Generic activity is a natural process laid down by nature. It occurs after the mother’s body is ready to expel the mature fetus from the uterine cavity. In most cases, this occurs at 38–40 weeks of gestation. If the delivery did not occur on time, the pregnant woman may need artificial stimulation of the birth in the hospital. How this process occurs, what methods are used, what are their pros and cons, read more about this in the article.
Indications for stimulation of labor
In some cases, a woman needs outside intervention to start a natural delivery. And it doesn’t matter whether the first is childbirth or the subsequent ones, whether the pregnant woman had been in conservation for a long time before or entered the ward with contractions. It all depends on the individual characteristics of the body. There are a number of indications for stimulation of labor in the hospital:
- Repotting. At 40 obstetric weeks, the baby is considered 100% mature, although childbirth can begin at 38 and 39 weeks. Each case is unique. Until 41 weeks, doctors, as a rule, still observe the pregnant woman, recommending natural methods of stimulating labor for this period, but after this period they begin decisive actions. Overexposure is fraught with aging of the placenta and a change in the consistency and color of amniotic fluid, in which toxins accumulate. This condition can be dangerous for the fetus.
- Water discharge without the onset of labor. If 12-24 hours have passed since the outflow of amniotic fluid, and the contractions do not intensify, doctors try not to delay with emergency care.
- Termination of contractions. It happens that the labor that has begun suddenly stops, the contractions subside, and the cervix is not smoothed out.
- Problems associated with the normal development of the fetus. If the baby's weight at 40 weeks is less than 2500 g and more than 4500 g, medical stimulation is performed. In the first case, the child may not receive the necessary nutrients, and in the second case, intervention in the natural process is necessary in order to avoid complications in childbirth, which is associated with a large weight of the fetus.
- Chronic pathologies in the mother. If a pregnant woman has a history of kidney, heart, and vascular diseases, stimulation is carried out already from 38 weeks.
- Multiple pregnancy. As in the previous case, intervention in labor is carried out after 38 weeks, when the babies are already fully ripe, have a weight of more than 2500 g and are ready for birth.
The benefits of artificial labor stimulation
In some cases, this method is vital for both the mother and the fetus. But focusing only on the estimated date of birth is not worth it. Before making the final decision, an ultrasound examination is mandatory, with which the doctor assesses the condition of the placenta, the amount of water and other indicators. In the normal course of pregnancy, stimulation is carried out only after 41 weeks.
The advantages of such actions:
- reduced risk to the fetus with hypoxia and intrauterine growth retardation;
- relief of a woman's condition with exacerbation of chronic diseases and preeclampsia;
- the resumption or stimulation of labor during weak contractions.
Usually pregnant women are very negative about interfering with the natural process, directly related to the birth of the baby. A good doctor will definitely explain how labor is stimulated in the hospital, and will choose the best way for the woman. All manipulations are carried out only in the department and strictly under the supervision of specialists.
Disadvantages of the method
Any intervention in the natural birth can lead to unpredictable results. That is why it is important to consider not only the pros, but also the minuses of stimulation. The latter include:
- more severe pain compared with natural childbirth without intervention;
- the risk of oxygen starvation of the fetus;
- inconvenience to the woman in labor when used to call contractions of a dropper with oxytocin;
- high probability of having a baby with jaundice and problems from the nervous system.
Most experts oppose drug stimulation. They believe that it is advisable to conduct it only in case of vital necessity, when the expectation of the start of the natural process can be dangerous for the mother and the fetus.
Methods of stimulating childbirth in the hospital
Before interfering with the delivery process, the doctor carefully examines the pregnant woman’s exchange card. Only after that a specific method of stimulation of labor is determined. How this procedure is done in the hospital, directly depends on the chosen method:
- detachment of the amniotic membranes;
- Foley catheter stimulation;
- the use of prostaglandins (candles, gels);
- the use of kelp;
- amniotomy;
- droppers with oxytocin;
- pills for stimulation.
All methods can be conditionally divided into those in which intervention in the process of childbirth is carried out medically, and others, involving a mechanical effect on the cervix. All of them have their advantages and disadvantages.
In some cases, combined methods of stimulation of labor in the hospital are used. How such an intervention goes depends on the methods chosen. For example, to prepare the cervix in a pregnant woman, kelp and gel can be used. Combined methods can reduce the risk of cervical rupture during childbirth by 40% and reduce the likelihood of having a baby with hypoxia by almost half.
Mechanical methods of stimulation
The methods listed below require minimal use of medications to start the birth process. These include:
- Detachment of the amniotic membranes. During a gynecological examination, the doctor separates the membranes connecting the uterus with the fetal bladder. This contributes to the production of prostaglandins necessary to activate the birth process. Manipulation is painless for a woman, but can cause her discomfort.
- The use of the Foley catheter. With the help of this urological instrument, gynecologists carry out the expansion of the cervix before childbirth in the hospital. The stimulation is as follows: a catheter is inserted into the cervical canal and filled with water in a volume of 30-60 ml. As a result, the cervix expands so that doctors can begin to actively stimulate childbirth. The disadvantage of this method is that the contractions very rarely begin on their own. Most often, a pregnant woman additionally pierce the fetal bladder and put a dropper with oxytocin.
- Stimulation of labor by kelp. This mechanical method of cervical dilation is more preferable than the use of a Foley catheter. Dry algae with a thickness of 2-3 mm are introduced into the cervical canal. Under the influence of moisture, kelp increase in volume during the day by 5 times, thereby expanding the cervix. The minus of the method is the discomfort that occurs in some women during the introduction of algae into the cervical canal. Despite this, gynecologists very often use this particular method of stimulating labor in the hospital at 41 weeks of gestation.
- Amniotomy. If the woman’s labor activity is weak enough, while the water has not yet departed, you can speed up the process by piercing the fetal bladder. The procedure is carried out using a special tool. After piercing the fetal bladder, water departs and labor begins.
Use of tablets
Very often, the prescription drug Mifepristone is used to stimulate labor in the hospital at 41 weeks. It is worth noting that it is used not only in this case, but also for abortion in the early stages, the so-called medical abortion.
A pill for stimulating labor in the hospital is issued strictly in the presence of a doctor. The drug "Mifepristone" can be quite dangerous if taken in violation of the instructions. The dosage regimen is as follows: the first tablet with a dosage of 200 mg is taken immediately, and the second after 24 hours. If after two days, labor is not activated, then the woman is injected vaginally with prostaglandins in the form of a gel. If the tablet gave the desired effect, childbirth usually begins in a day. At the same time, the fetal bladder is pierced to accelerate the process of the pregnant woman.
If the water has departed, and the cervix is not yet ripe, the second Mifepristone tablet is taken not 24, but 6 hours after the first. This is due to the fact that a long anhydrous period can be dangerous for the fetus.
Contraindications
In order to avoid the negative consequences of artificial intervention in the natural process of the baby’s birth, the doctor should discuss in advance with the pregnant patient all aspects related to the stimulation of childbirth in the hospital: how the procedure occurs, what are the advantages of the chosen method and other nuances. It is important to take into account the state of health of a woman, take into account the results of the latest ultrasound. This will allow you to timely identify all contraindications for:
- cesarean section as a result of previous birth;
- mismatch of the size of the fetal head with the pelvis of a woman;
- improper placement of the fetus or placenta;
- unsatisfactory condition of the fetus;
- premature detachment of the placenta;
- a history of diabetes in a pregnant woman;
- hypertension.
When a pregnant woman identifies one of the above conditions, a woman is not stimulated with medication, but is prepared for surgery.
The consequences of labor stimulation for mother and baby
Any intervention in the work of the pregnant woman is a risk. But the consequences of stimulating childbirth in the hospital can be much less dangerous than having the fetus overtaxed. It must be remembered that while a woman is expecting contractions at 42 weeks of gestation, the baby at this time suffers from a lack of oxygen and nutrients due to an aging placenta. The amount of amniotic fluid after 40 weeks is also gradually decreasing, which in no way benefits the baby.
A woman should not be afraid of stimulation if she has indications for this. If at the 40th week of pregnancy the cervix is immature, the doctor will strongly recommend proceeding to its softening using one of the methods described above. As practice shows, most women are scared of droppers with oxytocin. But in most hospitals, this drug is administered after the cervix has matured, while contractions are not effective enough. In any case, the need for this drug is evaluated by the doctor. A pregnant woman should fully rely on his experience and professionalism.
Is it possible to stimulate childbirth at home?
After 40 weeks of pregnancy, when the delivery did not occur on time, a woman may try to start the natural process on her own. Such methods involve an increase in physical activity and a change in diet. The fact is that many pregnant women have a certain experience or have heard from friends how the stimulation of childbirth occurs in the hospital, therefore they try to delay this moment in every way or to avoid it altogether.
To start the natural process of the baby being born at home, the following can be used:
- Sexual intercourse without a condom. Scientists have proved that prostaglandins contained in male sperm help smooth the cervix, which is especially true when the gestational age approaches its logical conclusion.
- Massage the nipples. It may seem strange, but such a massage really helps to reduce the uterus and the speedy onset of childbirth.
- Long walks in the fresh air. They can be attributed to moderate physical exertion, such as washing floors manually, stepping over a step, etc.
- Warm bath. Moderately hot water along with aromatic oils helps to relax muscles and activate labor.
- Special food. Women who dream of expediting delivery are advised to lean on pineapples, beets, raspberry tea (from leaves), currants, and fresh parsley. All these products contribute to smoothing the cervix, that is, they act as natural prostaglandins.
Reviews on labor stimulation
Many women are familiar with the situation when childbirth did not start on time or this activity was not active enough. In this case, some of them resorted to home methods, while others relied on help from doctors. Judging by the reviews, the stimulation of labor in the hospital is quite easy. Girls note that:
- it was painful, but very fast;
- next time also agree to stimulation;
- when the fetal bladder was punctured, it turned out that the water was dark, so it was decided to stimulate the birth with a dropper with oxytocin.
In general, pregnant women respond positively to stimulation, if necessary. The only negative that they call: very strong and painful fights, which, however, can be experienced for the sake of having a healthy baby.