I have had two babies, both boys, both born vaginally in a hospital.
My first baby was born two weeks early and I had a gruelling 24-hour labour, 10 hours of it active labour, vomited after trying the gas, then had an epidural that didn’t really work and had to have assistance getting him out as he got a bit stuck in my pelvis – almost an emergency caesarean but then he finally got out, thank goodness!
My second son came five weeks early and popped out within an hour of active labour, almost in the shower actually, with just two paracetamol tablets to dull the pain!
An epidural can slow down labour so I actually had to be helped along with a dose of synthetic oxytocin to get the contractions going again. I also know a few mums whose babies refused to budge up to two weeks after their due dates, so they needed to be induced.
If you find yourself in the position that you need to be induced, or want to be prepared for what to expect, here are some tips on what to happens when labour is ‘brought on’.
Why do you have to be induced?
It is important to understand the reason you are being induced. For example, you may be overdue, there is a complication with your pregnancy, your waters broke and contractions have not spontaneously started within 24 hours, your baby is not thriving and needs to be born or you and your doctor have made the decision for an elective induction.
If you do not feel comfortable, speak up and ask questions to your doctor as to what is going to happen and why.
There are four main ways that labour is induced and generally the doctor will follow the process until labour is established.
1. Membrane sweeping
If the amniotic sac is still intact, your doctor may try to get labour started by placing a finger inside your cervix and separating the membranes from and stretching the cervix at the same time. This causes the uterus to release the hormone prostaglandin, which should in turn cause the cervix to soften and contractions to start. This process can be uncomfortable, and you may experience some pain and bleeding.
2. Artificial Prostaglandin
If your cervix does not look like it is dilating and effacing naturally, your doctor will then use artificial prostaglandins to soften and open your cervix. It is applied as a gel or pessary into your vagina, close to the cervix.
3. Artificial Rupture of Membranes (ARM)
Again, if the amniotic sac is intact, it can be manually ruptured to encourage natural labour. During an ARM, a special hook is inserted through the cervix and punctures a small hole in the amniotic sac, allowing the amniotic fluid to leak. Once the membranes are broken, the doctor will only allow an hour or so to pass before you may need to attempt another method of induction.
4. Synthetic Oxytocin (Pitocin, Syntocinon)
If regular contractions have not been brought on within a couple of hours by the other methods, your doctor will slowly give you a synthetic form of the naturally-occurring hormone oxytocin via an IV drip. During a natural labour, the bloodstream is flooded with oxytocin, a hormone that stimulates the uterus to contract.
Artificial oxytocin is started at a low dose that is increased until your contractions are established, usually about 30 minutes later. These contractions may be more painful and stronger than contractions brought on naturally. So, if you are considering an epidural, request it in time so that it is working once your labour starts.