How does an induction work??

[Boomerslady]

So as you all know by now I'm going in later to be induced.

All I know about it is what I was told at my antenatal, which is that they put some sort of capsule up there (I guess that softens the cervix)

But when it was booked in for the induction I was told as I was already 1cm they'd attempt to break my waters straight away.

Can anyone give me any idea as to how it'll work?? As if they do break my waters then surely my cervix will be soft already.... Also will contractions start straight away? I hate being clueless as it'll make me feel more scared.

Any wisdom/knowledge you can impart would be great.

 

[PieMistress]

Hi B,

I can't speak from experience so don't know but just wanted to say that I hope it all goes well (and we have the same due date - today!). I might very well be coming back to check this thread if bubs hangs in there!

Will be thinking of you!

x

 

[Boomerslady]

Thanks piemistress I hope your LO is here in time for Christmas

Your buba could be here before mine as god knows how long an induction will take!!

I'll keep an eye out for your birth story

 

[anothersquish]

Normally they will wait til 3/4cm to break your waters but if they can get at them to do it its about the easiest and quickest way to kickstart contractions. If you are already dilating they may do one 'capsule' (or none!) then break your waters and see if that does the trick. If your contractions dont get going in a timely fashion they will want to put you on a drip which will help speed things along, its this bit that people generally say makes labour more painful.

 

[Snoopy]

The usual methods are a prostaglandin gel or pessary inserted to soften the cervix, artificial rupturing of the membranes (ARoM) and artificial oxytocin (syntocinon in the UK, pitocin in the US) given by drip to start or strengthen contractions. There's no point in starting contractions if the cervix is still unfavourable, and ARoM is done to speed up contractions and make them more effective.

HTH

 

[Boomerslady]

Thanks very much ladies

So if they can break my waters straight away they will. If not they'll insert a pessery and check again in the morning, then keep giving me more pesseries until they can be broken?

Do they only put you on a drip once they've broken your waters??

I'm still hoping it'll be quick so I can be home for Christmas. Thanks very much for the info as now I'll know roughly how far along I am.

 

[Snoopy]

Pretty much. If your cervix is already favourable, they can either choose ARoM first before putting you on syntocinon to see if that does the job adequately, or they can just go for the drip straight away and do ARoM to make it more effective afterwards.

Have you had any internals recently? D'you know how favourable your cervix is already?

 

[Beltane]

I was induced with my last child and it was fabulous! It all depends on your hospital but with me, they hooked me to an IV and gave me pitocin around 8 am. I sat and waited and watched tv with my husband all day. Was able to see the contractions on a screen but couldn't feel them. They broke my water in the afternoon and then I got an epidural. I gave birth at 4:30 p.m. It was just wonderful! Good luck!

 

[PieMistress]

What would happen if your induction date came around and your cervix was still 'unfavourable' - can they still induce?

 

[Boomerslady]

Pretty much. If your cervix is already favourable, they can either choose ARoM first before putting you on syntocinon to see if that does the job adequately, or they can just go for the drip straight away and do ARoM to make it more effective afterwards.

Have you had any internals recently? D'you know how favourable your cervix is already?

Snoopy you're a star!!!! I had an internal on Tuesday and she said my cervix was 1cm and favourable. That's about all she told me!!

I'm sooo nervous it's silly. I'm more worried as I'm pretty sure my OH will be sent home when I go onto the ward, I'm secretly hoping I'll be 3-4cms already and they let me stay in the labour suite, but I know that's very unlikely!!!

 

[Boomerslady]

What would happen if your induction date came around and your cervix was still 'unfavourable' - can they still induce?

From my limited knowledge my doc told me when I was admitted last week that if my BP hadn't come down overnight they'd induce me even if my cervix was unfavourable, so it must be possible.

Plus if your being induced at say 10 days over they do it no matter what.

I think anyway!!!

 

[Snoopy]

They'll 'force' your cervix to be favourable by the pessary or gel - it's prostaglandins that soften and dilate your cervix naturally, so they'll just use artificial ones to do the job instead

 

[LouLou78]

Here is a detailed account of the induction process at my unit, this may vary at different units but hope it helps.

At my unit when a woman is admitted once we are happy with a pre-prostin CTG to ensure baby is happy, the woman's medical history is noted including previous pregnancies and the woman is not contracting already, then an examination occurs to assess the cervix and a Prostaglandin pessary or gel will be inserted into the vagina to soften the cervix and encourage uterine tightenings. You may be a lucky one who is already ready to have an ARM (Artificial Rupture of Membranes) with no need for prostin. 6hrs later following prostin you are re-examined to see if you require another prostin or if you can have another. If you are contracting then a pessary will have to be witheld for that examination and a normal stretch and sweep is performed. Pessaries are not to be given with uterine activity.

Some women may require 3 or rarely 4 pessaries in total. So as you can imagine, with assessments 6hrly, some women's induction process can take days.

When it comes to breaking the waters it is hope that the cervix is not only open enough to get access to the membranes to break them, but that the cervix is not too long, anterior and has become soft. So it isn't just about dilitation. During the induction process the cervix is scored based on a 'Bishop Score' at my unit. A point is given on length, dilitation, CX position, Baby's head height and CX softness.

Then once a cervix at our unit is favourable for an ARM (Aritificial Rupture of Membranes), the woman is sent to Labour for this. Once an ARM happens the woman may start to contract within 2hrs, often women are contracting before the waters have been broken but if this doesn't happen after an ARM, that is when Syntocinon IV (AkA pitocin) is commenced to make the uterus contract.