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How to Induce Labor at the Hospital or at Home

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As your pregnancy nears its end, you may want to go into labor as soon as possible for a variety of reasons. You may have a growing baby or certain medical problems that make your doctor think it’s safer for you to deliver immediately. Or, you could pass the 40-week mark and worry about your baby coming (and the pelvic pain, disrupted sleep, and indigestion that will end).

Induction is the official term for the process of stimulating uterine contractions before you go into natural labor. About 22% of pregnant women in the United States experience induced labor, according to the American College of Obstetricians and Gynecologists (ACOG).

To induce labor, doctors often use techniques like dialysis or medication, but some try to turn everything over to alternative methods, from acupuncture to sex. Learn all about these common methods of labor induction and why it’s important to stay in regular contact with your healthcare provider as you consider ways to speed labor.

Labor caused by medicine

Many doctors will recommend induction if your pregnancy has passed 41 or 42 weeks since your placenta has become less effective at feeding your baby by that time. Some doctors recommend anesthesia at 39 weeks because research shows that babies born later have the healthiest outcomes. Previously, induction was only recommended when your or your baby’s health was at risk due to infection, a health condition such as preeclampsia, low amniotic fluid, or other problems.

There are many ways that a medical professional can induce labor. All of these methods should only be performed by a doctor or, in some cases, a midwife or doula. Don’t try them yourself.

A recent study found that those who initiated elective labor at 39 weeks were not more likely to have a cesarean section than those who went into labor after their due date. “This supports the safety of spontaneous onset of pregnancy at 39 weeks,” says Juan C. Sanchez, an obstetrician at the Center for Family Health at NYU Langone. . “However, many in the medical community still prefer to let patients wait for spontaneous contractions rather than schedule elective induction of labor.”

Membrane scan

An amniocentesis scan or stripping is when your doctor, midwife, or doula gently separates the amniotic membranes from your cervix to stimulate the release of prostaglandins, the hormone needed for the “ripening” (softening) of the cervix to prepare for childbirth.

“The membrane scan was done in the office after 38 weeks,” says Meleen Chuang, MD, medical director of women’s health at the Center for Family Health at NYU Langone. “There may be slight bleeding from the cervix and sometimes your water may break.”

Jada Shapiro, fertility specialist and founder of boober, adds that the procedure is sometimes offered for a term after your cervix begins to dilate. “For most people, this will induce labor within a few days.”

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Amniotomy

Most people go into labor within a few hours of their water breaking (when the fluid-filled amniotic sac breaks open). By artificially rupturing this sac, the doctor can start contractions that have not started or have stopped.

To perform amniocentesis, your doctor will use a special device to make a hole in the sac with a special instrument. Sometimes, medication is used along with this procedure to induce labor.

Air balloon tube

A balloon catheter, aka a Foley Bulb, is another option to discuss with your medical team if you’re having a baby. During this procedure, a catheter is placed and inflated with sterile water above the cervix, inside the uterus. The balloon mechanically dilates the cervix.

Dr. Chuang said balloon catheterization does not require the use of drugs. However, it can be used together with medicines such as Cytotec (misoprostol), which is a small pill that is inserted into the vagina or taken by a doctor that releases prostaglandins that help soften the cervix and cause contractions. tighten.

When used along with medication, the balloon has been shown to increase the chances of giving birth within 24 hours. However, this procedure can be uncomfortable and people with broken water cannot take advantage of this option. In addition, patients with previous surgical scars should not use oral misoprostol tablets because of the risk of uterine rupture.

Pitocin / Oxytocin IV . Infusion

Administered in a hospital under close medical supervision, pitocin and oxytocin infusions can be used to increase the speed and strength of contractions, says Dr. Chuang.

“While drug dosage is continuously adjusted to achieve the proper contraction pattern, fetal heart rate variability is continuously monitored to ensure the health of both mother and baby,” said Dr. “. “If the contractions are not well tolerated by the baby, this limits the ability to deliver oxytocin.”

Alternative therapies to induce labor

In addition to medical techniques, many people turn to alternative methods of inducing labor. Although some of these induction techniques have a long tradition of use in some cultures and tend not to be performed in hospitals, it is important to consult your doctor or pharmacist. trained midwives or specialists in trying them.

Chiropractic and massage methods

“There are ways to induce labor beyond conventional clinical methods,” says Shapiro. Chiropractors and specially trained massage therapists try to help correct the pelvis and stimulate labor through certain body movement techniques.

The Webster technique is a gentle adjustment method that chiropractors use to help create space in the pelvis. Some research indicates that this technique can be helpful if the baby is in the breech position. Prenatal massage therapists can stimulate specific acupressure points for labor.

Acupuncture

Acupuncture uses very fine needles that are inserted into specific points on the body to stimulate blood flow or relieve certain symptoms. Although acupuncture appears to be safe during pregnancy, there is limited data supporting its use to induce labor. “Limited Observability [studies] Dr. Sanchez said. “However, the duration of labor does not appear to be shortened.”

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Many acupuncturists emphasize that they do not induce labor, but instead, help a person’s body prepare physically, mentally, and emotionally for it. “We help prepare parents-to-be and prepare for the future,” says Daryl Thuroff, DACM, who holds a PhD in Acupuncture and Chinese Medicine and is the Director of the Body Program at Yinova in New York City. facilitate smooth labor, which is an important differentiator.

Acupuncture-based preparation for labor usually begins at about 36 weeks by a licensed professional. Along with acupuncture, practitioners often use moxa (wormwood) burning on specific parts of the body (usually to try to have a breech baby). Thuroff says they can also use Chinese herbal medicine for placenta masking and massage to help manage anxiety and pain caused by contractions.

Methods to induce labor at home

You must have heard of a friend or family member going into labor because they ate some strange foods or had sex daily during their third trimester. “There are many natural methods and legends that one can try at home to induce labor,” Dr. Thuroff said.

Keep in mind that while some common home remedies may help speed things up for some people, they may not work for everyone and a few have unpleasant side effects, Dr. Dr. Thuroff said.

Eat spicy food

There is very little research showing that spicy foods can induce labor, but some people believe it. Anecdotal evidence suggests abdominal discomfort may be the cause. “Spicy foods, for those unfamiliar, can increase digestive upset and the release of prostaglandins that can help induce labor,” says Shapiro.

Eating spicy foods isn’t usually a problem during pregnancy, but it’s best to make any dietary changes by your doctor. “It wouldn’t hurt to have a known GI disease, but it’s not recommended,” says Dr. Chuang [if you have] irritable bowel syndrome, Crohn’s disease, ulcerative colitis or peptic ulcer disease. ”

Castor oil

Castor oil is taken orally and is a laxative that can cause uterine irritation and contractions. “The An increased bowel movement can help stimulate labor to begin, Dr. Chuang explains.

The science isn’t certain, but some research suggests that castor oil can help induce labor within 24 hours if a woman is 40 weeks pregnant. But don’t try reducing castor oil without first talking to your doctor. “There aren’t any known downsides or harmful effects for the mother or baby but it can cause dehydration, diarrhea, or cramping in the stomach,” says Dr. Chuang.

If you are looking to increase bowel movements to speed up the onset of labor or just to deal with constipation during pregnancy, high-fiber fruits like pineapple, papaya or prunes are a better choice.

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Nipple stimulation

There is some evidence that this age-old technique of midwifery can safely induce labor on or after your due date. “Nipple stimulation can be done every few minutes while you monitor contractions and fetal movements,” says Dr. Chuang.

If your doctor gives you the green light, you can try some sexy games to help move things along. “Massaging and stimulating your nipples and reaching orgasm releases the hormone oxytocin, also known as the love hormone,” says Shapiro. “Oxytocin kicks off labor, induces uterine contractions, helps move your milk during breastfeeding, and is a hormone that promotes bonding.”

Sexual intercourse

“Semen is a prostaglandin and it is thought that stimulation from sex and semen can help promote the release of more prostaglandins,” says Dr. Chuang.

Sex is mostly considered safe during pregnancy, although there are concerns if you have certain medical conditions, including placenta previa or breech pregnancy. Discuss your personal risk factors with your doctor before having penetrative sex in late pregnancy.

Long walk

An easy way to make things go smoothly without side effects? Take a walk! “Walking every day after 37 weeks can help the fetus descend and increase contractions,” says Dr. Chuang.

A routine of gentle, regular pregnancy exercise like walking is a great way to stay healthy and stay mentally healthy during pregnancy. As you hit your due date, any kind of light physical activity can help. “Women who are more active are more likely to have a spontaneous labor,” says Dr. Chuang.

A very good word

It’s only natural that you want to speed up the start of labor as you become increasingly uncomfortable towards the end of your pregnancy. In some cases, such as when you have a medical condition that puts you or your baby at risk for problems before or during childbirth, your doctor may even suggest it. Make sure to talk to your obstetrician, midwife, or other medical provider about all of your labor induction options, both medical and natural. The most important thing is that your baby arrives at the safest and healthiest time and manner for both you and you.

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