Labor Induction Techniques - Know Your Options

If you are facing a medically necessary induction you may feel very confused or overwhelmed by the options. There are many induction techniques that you may use at home or in the hospital. Knowing the benefits and risks of each will help you to be a more informed consumer of your care.
Please note that only some risks are listed and a thorough investigation into the full risks of each is warranted and a lengthy discussion with your provider is essential to make the best informed decisions.

Natural Methods
Natural induction techniques are often things you can do at home to help nudge you into labor. Some are more well known and some may seem like old wives tales. ​

            Oxytocin Releasers
Sex

• It is often said what put the baby in, can take the baby out… Semen contains prostaglandins which helps the cervix to dilate. Orgasm also helps things along by causing uterine contractions.

Nipple Stimulation

• Again, this releases oxytocin producing uterine contractions. This can be done with a breast pump or manually. It is very effective. Think… tuning radio dials.

Massage

• By triggering certain acupressure points this can get oxytocin flowing. You can find massage therapists who will perform this massage. Most will not before 41, 42 weeks unless you are facing a medical induction.​

               Body Mechanics
Chiropractic adjustment

• Making sure everything is aligned gives the baby all the room they need to descend through the pelvis without getting stopped by a misalignment. 

               Old Wives Tales
​Walking 

• It won’t start labor but it will keep things going if they have started. 

​Pineapple or mango

• Contains bromelain which is thought to cause cervical ripening but there are no studies confirming this. 
• Different herbs have been theorized as helping but often times only anecdotal evidence exists.​

There are many other methods that some claim to be effective in starting labor. In the end, if the baby isn’t ready to be born, these natural methods likely won’t work. Talk with your provider and find out if your should try these options first if you are facing a medical induction. 

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    Medical Induction Techniques​
Amniotomy or breaking of the waters

• An amniohook, similar to a long crochet hook, is used to break the waters. 
• You do want to know the station of the baby. This is a measurement of descent in the birth canal in relation to the ischial spines. It is measured by centimeters from -3 to +3 above and below the ischial spines of the pelvis.
• If the baby is not engaged in the pelvis, the cord can slip out first when the water is broken and cause fetal distress and an emergent cesarean birth.
• Labor often gets harder often because the cushion of water is gone.
• Mom is usually put on a 24 hour time clock, because without the barrier in place there is a risk of infection. 

Foley Balloon

• They place a foley catheter into the cervix and blow up the balloon putting some pressure on the cervix encouraging dilation. It is oftentimes paired with a prostaglandin overnight and removed in the morning.

Cytotec

• Effective and inexpensive, also often used in postpartum hemorrhage. Causes the uterus to contract.
• Can’t adjust dose once administered.

Pitocin

• Artificial version of the love hormone, oxytocin. It cannot cross the blood brain barrier like oxytocin. This often leads to more painful contractions because the brain doesn’t send out the same endorphins (pain killers) like with an oxytocin surge. 
• Runs through an IV.
• Can be adjusted, so if labor is initiated, can be turned down or off.

Membrane Sweep

• Often done during a vaginal exam. Sterile gloved finger sweeps between cervix and bag of waters to stir up prostaglandin production encouraging cervical dilation. 
• Can cause bleeding, uterine rupture, cause infection, and be painful.

Prostaglandins

• Applied to the cervix to help dilate and efface.
• Found in semen.
• Cannot adjust dosage once applied.

Many of these options can be used to push the body into labor by causing cervical changes, and contractions. They are often paired up together, and can cause extra pain. This can lead to the cascade of interventions.
​ 
Being educated helps you to make informed choices regarding which options you are comfortable with. This can help you and your partner navigate through labor. There are so many options and different interventions that can be offered to you during birth.
​I encourage you and your partner to take an independent childbirth class and empower yourself with knowledge. If you don’t know your options, you don’t have any. Don’t let fear get in your way. You can have an amazing birth! 

I encourage you to watch this Ted Talk to learn more about the benefits of allowing labor to start on its own and why it matters how we are born.

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Paige is a wife and mom of two rambunctious preschoolers. She's a nurse, photographer and Birth Boot Camp childbirth educator located in Sioux Falls, SD. To follow Paige and Sioux Falls Birth Services like www.facebook.com/bbcpaige and follow www.siouxfallsbirth.com.