General Practice 2022

Induced birth: what é, when é indicated and when to avoid

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Induced birth: what é, when é indicated and when to avoid
Induced birth: what é, when é indicated and when to avoid

Induced labor is a medical procedure to stimulate uterine contractions during pregnancy, for vaginal delivery, being indicated by the obstetrician when labor does not start naturally or when there are situations that can endanger the life of the child. woman or baby, such as low amniotic fluid or fetal growth restriction.

Medical induction of labor is usually performed from 37 weeks of pregnancy, but there are home methods that can facilitate the process of starting labor at the end of pregnancy, such as having sex, if the woman feel comfortable for it, or stimulate the nipples, for example.

Although there are several indications for induction of labor, all of them must be well evaluated by the doctor, because sometimes, it may be safer to opt for a cesarean section instead of trying to stimulate the beginning of labor.See how the cesarean is performed and when it is indicated.

When to induce labor

Induction of labor must always be indicated by the obstetrician, which usually happens in the following situations:

  • Pregnancy that goes beyond 41 weeks without the onset of spontaneous contractions;
  • Rupture of the amniotic fluid bag without onset of contractions within 24 hours;
  • Infection in the uterus, called chorioamnionitis;
  • Gestational diabetes;
  • Preeclampsia, which is the development of high blood pressure during pregnancy and can affect other organs;
  • High blood pressure before pregnancy or that developed before 20 weeks of pregnancy;
  • Gestational hypertension, which develops after 20 weeks of pregnancy;
  • He alth problems such as kidney or lung disease, or obesity;
  • Rh factor mismatch;
  • Fetal growth restriction, in which the baby stops growing at the expected rate, due to having a lower weight than expected for the gestational age;
  • Decreased amount of amniotic fluid;
  • Total or partial placental abruption.

Furthermore, the appearance of diseases such as fatty liver or gestational cholestasis brings risks to the baby, and it may also be recommended to induce labor in these cases.

How is labor induction performed in the hospital

Induction of labor is performed by the obstetrician in the hospital, who may use one or more techniques together, according to the maturation of the cervix or the stage of labor.

The main labor induction techniques performed in the hospital are:

  • Use of oxytocin applied directly into the vein: is the hormone that stimulates contractions of the uterus. This form of labor induction is most effective in accelerating labor that has already begun;
  • Rupture of the amniotic sac: is done during the digital examination and is done when the cervix is ​​partially dilated and the baby's head is deep in the pelvis;
  • Placing a probe or special catheter into the cervix: contains an inflatable balloon filled with saline solution to encourage the cervix to mature;
  • Use of synthetic prostaglandins: are placed inside the vagina to thin or soften the cervix.

These four ways are effective and should only be performed in the hospital, where the woman and baby can be well accompanied by a team of doctors and equipment, which may be necessary if there is a need for an emergency procedure.

How long does the induction take?

After the process of inducing labor begins, the time for labor to begin will depend on how mature the cervix was before induction, the technique used by the doctor, and how the woman's body responds to the induction technique chosen by the obstetrician.

Is induced labor more painful?

Usually induced labor hurts more than spontaneous labor, but this can be resolved with epidural anesthesia. Those who want a natural birth, without epidural anesthesia, can control labor pain through correct breathing and the positions they can adopt during childbirth. Learn how to ease the pain of labor.

What to do to start labor naturally

Other ways to facilitate the beginning of labor naturally and that can be performed with the knowledge and guidance of the obstetrician, are:

  • Physical exercise, such as a long walk
  • Nipple stimulation, as it helps to promote the production of oxytocin causing the uterus to contract, inducing or increasing labor;
  • Sexual intercourse in late pregnancy can help release oxytocin during orgasm, favoring uterine contractions and labor;
  • Acupuncture Sessions.

Also, drinking raspberry tea can also help prepare the uterus for delivery, helping labor to progress at a good pace and not be as painful. See how to prepare raspberry tea to induce labor.

When it may be dangerous to induce labor

Induction of labor is not indicated and therefore should not be performed when:

  • Fetal distress or dead fetus;
  • More than 2 previous cesarean sections, due to the presence of scars in the uterus;
  • Prolapse of the umbilical cord;
  • Pregnancy with twins or more babies;
  • Baby is in a sitting position or not turned upside down;
  • Maternal pelvis is not wide enough for the baby to pass through;
  • Active genital herpes in women;
  • Full or partial placenta previa. Understand what placenta previa is;
  • Vasa previa, which consists of the proximity of the blood vessels of the umbilical cord to the internal orifice of the uterine cervix;
  • Decreased baby's heartbeat;
  • Baby is very large, weighing more than 4kg;
  • Positive HIV serology in women.

However, the decision to induction of labor should always be discussed with the physician, taking into account several factors that assess the risk and benefit of induction.

Possible complications

Some complications may occur during induction of labor such as failure in the induction process, which may require a cesarean section, increased risk of infections when using the amniotic sac rupture technique, or a decrease in the baby's heartbeat due to to the use of drugs to induce labor, which can cause excessive contractions, and as a consequence decrease the amount of oxygen for the baby.

Although rare, induction of labor can also cause uterine rupture, which is the uterus breaking through the scar from a previous cesarean section or uterine surgery, but it can also occur in women who have never had uterine surgery before.

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