Induction of labor is the artificial triggering of birth using various hormonal substances, with the triggering occurring before the onset of labor. Artificial induction of labor is performed for a wide variety of reasons.
What is induction of labor?
Induction of labor is the artificial triggering of birth using various hormonal substances, with the triggering occurring before the onset of labor. In labor induction, labor is artificially induced in a pregnant woman, and there are several possible reasons for this:
- Premature rupture of the membranes
- Missed due date
- Preeclampsia (pregnancy intoxication).
- Diabetes mellitus
- Intrauterine growth retardation
Because many women find artificial induction of labor extremely uncomfortable, it should also be performed only in exceptional situations.
Function, effect and goals
Artificial induction of labor may be necessary for a variety of reasons, as mentioned above. The most important indication from a medical point of view is a missed due date, also known as “carryover”. Normally, a pregnancy lasts 40 weeks. If the calculated date of birth is exceeded, the pregnancy is over. In the 41st and 42nd weeks of pregnancy, mother and child are monitored very closely, and in the second half of the 42nd week of pregnancy, the birth is induced artificially, because the placenta may no longer be able to perform its functions adequately. In this case, there may be circulatory problems and a lack of oxygen in the child. A birth is also induced if labor does not begin after a rupture of the membranes, as otherwise the risk of infection is very high. Diabetic women are also recommended to have the birth induced artificially after the 38th week of pregnancy, because diabetic women often give birth to very large children, which can lead to complications. Other reasons for artificial induction of labor may include:
- Acute or chronic conditions such as so-called preeclampsia (“pregnancy poisoning“) or liver or kidney disease.
- Strong psychological or physical stress
- Undersupply of the child
If the baby is not yet born after the 40th week of pregnancy, it is advised to first try home remedies, including, for example, warm baths, exercise, homeopathic remedies or taking the so-called labor cocktail, a mixture of castor oil, verbena, apricot juice, sparkling wine or cognac. However, drinking the cocktail can trigger very violent contractions and should be monitored medically in any case. Today, there are now twenty different methods of inducing labor. The most common method is the administration of oxytocin, which is injected into a venous blood vessel of the pregnant woman. This method is often combined with opening the amniotic sac. Another way to induce labor is priming with prostaglandin E2, which is inserted intracervically in the form of pessaries, gel, or tablets. Normally, prostaglandins are produced in the body itself. For induction of labor, they are used when the cervix is not yet mature. The prostaglandins cause it to soften and open. Misoprostol is administered orally or vaginally and, compared with prostaglandin E2, leads to a faster birth within 24 hours. However, a so-called labor storm often occurs here as well. Another option for inducing labor is a so-called Eipol solution. In this process, the membrane surrounding the baby is detached from the cervix. This procedure has a stimulating effect on labor and is often repeated two to three times. Bladder rupture is no longer recommended, as artificial rupture of the membrane does not always lead to the hoped-for success and also exposes the baby to the risk of infection. During bladder rupture, the amniotic sac is incised or punctured, allowing the amniotic fluid to drain. This causes the release of prostaglandins and the onset of labor. Natural induction methods are also available, including, for example, clove oil tampons inserted through the vagina. Labor can also be induced by emptying the bowel with the help of an enema.Many midwives also recommend spicy food to stimulate bowel activity in this way. If the amniotic sac is still intact, labor can also be stimulated by sexual intercourse. Seminal fluid contains natural prostaglandins, which can induce labor.
Risks, side effects, and dangers
Many women who have a birth induced artificially often suffer from severe contractions and often require an epidural as well. In addition, other labor-enhancing measures or invasive monitoring methods are often necessary. Furthermore, the likelihood for a cesarean section or vaginally invasive methods (suction cup, forceps) is also increased. If the amniotic sac is opened artificially, this may cause fetal stress, increasing the likelihood of a cesarean section. In addition, umbilical cord prolapse may occur in some circumstances. The risks of prostaglandin are relatively low, which is why it is the most commonly recommended method today. However, overstimulation of the uterus may occur, reducing oxygen delivery to the baby. Syntocinon can cause relatively strong contractions and stress in the baby. Therefore, the mother and baby should be constantly monitored here, and sometimes an epidural is required. However, late effects of artificial induction of labor are not known. Induction of labor should also not be performed in the following cases:
- Allergy to prostaglandins
- Placenta praevia
- Acute genital herpes
- Umbilical cord prolapse
- Mismatch between the maternal pelvis and the fetal head.
- Severe amniotic infection syndrome
