaged. This can be done either by the pregnant woman or by involving her partner. Positive stimulation releases the hormone oxytocin, and it may be that the child is ready to take the plunge. This is also a very labor intensive method. The nipples are massaged for one minute and then interrupted for two to three minutes, and this should be done for half an hour. But if contractions occur at this time, the uterus is ready for birth.

  • Prostaglandins

Prostaglandins are physiologically active substances independently produced by the human body. They cause the cervix to ripen and dilate. The drug is administered in the form of a gel or suppositories vaginally, and within half an hour labor usually begins. The procedure does not hinder movement, does not cause discomfort, has no side effects or contraindications, and does not have any effect on the fetus.

Probably the most enjoyable way to get started is through sexual intercourse. Admittedly, it is no longer so easy to find a suitable position as your waist circumference increases. But in addition, the hormone oxytocin, which is also released, and the reduction of orgasm on the part of the woman can stimulate labor. Ejaculatory male containing prostaglandins are also acceptable. They are even used during artificial induction in the hospital.

Also very pleasant for a woman is abdominal massage as a possible option for contractions. This is where his better half's partner can do something really good again. First, the belly ball is moistened with a little warm water and then the massage can begin with almond oil and various essential additives such as cinnamon, ginger or cloves. You don't need an apprenticeship for this, it's just a little tact. For two days, baby massage may be successful, but even if it doesn't hit, it's a pleasant and intense time that you can spend again before the baby arrives with your partner.

  • Puncture of the amniotic sac

Puncture of the amniotic sac is dangerous due to infection. Used when contractions drag on too long. An amino hook (a long plastic hook-like instrument) is inserted into the vagina, hooks the amniotic sac through the cervix and pierces it, causing rupture amniotic fluid.

The following tip may sound a little like witch cooking, but certain spices and aromas have been shown to have a positive effect on contractions. To do this, you must prepare a brew of 1 liter of water, a cinnamon stick, ten cloves, a small ginger root and a tablespoon of verbena. Called vervain or verbena herb, you find yourself in a pharmacy. You should drink this warm tea throughout the day and assuming you are actually ready for birth, it usually starts two days after contractions.

Methods to induce contractions at home

If this is too difficult for you, you may prefer to eat fresh pineapple. The enzymes they contain are also considered to promote labor. If all these measures do not lead to the expected success, you still should not apply pressure. You cannot force anything and all home remedies only help when the baby is ready to be born. However, for many women, all of these methods provide an opportunity to do something and not sit idly by. This feeling is worth a lot and reduces the wait. Otherwise, you should still try the remaining time to try, because soon you will have your hands and some more time for yourself and your own needs.

  • Oxytocin


Oxytocin is a synthetic drug, an analogue of a natural hormone that stimulates uterine contractions. It is used in cases of attenuation of labor and a decrease in the intensity of contractions. It is administered intravenously using a dropper. This method of stimulation is fraught with an overdose of the drug, which can lead to oxygen starvation of the child, as well as too painful contractions.

Babies after their estimated birth date are more mature. In itself, every day a baby is allowed to remain in the womb is a positive thing. Babies born around the estimated birth date tend to be more mature. If 14 days are reached after the estimated date, then the birth takes place in the clinic. Although many women do not want this, every woman also views this situation differently. In the end, only the result is counted, and that is a healthy child and a happy mother.

By Sarah Metzker Erdemir. Women whose pregnancy lasts 40 weeks or more may worry about the birth of their children. The last weeks of pregnancy can be uncomfortable and the anticipation of expecting a new baby can be overwhelming. Doctors also tend to get nervous when a pregnancy is overdue due to the increased risk of compression of the cord and the fetus, and many women feel fear when their doctor starts talking about cesarean sections and chemically induced inductions. If you are more than 40 weeks pregnant, there are some things you can do at home to speed up your birth. naturally.

  • Pills

Modern drug stimulation of labor involves the use of special tablets that contain artificially synthesized antihistogens. They block the receptors of the uterus, accelerate the ripening and opening of its cervix. The advantage of the tablets is that they do not have any effect on the condition of the woman and baby.

Due to ease of use, maximum effectiveness and minimal side effects, today this method of inducing labor is considered the most preferable. However, it has many contraindications: liver and kidney failure, diabetes, asthma, problems with blood clotting, individual intolerance.

  • Natural methods of stimulation

The most courageous women, realizing the need to speed up labor and the inability to do this in a hospital, carry out stimulation at home. In this case, a preliminary consultation with a doctor, at least by phone, is simply necessary. Natural stimulation methods include:

  1. sex, during which the uterus contracts, which becomes the starting point of natural childbirth;
  2. castor oil taken orally leads to increased intestinal activity, which provokes labor; the method is questionable, as it causes diarrhea, nausea and dehydration;
  3. light physical activity will speed up the birth of the baby;
  4. Acupuncture also helps initiate labor.

Artificially induced labor with stimulation - necessity, help female body and the child. You shouldn't be afraid of this, because the doctors know what they are doing. Trust them. Moreover, without the consent of the woman in labor, no one has the right to interfere with the natural process of childbirth - not even a doctor.

Most labor begins vaginally after 37 weeks and progresses until the baby is born. In some cases this is not observed. Labor may not begin when expected, or there may be medical indications for the baby to be delivered earlier. On the other hand, labor that begins spontaneously may progress slowly and even stop. Contractions may stop or be insufficient to dilate the cervix and release the baby (so-called weak labor).

Sometimes you can speed up a slow labor by walking or changing position. Be patient and don't lose control. If you are tired or your baby is suffering, they will help you speed up labor. If labor does not begin within 12 hours after rupture of the membranes, the doctor may suggest artificial induction of labor - stimulation.

Stimulation is carried out very carefully. Doctors try to achieve a result of 1 contraction every 3-5 minutes, no more. During this procedure, doctors monitor the condition of mother and child. If 3-4 hours pass after stimulation and there is no result or there are contraindications to stimulation, then a cesarean section is performed. Problems with contractions and cervical dilatation are most common in women with menstrual cycle, with endocrine problems, with inflammation. Before inducing labor, doctors must weigh the pros and cons.
Methods of inducing labor
All methods of stimulation can be formally divided into those that stimulate uterine contractility and those that affect the dilatation of the cervix.

Methods affecting the cervix

For some women, the reason for the slow progress of labor is the unpreparedness of the cervix to open - in the language of doctors, its resistance or immaturity. The most common method to help the uterus “mature” is the use of prostaglandins.

Prostaglandins are hormones that have a pronounced effect on reproductive function. They are found in small quantities in almost all tissues of the body, but most of them are in seminal fluid and amniotic fluid. Currently, the method of introducing a viscous gel or suppositories containing prostaglandins into the vagina or cervical canal is quite widely used.

With this method of administration, unlike others, side effects are minimal, and the effect on cervical dilatation is significant. Prostaglandin does not penetrate into amniotic sac, in which the child is located. They are inserted deep into the vagina in order to speed up and then open the cervix, which, in fact, is the initial stage of labor itself. Prostaglandin suppositories also stimulate your body to produce prostaglandin, which causes your uterus to contract. Gels and suppositories are completely safe and do not hinder your movements until their effect begins (after 30 minutes). In the meantime, you can move freely around the room, waiting for the medicine to start working.

Methods affecting the contractile activity of the uterus

In this group, the most popular among obstetricians are amniotomy and synthetically produced analogues of natural hormones, in particular oxytocin.

Opening of the amniotic sac
This method also has another name: amniotomy. It involves the doctor inserting a small plastic instrument that resembles a long hook into your vagina. The instrument is passed through the cervix, grasps the amniotic sac, and then opens it, causing amniotic fluid to leak. This procedure is painless, since the bladder does not have nerve endings, but it may not be entirely pleasant. After the water breaks, the pressure inside the uterus drops sharply. The baby's head begins to press on the pelvic bones and open the cervix, which provokes labor.

Amniotomy is considered a safe method, it does not affect the child’s condition in any way, and any complications are quite rare. To avoid complications, if possible, they try to carry out amniotomy after the fetal head enters the pelvis, squeezing the amniotic sac and the vessels passing along its surface. This prevents bleeding and prolapse of the umbilical cord. If contractions still do not begin, you may need one or another drug to stimulate contractions, since after the water breaks there is a high risk that some kind of infection will penetrate to the baby through the cervix.

Oxytocin
This is a synthesized analogue of the hormone produced by the pituitary gland. The action of oxytocin is based on its ability to stimulate contractions of the muscle fibers of the uterus. Oxytocin is used in the form of tablets, but more often in the form of a solution for intramuscular and subcutaneous injections and especially intravenous administration. The last option for using the drug is the most common. True, it has a significant drawback: a woman with a connected drip system (“drip”) is very limited in her movements.

Oxytocin has no effect on the readiness of the cervix to dilate. In addition, in most women, after oxytocin begins to act, labor pain intensifies, so, as a rule, it is used in combination with antispasmodics (drugs that relax the muscles of the uterus). Different women respond differently to the same dose of oxytocin, so there is no standard regimen for using this drug. Doses are selected individually.

Oxytocin is not used in case of: impossibility of delivering a child through the natural birth canal, abnormal position of the fetus, hypersensitivity to the drug, placenta previa, presence of scars on the uterus, etc.

The most common side effect of oxytocin is excessive contractile activity of the uterus, which can lead to poor circulation in this organ and, as a result, to a lack of oxygen in the fetus.
When is induction of labor justified?

Post-maturity

The most common reason for inducing labor is when the pregnancy is longer than 40 weeks. This can lead to complications from post-term pregnancy, when the placenta is less effective at feeding the baby. Some doctors prefer to artificially induce labor when the pregnancy lasts 10 days, others wait two weeks. During the waiting period, the baby will be monitored to check whether he has any complications (lack of oxygen) or whether his development has slowed down. Amniotic fluid samples are also taken.
Multiple pregnancy after 38 weeks

If you have a multiple pregnancy, labor is induced after 38 weeks because the babies are already mature and allowing them to continue to grow further in the womb can cause problems. Also, if an ultrasound done at 37 or 38 weeks shows that the baby is very large, you may be offered to induce labor to avoid the need for a caesarean section in the future. This is a difficult decision because the baby's weight is difficult to accurately determine.
Medical indicators of the condition of the pregnant woman or fetus

Certain medical conditions for you or your baby may also favor stimulating. Rh conflict and some heart complications that require surgery may require the doctor to induce labor. Stimulation is also recommended if you suffer from gestosis, high blood pressure or diabetes, which worsens your condition or the condition of the baby.
Failure during childbirth
Premature rupture of amniotic fluid (as the likelihood of infection through the cervix increases);
The cervix does not dilate;
Weak, rare, short, unstable, irregular contractions for a long time;
The contractions suddenly stop;
The uterus is too distended due to polyhydramnios, a large baby or twins;
If a woman is tired and completely exhausted from contractions.
Is there a risk?

Labor should only be induced for medical reasons for the well-being of the baby or mother. Inducing labor carries some risks: artificially induced labor may be more painful than natural labor; stimulation may not work, labor will not progress, and this will lead to caesarean section, which would not otherwise be needed.

The decision to induce is made after deciding what is more dangerous: inducing labor or continuing to wait. Your doctor must be confident that the baby will be better off outside the womb, or, if induced due to your health condition, that it is truly necessary.

Even if everything goes smoothly, stimulation still causes discomfort. Artificially induced contractions are almost always stronger than spontaneous ones, the intervals between them are shorter, and the woman in labor does not have time to get used to their gradual increase. During labor that began spontaneously and was then accelerated, the contractions are also stronger. Their power can be shocking. If you are on a drip, you cannot move. You may need more pain medication.

There is a risk of negative consequences for the child. The child and the administration of hormones should be closely monitored. If contractions caused by oxytocin are stronger than necessary for labor to progress, they can reduce the oxygen supply to the baby. All contractions reduce the oxygen supply, but induced contractions are more frequent and the baby has little time to recover from them. Complications in the child usually arise with this method of inducing labor.
Stimulation is not carried out if:
The size of the baby's head does not correspond to the size of the mother's pelvis;
The child feels unwell according to the heart monitor;
Incorrect positioning of the child;
Maternal health problems (such as uterine scars or hypertension)

Share with friends:
Related publications