Stimulation of labor

Labor induction - Mayo Clinic

Overview

Labor induction — also known as inducing labor — is prompting the uterus to contract during pregnancy before labor begins on its own for a vaginal birth.

A health care provider might recommend inducing labor for various reasons, primarily when there's concern for the mother's or baby's health. An important factor in predicting whether an induction will succeed is how soft and expanded the cervix is (cervical ripening). The gestational age of the baby as confirmed by early, regular ultrasounds also is important.

If a health care provider recommends labor induction, it's typically because the benefits outweigh the risks. If you're pregnant, understanding why and how labor induction is done can help you prepare.

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Why it's done

To determine if labor induction is necessary, a health care provider will likely evaluate several factors. These include the mother's health and the status of the cervix. They also include the baby's health, gestational age, weight, size and position in the uterus. Reasons to induce labor include:

Nearing 1 to 2 weeks beyond the due date without labor starting (postterm pregnancy).
When labor doesn't begin after the water breaks (prelabor rupture of membranes).
An infection in the uterus (chorioamnionitis).
When the baby's estimated weight is less than the 10th percentile for gestational age (fetal growth restriction).
When there's not enough amniotic fluid surrounding the baby (oligohydramnios).
Possibly when diabetes develops during pregnancy (gestational diabetes), or diabetes exists before pregnancy.
Developing high blood pressure in combination with signs of damage to another organ system (preeclampsia) during pregnancy. Or having high blood pressure before pregnancy, developing it before 20 weeks of pregnancy (chronic high blood pressure) or developing the condition after 20 weeks of pregnancy (gestational hypertension).
When the placenta peels away from the inner wall of the uterus before delivery — either partially or completely (placental abruption).
Having certain medical conditions. These include heart, lung or kidney disease and obesity.

Elective labor induction is the starting of labor for convenience when there's no medical need. It can be useful for women who live far from the hospital or birthing center or who have a history of fast deliveries.

A scheduled induction might help avoid delivery without help. In such cases, a health care provider will confirm that the baby's gestational age is at least 39 weeks or older before induction to reduce the risk of health problems for the baby.

As a result of recent studies, women with low-risk pregnancies are being offered labor induction at 39 to 40 weeks. Research shows that inducing labor at this time reduces several risks, including having a stillbirth, having a large baby and developing high blood pressure as the pregnancy goes on. It's important that women and their providers share in decisions to induce labor at 39 to 40 weeks.

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Risks

Uterine incisions used during C-sections

A C-section includes an abdominal incision and a uterine incision. After the abdominal incision, the health care provider will make an incision in the uterus. Low transverse incisions are the most common (top left).

Labor induction carries various risks, including:

Failed induction. An induction might be considered failed if the methods used don't result in a vaginal delivery after 24 or more hours. In such cases, a C-section might be necessary.
Low fetal heart rate. The medications used to induce labor — oxytocin or a prostaglandin — might cause the uterus to contract too much, which can lessen the baby's oxygen supply and lower the baby's heart rate.
Infection. Some methods of labor induction, such as rupturing the membranes, might increase the risk of infection for both mother and baby. The longer the time between membrane rupture and labor, the higher the risk of an infection.
Uterine rupture. This is a rare but serious complication in which the uterus tears along the scar line from a prior C-section or major uterine surgery. Rarely, uterine rupture can also occur in women who have not had previous uterine surgery.

An emergency C-section is needed to prevent life-threatening complications. The uterus might need to be removed.
Bleeding after delivery. Labor induction increases the risk that the uterine muscles won't properly contract after giving birth, which can lead to serious bleeding after delivery.

Labor induction isn't for everyone. It might not be an option if:

You've had a C-section with a classical incision or major uterine surgery
The placenta is blocking the cervix (placenta previa)
Your baby is lying buttocks first (breech) or sideways (transverse lie)
You have an active genital herpes infection
The umbilical cord slips into the vagina before delivery (umbilical cord prolapse)

If you have had a C-section and have labor induced, your health care provider is likely to avoid certain medications to reduce the risk of uterine rupture.

How you prepare

Labor induction is typically done in a hospital or birthing center. That's because mother and baby can be monitored there, and labor and delivery services are readily available.

What you can expect

During the procedure

There are various ways of inducing labor. Depending on the circumstances, the health care provider might use one of the following ways or a combination of them. The provider might:

Ripen the cervix. Sometimes prostaglandins, versions of chemicals the body naturally produces, are placed inside the vagina or taken by mouth to thin or soften (ripen) the cervix. After prostaglandin use, the contractions and the baby's heart rate are monitored.

In other cases, a small tube (catheter) with an inflatable balloon on the end is inserted into the cervix. Filling the balloon with saline and resting it against the inside of the cervix helps ripen the cervix.
Sweep the membranes of the amniotic sac. With this technique, also known as stripping the membranes, the health care provider sweeps a gloved finger over the covering of the amniotic sac near the fetus. This separates the sac from the cervix and the lower uterine wall, which might help start labor.
Rupture the amniotic sac. With this technique, also known as an amniotomy, the health care provider makes a small opening in the amniotic sac. The hole causes the water to break, which might help labor go forward.

An amniotomy is done only if the cervix is partially dilated and thinned, and the baby's head is deep in the pelvis. The baby's heart rate is monitored before and after the procedure.
Inject a medication into a vein. In the hospital, a health care provider might inject a version of oxytocin (Pitocin) — a hormone that causes the uterus to contract — into a vein. Oxytocin is more effective at speeding up labor that has already begun than it is as at cervical ripening. The provider monitors contractions and the baby's heart rate.

How long it takes for labor to start depends on how ripe the cervix is when the induction starts, the induction techniques used and how the body responds to them. It can take minutes to hours.

After the procedure

In most cases, labor induction leads to a vaginal birth. A failed induction, one in which the procedure doesn't lead to a vaginal birth, might require another induction or a C-section.

By Mayo Clinic Staff

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Labor Induction | ACOG

Amniotic Fluid: Fluid in the sac that holds the fetus.

Amniotic Sac: Fluid-filled sac in a woman's uterus. The fetus develops in this sac.

Amniotomy: Artificial rupture (bursting) of the amniotic sac.

Anesthesia: Relief of pain by loss of sensation.

Breech Presentation: A position in which the feet or buttocks of the fetus appear first during birth.

Cervix: The lower, narrow end of the uterus at the top of the vagina.

Cesarean Birth: Birth of a fetus from the uterus through an incision (cut) made in the woman's abdomen.

Chorioamnionitis: A condition during pregnancy that can cause unexplained fever with uterine tenderness, a high white blood cell count, rapid heart rate in the fetus, rapid heart rate in the woman, and/or foul-smelling vaginal discharge.

Diabetes Mellitus: A condition in which the levels of sugar in the blood are too high.

Eclampsia: Seizures occurring in pregnancy or after pregnancy that are linked to high blood pressure.

Fetus: The stage of human development beyond 8 completed weeks after fertilization.

Fibroids: Growths that form in the muscle of the uterus. Fibroids usually are noncancerous.

Genital Herpes: A sexually transmitted infection (STI) caused by a virus. Herpes causes painful, highly infectious sores on or around the vulva and penis.

Gestational Diabetes: Diabetes that starts during pregnancy.

Hemorrhage: Heavy bleeding.

Hormone: A substance made in the body that controls the function of cells or organs.

Hypertension: High blood pressure.

Intravenous (IV) Line: A tube inserted into a vein and used to deliver medication or fluids.

Kidneys: Organs that filter the blood to remove waste that becomes urine.

Laminaria: Slender rods made of natural or synthetic material that expand when they absorb water. Laminaria are inserted into the opening of the cervix to widen it.

Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women's health.

Oxytocin: A hormone made in the body that can cause contractions of the uterus and release of milk from the breast.

Placenta: An organ that provides nutrients to and takes waste away from the fetus.

Placenta Previa: A condition in which the placenta covers the opening of the uterus.

Preeclampsia: A disorder that can occur during pregnancy or after childbirth in which there is high blood pressure and other signs of organ injury. These signs include an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain over the upper abdomen, fluid in the lungs, or a severe headache or changes in vision.

Prelabor Rupture of Membranes (PROM): Rupture of the amniotic membranes that happens before labor begins. Also called premature rupture of membranes.

Prostaglandins: Chemicals that are made by the body that have many effects, including causing the muscles of the uterus to contract, usually causing cramps.

Umbilical Cord: A cord-like structure containing blood vessels. It connects the fetus to the placenta.

Uterus: A muscular organ in the female pelvis. During pregnancy, this organ holds and nourishes the fetus. Also called the womb.

Essence and types of incentives | Labor motivation

Labor stimulation is, first of all, an external motivation, an element of the labor situation that affects a person's behavior in the sphere of work, the material shell of personnel motivation. At the same time, it also carries an intangible burden that allows the employee to realize himself as a person and as an employee at the same time. Stimulation performs economic, social and moral functions.

The economic function is expressed in the fact that the stimulation of labor contributes to an increase in the efficiency of production, which is expressed in an increase in labor productivity and product quality.

The moral function is determined by the fact that incentives to work form an active life position, a highly moral climate in society. At the same time, it is important to provide a correct and justified system of incentives, taking into account tradition and historical experience.

The social function is provided by the formation of the social structure of society through a different level of income, which largely depends on the impact of incentives on different people. In addition, the formation of needs, and ultimately the development of the individual, are predetermined by the formation and stimulation of labor in society.

The stimulus is often characterized as an external influence on the employee in order to encourage him to work effectively. There is a certain dualism in the stimulus. The dualism of the incentive is that, on the one hand, from the standpoint of the administration of the enterprise, it is a tool for achieving the goal (increasing the productivity of workers, the quality of their work, etc.), on the other hand, from the standpoint of the employee, the incentive is an opportunity to obtain additional benefits (positive stimulus) or the possibility of their loss (negative stimulus). In this regard, we can distinguish between positive stimulation (the possibility of owning something, achieving something) and negative stimulation (the possibility of losing some item of need).

When stimuli pass through the psyche and consciousness of people and are transformed by them, they become internal motives or motives for the worker's behavior. Motives are conscious incentives. Stimulus and motive do not always agree with each other, but there is no “Chinese wall” between them. These are two sides, two systems of influence on the worker, inducing him to certain actions. Therefore, the stimulating effect on the staff is aimed primarily at enhancing the functioning of the employees of the enterprise, and the motivating effect is aimed at enhancing the professional and personal development of employees. In practice, it is necessary to use mechanisms for combining labor motives and incentives. But it is important to distinguish between the stimulating and motivational mechanisms of the behavior of employees and the administration of enterprises, to realize the importance of their interaction and mutual enrichment.

Incentives can be financial or non-monetary.

The first group includes monetary (wages, bonuses, etc.) and non-monetary (vouchers, free treatment, transportation costs, etc.). The second group of incentives includes: social (the prestige of work, the possibility of professional and career growth), moral (respect from others, awards) and creative (the possibility of self-improvement and self-realization).

There are certain requirements for the organization of labor incentives. These are complexity, differentiation, flexibility and efficiency.

Complexity implies the unity of moral and material, collective and individual incentives, the value of which depends on the system of approaches to personnel management, experience and traditions of the enterprise.

Differentiation means an individual approach to stimulating different strata and groups of workers. It is known that approaches to wealthy and low-income workers should differ significantly. Approaches to qualified and young workers should also be different.

Flexibility and responsiveness are manifested in the constant revision of incentives depending on the changes taking place in society and the team.

Incentives are based on certain principles.

Availability. Every incentive must be available to all employees. Incentive conditions should be clear and democratic.

Perceptibility. There is a certain threshold for the effectiveness of the stimulus, which varies significantly in different teams. This must be taken into account when determining the lower stimulus threshold.

Gradual. Material incentives are subject to constant upward correction, which must be taken into account, however, a sharply inflated remuneration, not subsequently confirmed, will negatively affect the employee's motivation in connection with the formation of an expectation of increased remuneration and the emergence of a new lower incentive threshold that would suit the employee.

Minimization of the gap between the result of labor and its payment. For example, switching to weekly wages. Compliance with this principle allows you to reduce the level of remuneration, because. the principle “Less is better, but immediately” applies. The increase in remuneration, its clear connection with the result of labor is a strong motivator.

Combination of moral and material incentives. Both those and other factors are equally strong in their impact. It all depends on the place, time and subject of influence of these factors. Therefore, it is necessary to reasonably combine these types of incentives, taking into account their purposeful effect on each employee.

Combination of incentives and disincentives. A reasonable combination is required. In economically developed countries, the transition from anti-incentives (fear of job loss, hunger, fines) to incentives prevails. It depends on the traditions that have developed in society, the team, views, mores.

Forms of staff incentives

Forms of incentives include material remuneration and additional incentives.

Wages are the most important part of the system of remuneration and labor incentives, one of the tools to influence the efficiency of an employee's work. This is the tip of the iceberg of the company's personnel incentive system, but at the same time, wages in most cases do not exceed 70% of the employee's income. Among the forms of material incentives, in addition to wages, bonuses can be attributed. Bonuses replace the thirteenth salary in many cases. Bonuses are preceded by an assessment or certification of personnel. In some organizations, bonuses amount to 20% of an employee's income per year. Incentives such as profit sharing and equity participation are growing in importance.

Intangible incentives also become important not only because they lead to social harmony, but also provide an opportunity to avoid taxes.

Intangible incentives include such basic forms as payment for transportation costs, discounts on the purchase of company goods, medical care, life insurance, payment for temporary disability, vacation, pensions, and some others.

The concept and essence of labor stimulation

Dikareva Irina Alexandrovna
Ulyanovsk State University
4th year student of the Faculty of Transfer Specialties

Annotation
The article deals with the concept, functions and significance of labor stimulation in a modern organization. The research topic is relevant, since today staff incentives are the main tool for ensuring the efficient use of organization resources.

Key words: management, motivation, incentive, labor stimulation, human resource management

References to the article:
Dikareva I.A. The concept and essence of labor stimulation // Economics and management of innovative technologies. 2019. No. 1 [Electronic resource]. URL: https://ekonomika.snauka.ru/2019/01/16410 (date of access: 11/25/2022).

At present, the most important resource of an organization is its staff, since the success of the company depends on the quality of work. Thus, the task of the modern manager is to use the capabilities of employees as efficiently as possible. Achieving this goal is impossible without stimulation [1, p.159].

Under the stimulus in management science, it is customary to understand the motivating cause of behavior, the interest in doing something. According to E.V. Erentraur, a stimulus is an impact on an employee in order to correct his behavior in an organization [2, p.155], and some authors, including I.V. Gorbachev, consider this concept as a benefit or a set of benefits that forms the motive of labor [3, p.30].

However, in our opinion, a more accurate definition is given by A.V. Shilaev, the researcher reveals the definition under consideration as an external impact on the employee by the management in order to encourage him to work effectively and characterizes it from two positions:

1. On the part of the administration of the enterprise - the incentive is a tool to achieve the goal.

2. On the part of the employee - the incentive is the possibility of obtaining additional benefits (positive incentive) or the possibility of their loss (negative incentive) [4, p.106].

In this regard, positive incentives (the possibility of receiving a bonus or bonus) and negative incentives are distinguished.

Today, there are many definitions of the concept of "labor stimulation". So, A.A. Kogdin believes that labor stimulation is a set of measures that are a means of meeting the specific needs of an employee [5, p. 80], M.B. Bannykh understands this concept as a set of methods of influencing an employee in order to meet certain needs, aimed at inducing to improve labor activity [6, p. 31], and A.V. Vinogradov - a way to reward employees for work, based on a comparison of labor efficiency and remuneration [7, p.109], O.V. Lobtsova, on the other hand, speaks of stimulating labor as a set of economic, organizational and socio-psychological levers of influence on the employee, taking into account his internal incentives and aimed at ensuring the interest of the staff in the results of labor that correspond to the goals of the organization [8, p. 98].

Based on the above opinions, we can conclude that labor incentives are a set of requirements, punishments and rewards that take into account human motives, with the help of which the organization's management influences the employee in order to improve his labor activity.

Thus, labor stimulation has the following characteristics:

1. It is carried out by the administration, the management of the organization;

2. Takes into account the incentive motives of the employee;

3. Aimed at improving the efficiency of the employee's labor activity.

Labor stimulation has a set of specific functions. According to O.V. Lobtsova, this set includes:

1. Economic function, which is expressed in the fact that labor stimulation helps to increase production efficiency, increasing labor productivity and improving product quality.

2. Moral function, which manifests itself in the formation of an active life position and a highly moral climate in society due to incentives.

3. Social function, which is expressed in different levels of income, since people's incomes largely depend on the incentives applied. This is how the social structure of society is formed. [8, p.99].

Researchers such as V.N. Belkin and O.A. Antonov, distinguish the socio-psychological function of stimulation. This function, according to the authors, is the impact that the entire organization of the incentive system has on the formation of the inner world of the employee: his needs, values, orientations and attitudes, as well as the formation of one or another type of attitude to work [9, p.83]. In our opinion, the socio-psychological function is closely related to the moral function, which reflects the degree of influence of incentives on the formation of the moral qualities of the employee and labor morality, therefore, it does not need to be singled out separately.

According to some researchers, including T.V. Podlegayeva, stimulation has an impact on the following characteristics of activity:

1. Effort, which consists in the involvement of the employee in the performance of the labor function of the maximum amount of power, skills and abilities.

2. Effort, which is expressed in the desire of staff to work with full dedication, not to shirk from tasks, to improve their qualifications and improve their abilities.

3. Perseverance, which consists in the performance of the work begun by the employee with interest, desire.

4. Integrity, which is expressed in the responsible performance of work, taking into account all necessary requirements and regulations.

5. Orientation, indicating what the employee is striving for, carrying out certain actions. A person can do work because it brings satisfaction or because he wants to help the organization achieve its goals [10, p.219].

Thus, the stimulation of labor is the most important tool for improving the efficiency of the enterprise, which, influencing the characteristics of the activities of employees, improves the quality of the product or service.

References

Shapiro S.A. Fundamentals of labor motivation: textbook. - M.: "KnoRus", 2016. 296 p.
Ehrentraut E.V. Stimulating the work of civil servants//International scientific journal "Symbol of Science". 2017. №3. pp. 154-156.
Gorbachev I.V. Stimulation of labor as an economic phenomenon// Chelyabinsk humanitarian. 2015. No. 4. pp. 30-34.
Shapiro S.A. Factors for improving the efficiency of personnel work: a textbook. - M.: Publishing House "ATISO", 2012. 222 p.
Kogdin A.A. Motivation and stimulation of labor activity in personnel management//Fundamentals of Economics, Management and Law. 2012. No. 4. pp. 80-83.
Bannykh M.B. Methods of motivation and stimulation of labor in the organization//Problems of economics and management. 2016. No. 1. pp.31-34.
Vinogradov AV Development of labor incentive programs//Young scientist. 2018. No. 41. P. 109-115.
Lobtsova O.
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