Pregnancy is considered full-term from 38 to 42 weeks. During this period of time, childbirth can begin at any time, therefore, the expectant mother and the gynecologist conducting this pregnancy are always ready. But there are special cases when doctors decide not to wait for a natural delivery and artificially accelerate the process. Indeed, sometimes in time taken interventions can save a mother and a child from many serious problems and even save a life. Below we will talk about methods of stimulating the uterus in the hospital, and how to cause childbirth at home.
What is induction?
Induced labor is the stimulation of labor before the process begins. That is, in other words, doctors using various means and manipulations push the uterus and baby to an early birth. Unfortunately, the procedure is extremely unsafe for both the fetus and the woman in childbirth, and therefore the birth induction is carried out strictly according to the indications and only under the supervision of a doctor. Be that as it may, this is sometimes the only correct way out of the situation.
No self-respecting doctor will abuse induction in order to complete the process as soon as possible. If labor activity is somewhat delayed, but at the same time all the indicators of the mother and the fetus are normal, most likely, the gynecologist will not apply stimulation, but wait for the natural completion.
In what cases do doctors prescribe induction?
In order to start stimulating childbirth, without waiting for the natural course of events, the doctor must have good reasons. Indications for induced childbirth can be both on the part of the mother and on the part of the fetus. Direct indications from the part of the woman in labor are the following:
post-term pregnancy, that is, 42 weeks of pregnancy are going on, and childbirth does not begin;
leakage or outflow of amniotic fluid;
sudden stop or severely weakened intensity of contractions;
low water or, conversely, high water;
multifunctional disorders in the fetal-placenta system, placental abruption;
intrauterine hypoxia;
preeclampsia;
chronic diseases that worsened during pregnancy;
diabetes;
arterial hypertension;
oncology.
Even if the expectant mother is absolutely healthy, and there is no reason on her part, the doctor can still offer stimulation, focusing on the condition of the fetus. Indications for induced childbirth:
delay in fetal development;
rhesus conflict;
fetal malformations, in which intervention is required at an emergency;
fetal death of the fetus.
In what cases is the procedure contraindicated?
If there are no obvious reasons for stimulating childbirth, it is better to tolerate a little more time and wait for the onset of natural labor. In addition, there are a number of factors in which the provoked birth is not only superfluous, but can also be dangerous for the health of the mother and baby. We list the contraindications to induction:
the presence of a scar on the uterus from a previous cesarean section or other surgical interventions;
the fetus is not located head down, that is, is in the transverse or gluteal previa;
placental abruption ahead of time;
more than 3 births in history;
narrow pelvis;
individual intolerance to the drugs that the doctor is going to use.
But it should be understood that the above contraindications are not absolute and can be reviewed by a gynecologist at any time. In each case, doctors decide the issue on an individual basis and may be inclined to use induction if the intended benefits for the mother and baby outweigh the risk. In addition, in some cases, the situation may radically change at the very last moment, for example, the fetus can sharply turn over and take a favorable position for stimulation.
How to cause childbirth in the hospital?
Before stimulating childbirth, preliminary preparation is necessary. First, the obstetrician-gynecologist advises the patient about the drugs and methods of induction, warns of possible risks and complications. Next, the gestational age and general condition of the pregnant woman and the fetus are carefully checked again. After the consent of the future mother, the doctor prescribes induction.
It is a mistake to think that medical staff specially accelerates childbirth so as not to waste time on a pregnant woman. This is not so if stimulation is prescribed to you, which means that there are direct indications.
What method of initiation of labor the doctor will choose depends on the condition of the uterus, more precisely, on the degree of its maturity and, in fact, on the capabilities of the maternity ward.
If the cervix is not ripe
In cases where the cervix is not at all ready for childbirth, the woman is injected with the drug Mifepristone, which is used once in the presence of a doctor. Further, the condition of the cervix is monitored for 72 hours. If during this period of time the neck has become softer and shorter, continue preparations for induction. If no visible results are observed, the doctor may decide on a cesarean section.
When the cervix is ready for childbirth
With a matured neck, the doctor can prescribe the stimulation of childbirth with medication or mechanical stress. The main task is to cause uterine contractions.
By mechanical action is meant the use of a Foley catheter and a puncture of a bubble. Induced childbirth in this embodiment is successful in more than 90% of cases. In the first case, a special catheter is inserted into the cervix and is filled with fluid. Under the influence of gravity, the neck gradually opens.
Amniotomy irritates the uterus and causes it to contract, while the doctor constantly monitors the fetal heart activity and the intensity of contractions. The state of amniotic fluid is separately assessed, if it is light, the observation of the woman continues for some time.
But in some cases, uterine contractions do not begin, and then medications such as Oxytocin go into action. The medicine is administered intravenously and the next 5 hours CTG monitoring is carried out in dynamics. If there is no visible effect, the question of caesarean section is considered.
Possible complications and consequences
Any intervention in the normal course of pregnancy can harm the fetus and mother, especially when it comes to artificial delivery. With stimulation in the maternity hospital, a pregnant woman is constantly monitored by a doctor who checks CTG in dynamics, therefore, a woman in labor has to lie all the time, which leads to fetal oxygen starvation. In addition, there are other complications of induction:
The likelihood of infection increases many times.
Premature detachment of the placenta.
Uterine rupture due to severe contractions. This is usually observed after using oxytocin.
Hypoxia, cerebral dysfunction, cerebral ischemia of the fetus.
Increased uterine bleeding.
In addition, it is known that artificial stimulation of labor with oxytocin contributes to excessive pain, and not every woman is able to endure such pains.
How to stimulate childbirth at home?
Suppose all the waiting periods are over, the baby is not even going to leave his warm shelter, and you are afraid to harm him with medicines. You can try to activate natural contractions.
Before stimulating childbirth at home, prepare everything you need for the hospital in advance, notify your doctor of your intention and consider how you will get to the hospital.
So, here is a list of what a pregnant woman can do to get started in the near future:
Clear-out of the whole house. Just do not take risks and climb high, or even worse - use potent chemicals. Judging by the reviews of women, contractions began after they had washed floors or windows.
Sex. During sexual intercourse, the hormone oxytocin is produced, and sperm contains prostaglandins that soften and prepare the cervix. In addition, an orgasm provokes uterine contractions.
Rubbing the nipples. The principle of the method is similar to paragraph 2: during the massage of the nipples in the body of the pregnant woman, oxytocin is produced, which helps to reduce the uterus.
Walking up the stairs. Hiking or abandoning the elevator will lower the fetus.
Laxatives, microclysters irritate primarily the intestines, and then the uterus. But you need to use such drugs very carefully and only after the permission of the doctor.
Agree or not to intervene?
Recently, the number of births ending in artificial stimulation is growing rapidly. This is due to the new capabilities of doctors to correctly assess the condition of mother and fetus. To agree or not to induction is a personal matter for every pregnant woman, but it is better to listen to the opinion of the doctor, and if you are told that it is really necessary, then that is the way it is.
On the other hand, we already wrote about how childbirth is caused in the hospital and what complications are possible after this. Therefore, if there is no direct evidence, you should not rush things and it is better to wait for natural fights. In cases where there is no strength to endure and you want to give birth as soon as possible, a woman can try the idea of how to cause a birth at home. Naturally, with one caveat - only after the permission of your doctor!