Labor induction: reasons and methods

Whether and when a premature birth is necessary depends, among other things, on your week of pregnancy . If complications arise relatively shortly before the calculated due date, the birth will be initiated even if the risk is relatively low. Because your baby’s organs are already fully developed and his lungs are able to breathe independently. At an earlier stage, the doctor will try to delay the birth of your child for as long as possible.

Reasons for drug induction of labor

• Placental insufficiency: The most common reason for premature labor induction is placental insufficiency. Here the baby is no longer optimally supplied with oxygen.
• Visible danger during screening: If the ultrasound , CTG and Doppler ultrasound examination show that the child is at risk, your doctor may advise you to start the birth.
• Very large child: If your baby is already very large before the 38th week of pregnancy and the course of growth suggests that it will become much heavier, a premature birth can make sense. So you can be relatively sure that your baby will be born healthy and without major complications.
• Premature rupture of membranes without contractions: If there are no contractions due to premature rupture of membranes, the risk of infection for your baby can be prevented by inducing labor with medication.
• Twins: Twins are often born by caesarean section, but spontaneous births are still possible in principle. Because twins are usually born of their own accord before the expected date of birth. But even if one of your children or both of them are no longer being adequately cared for, the birth will be initiated prematurely.
• Illness of the unborn child: If your baby is ill and cannot be treated in the womb, it is also possible that the doctors will initiate the birth. This is especially true if your baby has severe anemia.
• Illnesses of the mother: Even if you are ill, for example with gestational diabetes or pregnancy-related high blood pressure , a premature delivery may be necessary.
• Physical and psychological stress on the mother: If you are increasingly suffering from psychological and physical problems after the 37th week of pregnancy and your baby is already very mature, a premature birth can be initiated.

Labor induction methods

• Induction of labor with oxytocin infusion: With this method, the time of birth can be estimated well and a lengthy induction of labor can be avoided. Your baby will be monitored with the CTG, often with a portable one, from the time of labor infusion. This method is used when the cervix is ​​already soft and dilating slightly, making the uterus ready for labour.
• Induction of labor with prostaglandins:This method of inducing labor is used when the cervix is ​​still immature. The medication is not given to you as an infusion, but as a gel, pessary or tablet placed locally near the cervix. As a result of their influence, the cervix softens and begins to open. After two to three hours, you will have contractions. If you don’t go into labor, you’ll be given more prostaglandins after six hours. Here the CTG is not monitored continuously, it is sufficient if a CTG is written every two hours after the onset of labor. If your cervix is ​​mature, the birth can be further supported with a labor IV. If you don’t start contractions within two days, you have to think about whether you should try again or take a break.caesarean section may be required.

Alternative ways of inducing labor

There are also some alternative methods to the usual means of induction of labor prostaglandins and oxytocin infusion. A few of them are presented here.

• Herbs that promote labor: You can put cinnamon, ginger and cloves in the form of aromatic oils in an aroma lamp or mix them with almond oil and use them as massage oil. If you massage your uterus with it over the abdominal wall in the upper area, you can gently help your baby to get going. A warm full bath with cinnamon leaves, clove or ginger root oil can also have a labor-inducing effect.
• Castor Cocktail : Almost every pregnant woman knows a friend who has tried it. However, doctors strongly advise against this method. Because it causes damage to the intestines, which in turn triggers labor. The contractions thus triggered lead to contractions in the immature cervix without actually initiating labor. However, the contractions can affect the child’s oxygen supply. Without CTG monitoring, this can even become dangerous for the baby. Side effects often include diarrhea, nausea and intestinal cramps. Many women add alcohol to the oil to make the taste less unpleasant. Then there are the harmful effects of alcohol for the child. Despite widespread use, the use of castor oil is therefore not recommended.
• The famous “climbing stairs” : Physical exertion such as climbing stairs can indeed induce labor as it causes more redistribution of blood to the placenta. Nevertheless, doctors advise against this method, because it drains energy that you will urgently need during the birth and of course it is not very reliable.
• Sexual intercourse: Regular sex at the due date reduces the likelihood that your child will be overdue. Sex is believed to work in two ways. On the one hand, it stimulates the production of the labor hormone oxytocin, and on the other hand, semen contains prostaglandins, which also have a labor-inducing effect.
• Egg Detachment: This method is performed around the 40th week of pregnancy and only when the cervix is ​​slightly dilated. The obstetrician puts his finger in the cervix. With a twisting motion, he massages the inner os of the cervix, gently loosening the fetal membranes to induce labor. However, this method needs to be done very carefully as it can be painful for you and cause bleeding. You should therefore think carefully about whether you want to use this method of inducing labor at all.
• Nipple stimulation : Stimulating the nipples releases the hormone oxytocin, which can induce labor. However, this only happens when the cervix is ​​also mature. The method can be used in addition, but is not a recommended measure on its own, as its effect is very uncertain.
• Opening of the amniotic sac: If your amniotic sac is opened and your amniotic fluid is released, the volume in the uterus changes. Contractions are often the result, from which labor develops. However, this method is only recommended for women with a well dilated cervix and multiparous women.
• Complementary therapies: You may find therapies such as prenatal acupuncture or reflexology beneficial. However, reliable induction of labor is not possible with this.