What happens in an induction?
Induction of labour is basically the initiation of labour by artificial means, trying to 'mimic' the body's natural processes.
All hospitals will offer a slightly different induction 'package', but it usually involves a number of steps and can be quite a long process, especially if it's your first baby - although that’s not always the case.
There are generally two phases of starting an induction:
‘Ripening’ the cervix (trying to soften the cervix, where your baby will pass through, and encouraging it to open to start labour). This can consist of a membrane ‘sweep’, a prostaglandin pessary/gel, or a Foley Balloon.
Artificially starting your contractions. This can take the form of having your membranes ruptured (breaking your waters) or being offered a syntocinon drip.
If induction is being discussed it's a good idea to ask what the procedure is at your hospital.
Why might I be offered an induction?
The most common reason for being offered an induction during an antenatal appointment is being 'overdue'. In the UK, as you approach 42 weeks the potential risks of a prolonged pregnancy will be discussed.
If your waters release and labour doesn't start within 24 hours, you'll likely be offered an induction due to potential infection risk.
Potential complications with mum or baby might also trigger induction conversations.
Note the repeated use of the word potential! The evidence for/against induction isn't always clear cut, so it's worth asking questions and doing your own research.
So should I have one?
The decision to have an induction is ALWAYS yours, and yours alone. It might not seem that way sometimes, but it is.
I'm not going to tell you whether you should or shouldn't have an induction - there are so many reasons why you might decide to have one, or might decide not to, and every situation is different.
But there are a few things you might want to consider when you’re making the decision about whether to accept an induction:
Ask questions about YOUR situation. Why is an induction being recommended? Is there any immediate risk to you or your baby? If you’re told there is a risk of X, ask what evidence that’s based on so you can look at it yourself - and also try to do your own research.
Be mindful of how information is presented. Sometimes we are told about the relative risk rather than the actual risk - i.e. You might be told your risk ‘doubles’, but actually what that means is the risk of that happening goes from, for example, 0.5 in 1000 to 1 in 1000. This can be helpful in helping you decide how you feel.
It’s very rare that a decision will be needed immediately - take some time to consider the benefits and risks before making a decision.
Possible risks of an induction are that surges could be stronger and more painful with some methods, and baby’s heart rate may need to be monitored which can restrict your movement in labour. Both of these factors can lead to a ‘cascade of intervention’ - you may be more likely to request an epidural, and/or more likely to have an assisted delivery (forceps/ventouse) or a C-Section.
Follow your instincts and do what’s right for you.
Where can I get more information?
Evidence Based Birth is a great website which looks at the latest research around birth and sets it out in a clear, unbiased way. There are a number of articles about induction on there.
Dr Sara Wickham, a midwife, author and researcher, has also written a number of evidence-based books on induction which can help with your decision-making.
I’ve decided it’s the right thing for me - how can I prepare?
If you’ve decided that being induced is the right thing for you, then there are lots of things you can do to prepare, and to help make it a positive and empowering experience:
Firstly, don’t be afraid to mourn the loss of your ‘plan A’. Take the time to acknowledge those feelings, then start to focus on your ‘plan B’.
Read positive induction stories. There are loads of them out there, and by surrounding yourself in this positivity you can change your mindset and start to release any fears you may have around induction.
Practice your hypnobirthing techniques - fine tune your breathing, do as much as you can to relax, visualise a positive birth. If you have time, find (or write) some positive affirmations about your new birth plan.
Do research and write, or redefine, your birth preferences, with a focus on your new plan.
Boost your oxytocin! Being induced can affect your body’s natural birthing hormones, but doing what you can to produce your own, natural oxytocin can really make a difference and make your birth more comfortable. Download funny films to watch in the hospital, bring familiar, comforting items like your favourite pillow or PJs, have lots of hugs with your partner, light touch massage, go for a walk, comforting snacks - anything that makes you feel good!
If you decide that an induction is the right thing for you, then OWN that decision and focus on how you can make it a positive experience. And you don’t have to justify that decision to anyone - if you’ve come to that decision in an informed way then it’s the RIGHT decision for you.
I talk about induction methods, and how you can use hypnobirthing techniques during an induction, in more detail in my hypnobirthing courses. Click here to have a look at what I can offer.
Katie x
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