Pregnancy

 Natural Induction of labour ………………….

If you are reading this blog I can only assume 1 of 3 things; 1) you are over being pregnant, 2) you have gone over your due date, or 3) your doctor has started to indicate or discuss induction with you.  The problem these days is that many pregnant women believe that their baby is going to arrive on ‘the due date’.  I hate to be the bearer of bad news but the likelihood of this actually happening is very slim.  Health Professionals know the due date by the term: Estimated Date of Confinement (EDC).

They are very generous with this date as +/- 5 days always accompanies this date with most Health Care Professionals classifying a term pregnancy from 37-42 weeks.

Most mums are constantly being asked ‘when is the baby due’ ……. This unfortunately leads to an impatient waiting game.  Here’s a tip to mum’s to be – tell family and friends that the baby is due ‘early’ of ‘late’ in the month it’s due.  Hopefully this will stop people hounding you!

Obviously there are medical ways to induce labour (refer to my previous blog), but many women aren’t aware that there are a few ‘natural’ ways to help stimulate labour.  I’m not saying that these are going to work for you … but they are at least worth a try.  Without repeating myself from previous blogs … remember a baby will come when it’s ready and as long as both of you are well, you are better off letting nature take its course.

It’s important to discuss your options with your chosen Health Care Professional especially if you have any underlying health or medical conditions.

I am sure that everyone has heard that SEX is a common method of naturally inducing a pregnancy (if not you are now!).  I say ‘sex got you into this predicament so sex can get you out!  Found in semen is a naturally secreted hormone by the body known as Prostaglandin.  Prostaglandin helps ripen the cervix which is why in its synthetic form it is commonly used as a means of medical induction.  I know that being 40 weeks pregnant the thought of sex is the furtherist thing from your mind …. It’s worth a shot.  Position is all I will say here.

Acupuncture, Acupressure or Massage; are all independent methods in their own right but have been known to assist with natural induction.  PLEASE do your homework and research that the person treating you is not only a fully qualified practitioner, but also experienced when working with pregnant women.  There are many points that should be avoided during pregnancy and others which can help with the induction process.  Generally 1 – 2 treatment is required from either of these specialized areas – with better results if they were used throughout the pregnancy itself.  Without pointing out the obvious here … You should have reached your due date or have past it AND have discussed your options with your chosen Health Care Professional BEFORE treatment begins.

Nipple Stimulation; allows the release of the naturally secreted hormone Oxytocin.  Oxytocin stimulates the uterus to contract.  This is why the synthetic version of Oxytocin (Syntocinon) is used in Medical induction and augmentations and to assist with the 3^rd stage of labour.  You can stimulate your nipples for 10-15 minutes with your thumb and forefinger – one breast at a time and session 4 times a day.

Stripe & Stretch: (not a stripe & search someone once said during my antenatal classes!!!!). Your midwife or doctor can perform this.  A stripe and stretch involves a vaginal examination where the membranes are separated from the cervix.  A little vaginal spotting is common after this procedure.  I would DEFINITELY go home and have some sex!  With the cervix stimulated and some prostaglandin added to the mix …. You never know what might happen.

Castor Oil: there is a lot on conflicting advice when it some s to castor oil.  Caster oil stimulates the bowels and therefore causes diahorea in the mother (not an overly positive adverse reaction).  This in turn stimulates the uterus to contract…. And labour starts.  Interesting point to note here is that an early sign of labour can be diahorea.  There is a lot of debate and conflicting views on whether castor oil causes the baby to go into fetal distress – proven or otherwise I would stay away.  Instead try some hot spicy food – it too can have the same effect!

Raspberry Leaf Tea: this is Raspberry leaf tea – NOT raspberry tea – there is definitely a big difference in the taste.  Raspberry leaf tea comes in both tealeaf form and for those not keen on the taste, tablets are available.  Raspberry leaf tea is believed to tone the uterus making labour more effective.  Research is limited so once again do your homework and research.  I personally wouldn’t take it before 36 weeks but others recommended it from a lot earlier on.  Discuss your options with your health care provider and ensure they are aware if you have decided to take it.

Walking is an oldie but a goodie when it comes to inducing labour naturally.  Gravity does wonders to ripen a cervix and the increased oxygen supply to both mum and baby can only help the process.  So get on your walking shoes and if you are lucky enough to live near the beach – hit the sand (or pavement for those others).  Make sure you have your mobile phone on you, are wearing a hat and 30+ sunscreen and keep your fluids up.  It is very easy for pregnant women to become dehydrated.  Oh …. And don’t walk in the middle of the day – once again hopefully pointing out the obvious!

Don’t lose sight of the fact that pregnancy and birth are a natural process and as long as both you and your baby are well; your baby will come when it’s ready.  Don’t forget you have the next 60+ years to look after your baby so don’t be in a rush.  Most importantly good luck!

Medical Induction of Labour ……,.

‘Induction’ of labour (IOL) is the medical way to bring on labour and maintaining it.  Induction of labour occurs when the risks of continuing the pregnancy outweighs the risks of inducing the labour to deliver the baby.
It is important to understand the difference between an induction of labour and a labour ‘augmentation’.  Labour augmentation occurs when a labour has naturally started of its own accord but artificial means are used to ‘speed’ it up or maintain it.  Labour induction is starting the labour from scratch.

Obviously, if your baby was meant to be out …. It would be!  Don’t loss sight of the fact that we are trying to bring a baby (that may not be quite ready) out of a body that isn’t ready either …… it may mean we need to do more and more to get this baby out!  Although common and generally successful – IOL don’t always work.

Indications for a labour induction include but are not inclusive to:

• Baby overdue (A term pregnancy is considered between 37 – 42 weeks. Over this time there is an increased risk of fetal demise);
• High blood pressure or Pre eclampsia in the mother (as also commonly referred called PIH / toxemia: there are increased risks to the mother. Induction will occur after weighing up risk to mother and baby);
• Placenta function decrease (occurs for a number of reasons and is diagnosis by ultrasound. The placenta supplies baby with everything.  With decreased function there is decreased blood flow to baby & decreased growth of baby.  Induction is based on case of better out than in);
• Diabetic mother (pregnancy changes glucose and insulin needs of the mother. High levels of glucose and insulin leads to increased growth and fat deposition in the baby leading to an increased chance of having a large baby);
• Medical conditions in mother (pregnancy has significant effects on the body and existing problems can be made worse. Induction will occur after weighing up risks to mother and baby).

It is important to know that both mum and baby will be monitored throughout the entire induction process. Before induction, the doctor or midwife will perform a vaginal examination to determine if the cervix has started to dilate.  In turn this will determine the method of induction to be used.

Research also indicates that a medically induced labour does not increase the risk of a caesarean section and/or increase the risk to the baby. Pain relief options/use has been shown to be increased with an induction of labour.

There are a number of medical methods of induction including:

Prostaglandin:  A naturally found hormone that helps ripen, soften and hopefully thin and dilate the cervix.  The prostaglandin gel (Prostin) is inserted vaginally near the cervix.  Sometimes 2 or 3 doses over 24hours may be required.  If the cervix is very unfavorable a pessary (cervidil) may be inserted to assist the cervix to ripen and/or dilate overnight.

Artificial rupture of the membranes (ARM):  This is when the doctor or midwife breaks the bag of waters with a small hook known as an amnihook.  The aim of this is to trigger the onset of contractions and labour begins.  For the waters to be broken the cervix needs to be at least 1-2cm and head must be well down.  It is preferable that the baby is delivered within 24 hours due to risk of infection.  ARM can also be used as a labour augmentation.

Syntocinon:  This is an artificial form of the naturally secreted hormone from the pituitary gland – oxytocin.  Oxytocin stimulates the uterus to contract.  Synthetic oxytocin, Syntocinon is administrated through the drip and slowly increased until the uterus in contractions are frequent and strong.

You may only need one of these methods …. Or you may need all 3 depending on how your labour is progressing. It is possible to induce labour naturally.  Please read Naturally Inducing Labour!

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