Preparing for an Induction
It's likely that you are hoping to avoid an induction of labor for your birth. Most of our clients want their labor to start spontaneously for a variety of reasons. If you haven't already, check out our blog post on ways to try to avoid an induction. However, if you find yourself in the position where inducing labor is the best option for the health of you and your baby, we want you to be equipped and prepared for what to expect.
Some reasons why your care provider might recommend induction:
- You have preeclampsia, gestational hypertension, or HELLP syndrome (diagnosed or headed that direction)
- You have Gestational Diabetes
- You are diagnosed with Intrauterine Growth Restriction (your baby isn't growing to a normal weight in pregnancy)
- Your ultrasound shows low amniotic fluid
- Other health condition for you or your baby
- Your pregnancy lasts longer than 41 or 42 weeks (talk with your care provider about when they prefer to induce labor based on passing your due date - many midwives do not routinely recommend induction until closer to 42 weeks. This is always an important conversation between you and your care provider).
Anytime an induction is recommended, it should not occur before 39 weeks unless it is for a medical reason. Sometimes the benefits of delivering a baby before 39 weeks outweighs the risks to the mother, baby, or both of continuing the pregnancy. Usually, however, it's best to have your baby after 39 weeks. Once you reach 39 weeks, an option that is always on the table is to have an elective induction. This means that you can decide that you would like to be induced without a medical reason anytime from 39 weeks on. Some reasons why people might want an elective induction would be because they have a partner who might be deployed soon and they want to be sure that their partner will be with them. Other reasons could be because you are struggling emotionally or physically and would like some control in the situation and you decide that you would like to be induced. While I know that most of our clients don't want an induction (for good reason!), I want you to be informed of all your options.
Length of Labor
The timing of how long it will take from the time you get to the hospital to when your baby is born varies greatly from person to person. It will likely be different if this is a first full term vaginal birth or if you've had a prior vaginal delivery before. It also depends on what your cervix is doing. You can ask your provider if your cervix is favorable (soft, open, thinning) or unfavorable (long/hard, closed, thick) for an induction. If your cervix is favorable then it's likely that your induction will be shorter than if your cervix is unfavorable. In general, expect the process to be long. For most moms, it takes awhile for the process to get started. The longest part of an induction for most people is the early stages - getting the cervix thinned and effaced. Once you get to about 4-5cm, labor tends to get more intense and progress happens faster. It's possible for it to take 24-36 hours just to get the cervix to 4cm or so. Know that it's normal and common for this to take place. We can't emphasize how important it is to be patient with the induction process. In most instances, time is on your side. If you are healthy and your baby is healthy, we have time. Telling your body to start labor before it wants to can take awhile, but you have to be patient. On the other hand - it's possible that your body is ready for labor and just needed a small bit of encouragement to get labor started. In some instances, inductions can be as short as 4 hours from getting to the hospital to having a baby. Just like a rapid spontaneous labor, this isn't that common, but it CAN happen. So if this starts to happen, let your doula know ASAP and we will be right there with you through your rapid induction!
Rest and Nourishment
Rest and eat just like normal for as long as you possibly can. Just like with early labor in a spontaneous (not induced) labor - early labor can take awhile and it's so important to rest and eat in the early stages. For rest, bring in your own pillows and blankets to help you rest better. Turn off all the lights in the room. Bring your own music or sound app to play to drown out background noise. If you are being induced in a hospital, most midwives will encourage you to eat in an induction like normal (depending on your unique circumstances of course). Many doctors will say that you should not eat solid food in the early stages of labor. They usually say "clear liquids only" which includes things like broth, jello, Italian ice, sodas, and water. This is an important discussion for you to have with your care provider. Many clients do not do well when they are on day 2 of eating nothing solid. If you feel like you will do best eating in the early stages, then you need to make a conscious decision about that and talk to your care provider about your hopes and goals for rest and nourishment in the early stages of labor. You can ask your provider to explain to you the benefits and risks of eating during the early stages of an induction to help you decide what you'd like to do also.
One Intervention at a Time
Talk with your care provider about the induction process. Based on your history, your hopes for your birth, your reason for being induced, and what your cervix is doing when they start the induction will help your provider know the best way to start the induction. Inductions commonly include drugs like cytotec or cervadil to thin and soften the cervix. Some providers use a balloon catheter to manually dilate the cervix. Artificially rupturing your membranes (breaking your water) can be a useful tool. And then of course Pitocin is often used. You and your provider likely won't know all the tools that they will use in your induction at the beginning of an induction. They will use one intervention at a time, see how your body and your baby respond, and reassess. This blog post will not go into all the pros, cons, and questions to ask with each of these interventions - we encourage your to take a childbirth class and/or have us as your doulas to help you be informed and best equipped for each of these interventions. But you can always be sure to ask about the benefits, risks, and consider how you feel about each of the interventions. One aspect that we like to emphasize is for you to take each step of the induction as it comes. When you realize that you're going to be induced, you don't need to think that all of your hopes and dreams of an intervention free birth are out the window. You simply just take it one step and a time and see how things go. We will be with you every step of the way!
I want to leave you with a wonderful podcast that we encourage everyone to listen to if they are preparing for an induction. Listen to it here. And then here are a few birth stories from our clients who have been induced:
At the end of the day, remember:
- Be sure to have open and clear communication with your care provider.
- Know that your doula will be with you every step of the way.
- Most important - Remember that an induction means that you are having your baby!