Something that loads of people I work with have to at least fleetingly consider is the possibility of induction. It’s a horrible word and always makes me thing of a lurching pregnant robot shouting, Dalek-style “induction, induction, induction” while mowing you down with a pessary.
The good news is that most of the people who have to think about induction end up leaving those thoughts far behind them when their small person makes an appearance all by themselves. But for those of you whose radar its on, here are a few thoughts and resources that might help.
What is it anyway?
An induction of labour is an attempt to start the labour process via an external intervention, rather than the body’s own natural processes.
This can be something you do yourself (like acupuncture), something your midwife does (like a membrane sweep) or something that happens in hospital (from a prostaglandin pessary, to breaking of your waters to a syntocinon drip). See here for more detailed info on the methods of induction.
Do you need an induction and do you want one?
I don’t know the answer to either of those questions and possibly neither do you. If you aren’t 100% sure of the answer then you probably want to do some more digging to be certain.
Firstly if this is something you are doing yourself to bring labour on, then it’s worth working out why. Why do you feel it’s time for this baby to arrive? What would be the benefit to you, your family and your baby of starting things off now? What would happen if you waited?
If induction is being suggested by your midwife or doctor then you’ll want to have a detailed discussion to find out more. It can sometimes be worth checking who you will see to discuss this and asking to see the consultant. This means you’ll be seeing the most senior, experienced person who often has the level of skill and confidence to see outside of protocol and look at your individual case.
Think about making a list of questions to take with you, at the top of which might well be questions to get you to the bottom of whether you and/or your baby need this induction, based on evidence from tests and examinations of you, or whether this is just standard hospital protocol.
If you are being asked to consent to an induction for reasons of protocol, have a look at my post here and think about whether you feel comfortable with this. Remember it is 100% your choice and while occasionally hospitals use phrases like ‘you have to be induced at 40+10’ or ‘at this hospital all women have inductions before 42 weeks’, they are doing so incorrectly. If you feel more comfortable asking to wait and be monitored then the NICE guidelines tell clinicians clearly that this must offer this option and respect your wishes.
Feel free to ask for time to go away and think about your options – it’s often easier to clear your head outside of the hospital environment.
Is an induction always awful?
If you decide you need/want to have the recommended induction then this doesn’t mean your plans for a positive birth go out the window. Like any kind of birth, having a positive frame of mind, flexible attitude, great support and respect from your team will mean a huge amount.
- thinking in advance about what a positive birth means to you aside from a specific location or definite plan. This is often to do with feeling you have some control over the external factors and feel listened to and respected – totally achievable in an induction setting
- understanding how the induction will progress and working out what you are comfortable with
- taking time at every stage to discuss pros/cons of any further steps and making a positive decision to accept or decline
- making sure you have good support people around you
- bringing home comforts in the the room – don’t be afraid to de-hospitalise the hospital environment
- explore non-traditional options with your consultant – such as using the birth centre/birth pool if your labour starts with 1 pessary
I’ve been to some very positive inductions and know it’s possible!
How can I find out more?
Promise me you’ll get hold of the AIMS Induction booklet – available as an emailable PDF if you need it in a hurry. It sets out loads of great information about induction and gives a balancing perspective to what you may have already heard.
The homebirth website has some great information about going ‘overdue’ and other reasons for induction – useful whether or not you’re planning a homebirth.
The aforementioned NICE guidelines are well worth a read – especially as they say useful things about giving women options of labouring in water and monitoring post 42 weeks.
Over and out!