How to encourage labour after a sweep
What To Do After A Sweep To Bring On Labour
PREGNANCY
First published on Friday 22 April 2022
Old wives' tales talk about all sorts of natural ways to induce labour – but do any of them work? We investigate what you can do after a sweep to bring on labour
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A membrane sweep is typically performed at 40 weeks of pregnancy, to help kickstart labour.
It involves a midwife inserting their fingers into the cervix, and moving round in a sweeping motion. This separates the cervix from the sac containing amniotic fluid that surrounds your baby. This, in turn, stimulates the production of hormones that can start labour.
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What to do after a membrane sweep
In the majority of cases, you won’t need to do anything after a membrane sweep to bring on labour. Most women go into labour 48 hours after a membrane sweep, according to Cleveland Clinic.
Once you've had your sweep, keep an eye on how your body is feeling for any signs of labour starting. The NHS lists these telltale signs:
- Contractions or tightenings
- Spotting (if you notice heavy bleeding, however, you should tell your midwife or GP immediately)
- Losing your mucus plug (bloody show)
- Backache
- An urge to go to the toilet
- Waters breaking
If you notice these signs, call your midwife asap! It's particularly important to call if your waters have broken, you notice any bleeding, or your baby is moving less than normal, as these could all be signs that you need medical help sooner rather than later.
Aside from that, though, there's nothing particular that you need to do. Just try to relax and be kind to yourself. You'll be meeting your baby any day now!
However, if you feel like you're going mad and just want to try something, there are a few options.
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What are the natural ways to bring on labour?
While a membrane sweep usually helps to bring labour on, there is no guarantee that it will work. If you have had a membrane sweep but haven’t felt any changes, there are a few natural ways to induce labour that you might want to try.
In general, the NHS does not recommend these natural ways to induce labour, as there is not enough clinical evidence that they work. However, in most cases they will not harm you or your baby, so may be worth a shot if you are feeling impatient for labour to start.
If you do decide to try one of these natural methods, make sure to speak with your GP or midwife first. Do not attempt to induce labour before 40 weeks, as that can be dangerous for your baby.
Nipple stimulation
According to the NCT, breast and nipple stimulation can increase the production of oxytocin in your body.
Oxytocin is the hormone that causes contractions during labour, so the theory goes that breast stimulation will also help to bring on labour.
Research has found that pregnant women who massaged their breasts three times a day for 15 minutes from 38 weeks were more likely to go into spontaneous labour without being medically induced.
The study also says that even if massaging your breasts does not induce labour, it can increase the likelihood that you will have a vaginal birth without needing a caesarean.
Sex to induce labour
Oxytocin is also known as the “love hormone”, because your body releases it when you have sex. For this reason, some people say that having sex may help to bring on contractions.
Semen also contains prostaglandins, a chemical that may help to soften your cervix and relax its muscles, according to the NCT.
Your body naturally releases prostaglandins when you go into labour, or your doctor may give you a synthetic version as a pessary to medically induce the birth.
The NHS says that having sex during pregnancy is usually perfectly safe, though you should avoid it if your waters have broken, as it can risk infection.
You may also find that sex is too uncomfortable when you are about to give birth, especially if you are experiencing vaginal or pelvic pain.
Walking
Being upright and gently active may help your baby move down towards your cervix, which encourages it to open, according to this NHS guidance.
It is possible that walking could have the same effect. This study found that walking could reduce the likelihood of a caesarean and the need for medical induction, though more research is needed to confirm this.
One benefit that the NHS says walking does have is as a natural pain reliever. Gentle exercise releases endorphins in your body, which can help relieve some of the discomfort once your contractions start.
Raspberry leaf tea
Many women drink raspberry leaf tea in their third trimester, because they believe it can help to tone the uterus. This would help with contractions when you go into labour.
But clinical evidence that raspberry leaf tea works is very limited, according to this study.
We do not know if drinking it has any significant effect at all on your pregnancy.
Any adverse effects from raspberry leaf tea on your pregnancy lack evidence too, the study says, so it is likely that you can drink it safely if you want to. But it's best to limit all herbal tea in pregnancy to no more than a few cups a day, to be on the safe side.
Warm baths
While NICE says that there is no evidence that warm baths will bring on contractions, having a soak could help you to reduce your aches and pains once labour starts.
If you do decide to take a bath once your contractions start, just be sure not to have the water too hot as this can be bad for your baby.
Acupuncture
Some people recommend acupuncture as a way of inducing labour, as it is believed to stimulate the production of both oxytocin and prostaglandins.
However, the NHS says that there is not enough clinical evidence to support acupuncture’s use in labour.
While it probably does not induce labour, this analysis of NHS data has found some potential benefits of acupuncture.
Having acupuncture may make it less likely that you will need to be medically induced or require a caesarean. But more research is needed to prove this.
Any methods I should avoid?
Homeopathy
Cimicifuga and caulophyllum are two of the most common homeopathic remedies offered to induce labour, as practitioners believe that they can help to stimulate and moderate regular uterine contractions.
However, there is insufficient evidence to support this theory, and NICE advises against using homeopathy to induce labour. So it's best to give it a miss.
Castor oil
Castor oil is a laxative, and is thought to trigger uterine contractions as a side effect. However, research into its effectiveness is inconclusive, and the NHS does not recommend using it to induce labour.
So it's best to avoid using castor oil because it can cause diarrhoea and false contractions, which make going into labour more uncomfortable.
Enemas
Enemas have been given to women because some believe that they would make more room for the baby to be born, and shorten the time it takes to give birth.
But research has shown that enemas do not significantly impact how long labour takes, and can be more of a source of discomfort. The NHS does not recommend using enemas to induce labour.
Proven ways to bring on labour
The NHS says that if your membrane sweep does not work, you will be offered the option of having your labour medically induced.
This usually involves inserting a pessary or gel into your vagina. These can take a while to work, so try not to worry if you don’t start having contractions straight away.
If you have had a tablet or gel, and your contractions do not start after six hours, you may be offered another tablet or gel.
If you have had a pessary, and your contractions do not start after 24 hours, you may be given a second dose.
Your doctor or midwife will explain all your options, and help you make the decision that's right for you.
Wondering what else you should know as you prepare to give birth? Read our other articles below, or ask women who've been there about what to expect in the forum:
Related articles
Giving birth: labour, delivery, and after birth
CHAT: Natural ways to induce labour
11 things midwives wish we wouldn't do before giving birth
Can I make myself go into labour: myths or truths? | Pregnancy, Your pregnancy week by week articles & support
We discuss myths about what brings on labour to find out what’s true and what, if anything, might actually work.
One of the most common questions pregnant women are asked during pregnancy is ‘when is the baby due?’ So it’s understandable that this date becomes all-important and they might feel disappointed if their baby doesn’t stick to the schedule.
The pregnant woman might also feel impatient for labour to start because they're uncomfortable or they might want to avoid a membrane sweep or induction.
If that’s you and you’re wondering how to kick-start labour, it's helpful to remember that most babies do not arrive on their estimated due date.
Here’s why.
Why don’t babies arrive on their estimated due date?
Medical professionals use Naegele’s rule to calculate gestational age, which is based on a standard length of pregnancy and the date of the last period. The ultrasound scan offered between 11 and 14 weeks can confirm or adjust this age (NICE, 2021a). There is some discussion about whether this rule, dating from the 19th century, is helpful as anything more than a guideline (Lawson, 2021). It's good to know that pregnancies can vary in length by 37 days, which is over five weeks! (Jucik et al, 2013)
So a 'term' pregnancy is defined as any time between 37 and 42 weeks. And that’s why women often sail beyond their estimated due date.
Can some foods help bring on labour?
You might have heard that eating certain foods can help to start labour but wonder whether they’re myths. So here’s a rundown of the popular home remedies and whether there’s a grain of truth in any of them.
Spicy foods
Many pregnant women try eating hot curry, believing the laxative effect will stimulate the bowel and then the womb (Chaudhry et al, 2011).
There’s no research showing curry has the desired effect of bringing on labour, though there is a chance of spicy food giving you heartburn if you are prone to it during pregnancy.
Fruits
Fresh tropical fruits like pineapple, kiwi, mango and papaya are high in an enzyme called bromelain. This has never been tested in humans, although two small animal studies showed pineapple could have an effect on uterine tissue (Nuwankudu et al, 2015; Monji et al, 2016).
Pineapple is the popular one to try but the pregnant woman would need to eat a huge amount – which could cause an upset tummy. Still, reaching for fresh fruit is a good way to help maintain a healthy diet during pregnancy.
If you're a fan of dried fruit, then eating dates at the end of pregnancy might help to avoid induction (Al Kuran et al, 2011). One very small study in Jordan found that eating dried dates could help make women give birth closer to their due date and might help make labour shorter (Al Kuran et al, 2011).
The theory is that dates help stimulate the release of oxytocin. But again, more research is needed to say for sure whether it really does help.
Raspberry leaf
Raspberry leaf tea or tablets have long been a favourite among expectant parents (Ferguson, 2009). Raspberry leaf is popular because it's thought to tone the uterus, making contractions more effective (Ferguson, 2009).
Most research suggests that raspberry leaf has no effect on labour, although women in one study did have a shorter second stage of labour and were less likely to have an oxytocin drip than those who didn't take it (Bowman et al, 2021).
So if you are thinking about trying raspberry leaf tea, there is neither any evidence of harm nor any evidence of a positive effect. However, like anything in pregnancy, if you feel it is making you unwell, you can stop taking it and speak to your midwife.
Can sex kick-start labour?
Sex is often hailed as a way of bringing on labour because semen is rich in prostaglandins.
Prostaglandins are present when the cervix softens in early labour, and they are the chemical used in hospital inductions. Having sex or an orgasm also increases levels of oxytocin the ‘love hormone’, which is needed in labour. While sex is often recommended for this purpose, it’s uncertain whether it makes a difference or not (Kavanagh et al, 2001).
Whatever the outcome, sex late in pregnancy won’t harm the baby, although the logistics might be tricky. Having sex after the waters have broken is not recommended because it may increase the risk of infection (NHS, 2021).
Can breast or nipple stimulation kick-start labour?
Breast stimulation is also often suggested because it encourages the body to produce oxytocin, the same hormone that causes contractions in labour (Kavanagh et al, 2005).
Research shows that breast stimulation increases the number of women in labour within 72 hours (Kavanagh et al, 2005). Women in the research performed gentle breast and nipple stimulation on one breast at a time, for a total of one to three hours a day (Kavanagh et al, 2005).
A more recent study showed that breast and nipple stimulation was also associated with a higher chance of vaginal birth (Singh et al, 2014). Breast stimulation can also reduce the chance of excessive blood loss after birth (Kavanagh et al, 2005).
The research was unable to show if breast stimulation would be safe or not for women with more complicated pregnancies (Kavanagh et al, 2005).
Can walking kick-start labour?
Exercise, including long walks, rocking back and forth on a birthing ball, or climbing stairs are all frequently suggested as ways to kick-start labour. The idea is that exercise moves the pelvis, helping the baby to move down and put pressure on the cervix. One study found exercise to be the most common method used to encourage labour at the end of pregnancy (Chaudhury, 2011).
No recent studies have looked at whether walking does help labour to begin, though women who are upright or walking in the early stages are known to have shorter labours (Lawrence et al, 2013).
Staying active and fit in pregnancy will help you adapt to your changing shape and cope with labour, though you will find you need to slow down as pregnancy progresses (NHS, 2020).
Can complementary therapies help labour to start?
Aromatherapy, reflexology, acupuncture and pregnancy massage are often suggested to pregnant women who would like their labour to begin soon. They could be a nice, relaxing treat at the end of pregnancy. You will want to be sure that the practitioner is trained in pregnancy and has experience of treating pregnant women.
However, one study showed that using complementary therapies had no effect on labour starting (Levett et al, 2016). Other research found that acupuncture or acupressure softened the cervix but this did not mean the women who had these therapies would soon go into labour (Smith et al, 2017).
Still no change?
If you are eager to get things moving, don’t despair – it’s not all bad news. Late pregnancy is a good time to do things that help you unwind, like taking warm baths or doing some relaxation exercises.
Do membrane sweeps work?
A membrane sweep is where the midwife sweeps a finger or two around the cervix to separate the membranes around the baby from the cervix. This can release prostaglandins, which may help to start labour (NHS, 2020a).
A membrane sweep might increase the likelihood of labour starting and reduce the need for other forms of induction, but the evidence was low (Finucane et al, 2020). Membrane sweeping did not appear to affect how the baby was born (Finucane et al, 2020).
A membrane sweep can be performed at an antenatal appointment. Sweeps are offered after 39 weeks (NICE, 2021b).
It's good to be prepared and know that a membrane sweep can be uncomfortable and there can be slight bleeding and continued discomfort afterwards (NHS 2020a). Despite the discomforts, women surveyed after having the sweep said they would generally recommend it because they thought it might help to avoid a medical induction (Finucane et al, 2020).
The waiting game
Most women go into labour by 42 weeks (NICE, 2021b).
As the end of pregnancy approaches, you will be offered information about induction, and time to think about the information and ask questions (NICE, 2021b). The timing of any proposed induction will depend on your age, health, and how the pregnancy is going. If you prefer to wait for labour to begin, you will be offered 'expectant management,' which means you and your baby will be monitored more frequently (NICE, 2021b). Some women however prefer not to have either induction or expectant management.
As difficult as it probably sounds, it’s best to try to stay calm and make the most of your last few days without a newborn to care for. You could use the time to socialise or plan in some treats that will help you relax. Your baby will be here before you know it, so now’s the time to enjoy doing something for you.
This page was last reviewed in December 2021.
Further information
Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.
We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.
Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.
References
Al-Kuran O et al (2011) The effect of late pregnancy consumption of date fruit on labour and delivery. Journal of Obtetrics and Gynaecology 31(1):29-31. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21280989 [Accessed 21 March 2021]
Bowman, R. et al (2021) Biophysical effects, safety and efficacy of raspberry leaf use in pregnancy: a systematic integrative review. BMC Complement Med Ther 21, 56. https://doi.org/10.1186/s12906-021-03230-4
Chaudhry Z et al (2011) Women’s use of nonprescribed methods to induce labor: a brief report.
Birth (38):168–171. Available from: https://www.ncbi.nlm.nih.gov/pubmed/21599742 [Accessed 21 March 2021]
Ferguson P (2009) Raspberry leaves turning over a new leaf for pregnancy. Available at : https://www.rcm.org.uk/news-views/rcm-opinion/raspberry-leaves-turning-over-a-new-leaf-for-pregnancy/ (Accessed 21 Mar 21)
Finucane EM et al (2020). Membrane sweeping for induction of labour. Cochrane Database of Systematic Reviews 2020, Issue 2. Art. No.: CD000451. Available at: https://doi.org/ 10.1002/14651858.CD000451.pub3. Accessed 22 April 2021.
Humphrey T, Tucker JS. (2009) Rising rates of obstetric interventions: exploring the determinants of induction of labour, Journal of Public Health. J Public Health (Oxf). 31(1):88-94. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19141563 [Accessed 21 March 2021]
Jukic AM et al (2013) Length of human pregnancy and contributors to its natural variation. Human Reproduction. 28(10):2848-2855. Available from: https://www.
ncbi.nlm.nih.gov/pmc/articles/PMC3777570/ [Accessed 21 March 2021]
Kavanagh J et al (2001) Sexual intercourse for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews. (2):CD003093. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003093/full [Accessed 21 March 2021]
Kavanagh J et al (2005) Breast stimulation for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews. (3):CD003392. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003392.pub2/full [Accessed 21 March 2021]
Lawson, G.W. (2021), Naegele’s rule and the length of pregnancy – A review. Aust N Z J Obstet Gynaecol, 61: 177-182. https://doi.org/10.1111/ajo.13253
Lawrence A, et al (2013) Lewis L, Hofmeyr GJ, Styles C. Maternal positions and mobility during first stage labour.
Cochrane Database of Systematic Reviews, Issue 10. Art. No.: CD003934. DOI: 10.1002/14651858.CD003934.pub4. (Accessed 23 April 2021).
Levett KM et al (2016). Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour. BMJ Open. 2016 Jul;6(7):e010691. DOI: 10.1136/bmjopen-2015-010691.
Monji F et al (2016) Investigation of uterotonic properties of Ananas comosus extracts. J Ethnopharmacol. (193):21-29. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27426506 [Accessed 21 March 2021]
NICE (2017) Intrapartum care for healthy women and babies, Clinical guideline 190. Available from https://www.nice.org.uk/guidance/cg190 (Accessed 23 April 2021)
NICE (2021a) Antenatal care NG201. Available at: https://www.nice.org.uk/guidance/ng201 (Accessed 23 Apr 21)
NICE (2021b) Inducing labour.
NG207. Available at: https://www.nice.org.uk/guidance/ng207 (Accessed 2 December 2021)
NHS. (2021) Sex in pregnancy. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/sex-in-pregnancy/ [Accessed 21 March 2021]
NHS. (2020a) Inducing labour. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/induction-labour/ [Accessed 21 March 2021]
NHS (2020b) Exercise in pregnancy. Available at: https://www.nhs.uk/pregnancy/keeping-well/exercise/
Nishi D, Shirakawa MN, Ota E, Hanada N, Mori R. (2014) Hypnosis for induction of labour. Cochrane Database of Systematic Reviews 8: CD010852. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010852.pub2/full [Accessed 21 March 2021]
Nwankudu, N. O et al (2015) Oxytocic Effect of Ananas comosus Fruit Juice on Isolated Pregnant Rats Uteri. Nigerian Veterinary Journal, 36(4):1318-1326. Available from: https://www.ajol.info/index.php/nvj/article/view/147327 [Accessed 21 March 2021]
Scantamburlo G et al (2007) Plasma oxytocin levels and anxiety in patients with major depression.
Psychoneuroendocrinology. 32(4):407-410. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17383107 [Accessed 21 March 2021]
Singh N., et al, (2014) Breast stimulation in low-risk primigravidas at term: does it aid in spontaneous onset of labour and vaginal delivery? A pilot study. Biomed Res Int. 2014;2014:695037. Available at: https://doi.org/ 10.1155/2014/695037
Smith CA et al (2017). Acupuncture or acupressure for induction of labour. Cochrane Database of Systematic Reviews, Issue 10. Art. No.: CD002962. Available at: https://doi.org/ 10.1002/14651858.CD002962.pub4.
7 mistakes that mothers make from the first day after giving birth.
08.08.2019
I so want to be the best mother for my baby. But the best is the enemy of the good. And now you will see for yourself. We have collected the most common mistakes that young mothers make.
1. Panic
All young mothers, especially those who have given birth to their first child, are constantly norm limits.
And if the baby, suddenly, for some reason, does not want to obey these norms, then the mother begins real panic! “Something he doesn’t sit with us / doesn’t start to crawl / walk / talk,” - such questions are very characteristic of a panicking girl. And now she already thinks that something is wrong with the baby. nine0003
Stop panicking! If the pediatrician says that the baby is completely healthy, then there is no need to invent non-existent diseases for him. Another reason for panic - fear of harming the baby. Of course, a newborn baby seems to be a fragile creature, and the mother, for sure, afraid to hurt him. In fact, kids, despite their external weakness, are very strong creatures. Except Moreover, acting confidently, but gently, you definitely won’t do anything bad to the baby. But panic can make your child restless: remember, children are very susceptible to the mood of adults. nine0003
2. Do not accept help help from her husband and grandparents.
Get busy them, because the baby requires increased attention. Do not refuse the help of relatives and friends: they will give you the opportunity relax or do only those things that you enjoy. nine0003
3. Listen to other people's advice
The other extreme is not just to accept help from relatives, but listen carefully follow them. Some recommendations may be irrelevant or useless, and some may even be dangerous.
Only a mother knows what her baby needs, because it is not in vain that there is a maternal instinct. The only opinion to which worth listening to - this is the opinion of the pediatrician, based on the observation of the child and his examination. nine0003
4. Create sterile conditions
Of course, cleanliness is a guarantee of health! But the pathological desire for cleanliness of some mothers is one of the main mistakes, when a baby appears in the house. Of course, the baby should always be clean and dry, but everything is good in moderation. It is not necessary to treat all surfaces and floors in the children's room with bleach. By killing absolutely all bacteria and microbes, you create the prerequisites for the appearance of allergies in crumbs.
The child's immunity must adapt to the environment. environment and "train" to cope with infections. It is enough to carry out just a wet cleaning - to wash the floors with a clean water and wipe off dust with a damp cloth. Boiling water for bathing is also completely optional, only if you do not take from a well or reservoir. Ordinary tap water goes through several stages of purification and is not dangerous at all. crumbs. If you are calmer with boiled water, then bathe the baby in it until the umbilical wound heals. nine0003
It is not necessary to sterilize toys, bottles and nipples. To keep these things clean and safe to use, it is enough to wash them with water with a detergent for washing children's dishes and pour boiling water over them. Laundry is also an occupation that can be significantly reduced in time. The washing machine "with a bang" will cope with washing, and with boiling diapers and undershirt: use washing powder for washing baby clothes, set the temperature to 90-95 degrees, and two rinse mode. nine0003
5. Forget about themselves
behind them, put on a dressing gown and slippers. But the time allotted for "yourself beloved" is simply necessary! A beautiful and happy mother takes better care of her child, while a tired, routine woman is very quickly slipping into depression.
Of course, it is not necessary to spend a lot of time in salons doing haircut, manicure, massage. It's enough to look neat. Let the bathrobe be replaced by comfortable homemade trousers and a shirt, and instead of tousled hair on your head, you can make a neat styling or a stylish bun. And don't forget about favorite activities. If before giving birth you knitted, sewed, liked to read, draw, etc.
, be sure to allocate them time. This will keep you from "falling out of life". nine0003
6. They make mistakes in feeding
The most important and fatal mistake in this case can be an unreasonable transition to artificial feeding. Mom's reluctance to breastfeed because of the risk of "ruining the breast" or because of the illusion that the baby is malnourished during this period. called "lactation crisis", deprives the crumbs of vitamins and microelements necessary for health, as well as immunity, because antibodies enter the child's body with mother's milk.
In addition, during periods feeding, mother and baby are especially close to each other: such visual communication teaches the baby from the cradle contact people. If you have milk, in no case do not give up breastfeeding! Other A common mistake young mothers make is the early introduction of complementary foods. Because of this, work may be disrupted. pancreas, which can later lead to diabetes.
Therefore, introduce complementary foods only on the appointment of a pediatrician or not earlier than 6 months of age of the baby. nine0003
7. They restrict the child's movements
Some diligent mothers, listening to the advice of grandmothers, tightly swaddle their babies from birth. So they think that baby will sleep more peacefully and not be afraid of their own pens. Others (supposedly for safety reasons), as soon as the baby begins to walk, put him in an arena or a stroller. Tight swaddling not only restricts baby's movements, but also harms his health.
A toddler who cannot move his legs or arms is disturbed in his normal the functioning of the respiratory and digestive organs (hence colic and gaziki). In addition, tight swaddling leads to hip dislocation and dysplasia. If there is a need for swaddling, do it freely. Let the kid under diapers freely moves arms and legs. nine0003
Sitting in a wheelchair or playpen does not allow the feet to develop child: the moment of the first steps may come later.
And in general, the development of the baby in a limited space will run slower. The way out is to encourage your child to explore the world. Let the baby explore the space around him and learns to "stuff bumps": this experience will be much more useful for him than your overprotection.
Induction of labor or induction of labor
The purpose of this information material is to familiarize the patient with the induction of labor procedure and to provide information on how and why it is performed. nine0003
In most cases, labor begins between the 37th and 42nd weeks of pregnancy. Such births are called spontaneous. If drugs or medical devices are used before the onset of spontaneous labor, then the terms "stimulated" or "induced" labor are used in this case.
Labor should be induced when further pregnancy is for some reason unsafe for the mother or baby and it is not possible to wait for spontaneous labor to begin. nine0003
The purpose of stimulation is to initiate labor by stimulating uterine contractions.
When inducing labor, the patient must be in the hospital so that both mother and baby can be closely monitored.
Labor induction methods
The choice of labor induction method depends on the maturity of the cervix in the patient, which is assessed according to the Bishop scale (when viewed through the vagina, the position of the cervix, the degree of its dilatation, consistency, length, position of the presenting part of the fetus in the area pelvis). Also important is the medical history (medical history) of the patient, for example, a past caesarean section or operations on the uterus. nine0003
The following methods are used to induce labor:
- Oral misoprostol is a drug that is a synthetic analogue of prostaglandins found in the body. It prepares the body for childbirth, under its action the cervix becomes softer and begins to open.
- Balloon Catheter – A small tube is placed in the cervix and the balloon attached to the end is filled with fluid to apply mechanical pressure to the cervix.
When using this method, the cervix becomes softer and begins to open. The balloon catheter is kept inside until it spontaneously exits or until the next gynecological examination. nine0077 - Amniotomy or opening of the fetal bladder - in this case, during a gynecological examination, when the cervix has already sufficiently dilated, the fetal bladder is artificially opened. When the amniotic fluid breaks, spontaneous uterine contractions will begin, or intravenous medication may be used to stimulate them.
- Intravenously injected synthetic oxytocin - acts similarly to the hormone of the same name produced in the body. The drug is given by intravenous infusion when the cervix has already dilated (to support uterine contractions). The dose of the drug can be increased as needed to achieve regular uterine contractions. nine0077
When is it necessary to induce labor?
Labor induction is recommended when the benefits outweigh the risks.
Induction of labor may be indicated in the following cases:
- The patient has a comorbid condition complicating pregnancy (eg, high blood pressure, diabetes mellitus, preeclampsia, or some other condition).
- The duration of pregnancy is already exceeding the norm - the likelihood of intrauterine fetal death increases after the 42nd week of pregnancy. nine0077
- Fetal problems, eg, fetal development problems, abnormal amount of amniotic fluid, changes in fetal condition, various fetal disorders.
- If the amniotic fluid has broken and uterine contractions have not started within the next 24 hours, there is an increased risk of inflammation in both the mother and the fetus. This indication does not apply in case of preterm labor, when preparation of the baby's lungs with a special medicine is necessary before delivery. nine0077
- Intrauterine fetal death.
What are the risks associated with labor induction?
Labor induction is not usually associated with significant complications.
Occasionally, after receiving misoprostol, a patient may develop fever, chills, vomiting, diarrhea, and excessive uterine contractions (tachysystole).
In case of too frequent contractions to relax the uterus, the patient is injected intravenously relaxing muscles uterus medicine. It is not safe to use misoprostol if you have had a previous caesarean section as there is a risk of rupture of the uterine scar.
The use of a balloon catheter increases the risk of inflammation inside the uterus.
When using oxytocin, the patient may rarely experience a decrease in blood pressure, tachycardia (rapid heartbeat), hyponatremia (lack of sodium in the blood), which may result in headache, loss of appetite, nausea, vomiting, abdominal pain, depression strength and sleepiness. nine0003
Induction of labor compared with spontaneous labor increases the risk of prolonged labor, the need for instrumental intervention
(use of vacuum or forceps), postpartum hemorrhage, uterine rupture, onset of too frequent uterine contractions and associated deterioration of the fetus, prolapse umbilical cord, as well as premature detachment of the placenta.
