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Medical tests and treatment

Two thirds of babies are born after the estimated date of delivery. Routinely Obstetricians induce labour at 40 weeks + 10 days or 42 weeks gestation. This is mostly due to them being concerned about how your placenta is functioning and providing nutrients for your baby's growth. You can ask for a ultrasound scan to assess your baby's wellbeing prior to being induced. Most hospitals have protocols of when and for what reason they would like to induce your labour early

If you have an LMC Midwife then they will consult with a Doctor (obstetrician) regarding inducing you medically. You may be seen by the doctor to discuss early delivery of your baby for a medical reason like diabetes, high blood pressure or problems with your baby's growth and development in the antenatal clinic so then it is more planned and you are given a date to go to the hospital to be induced. Or it may happen as a more urgent decision and you may be taken by surprise. Often your midwife will manage the induction and the doctor will be in the background. If any problems develop then the doctors will be more hands on.

Kathys Tip

Ask your midwife how they manage an induction, often the hospital midwives will start the induction and your LMC midwife will arrive once you are in active labour.

Preparation

A few days prior to an induction the Midwife may try a 'Stretch and a Sweep' , which is having a vaginal examination and trying to stimulate your cervix and 'sweep the membranes' which is the balloon around your baby. This can be a little uncomfortable but can also work to try and get you to go into labour naturally.

Ripe?

If your cervix is 'ripe' which means it has already started to soften and shorten 'effacement' and opened up - 'dilated' - a little bit, the induction is seen as more favourable.
If starting an induction when the cervix is 'unripe' - which means it is long hard and closed - this is seen as unfavourable and the induction can be prolonged and end with medical birth outcomes.

The end result of a failed induction has more implications in the postnatal period for Mum and baby.

Stages of Medical Induction
  • Ripening the cervix with some medical gel called  'Prostaglandin' may be done, if needed. This is done by a vaginal examination and your baby's heart rate will be monitored closely as this can cause contractions which your baby can find distressing.
  • Once baby and Mother are seen as healthy then the Mother is free to walk around and mobilise with regular checks of your baby's heart rate and the Mothers wellbeing.
  • Once your cervix starts to open then they will often 'break your waters' called amniotomy. This is again a vaginal examination and your baby will be monitored before and after.
  • They will then start you on an intravenous drip with 'oxytocin drugs' in the IV fluid. You will be monitored continuously with a CTG machine.
  • Medical induction is often more painful than natural birth and you will be offered medical pain relief options.
  • You will stay on all the medical procedures and equipment until your baby is delivered.
Who will do what?

The hospital midwife may administer the gel called  'Prostaglandin' and/or 'break your waters' called amniotomy then when you start on an intravenous drip with 'oxytocin drugs' in the IV fluid your own LMC midwife will arrive and stay until your baby is born.
A Doctor will not be present through the whole labour and birth but it is the Midwifes role to consult with you and them as your labour progresses and seek a more medical presence if the Midwife is concerned.

When labour is induced medically it is vital that the Mother and Baby are closely monitored..