Gynecology And Obstetrics-

Induce labor

introduction

In certain situations it may be necessary to support the birth of the child with medical measures. In this way, the start of labor can be artificially brought about or accelerated by inducing labor.

Substances that stimulate labor are used to ensure that the childbirth process that is still absent or is not yet sufficient really gets going. Depending on the situation and the reason for induction of labor, both medication and natural, homeopathic remedies are suitable for this. Certain behavioral measures can also have a positive effect on the start of labor and the delivery process.

It is always important to have an individual approach with regard to the choice of suitable labor-inducing measures as well as a thorough examination of the indications. Medical supervision and the involvement of the midwife in the induction of labor is therefore essential.

Our next article will give you more information on this topic: Initiate birth

WHEN do you need to induce labor?

There are numerous reasons for labor induction measures, with maternal and child reasons being distinguished. Missing the due date (> 41 weeks of gestation) or so-called transfers (> 42 weeks of gestation) are among the most common reasons for induction of labor.

The situations justified on the mother's side include, for example, liver or kidney diseases, high blood pressure during pregnancy and the associated possible risk situations such as preeclampsia and eclampsia.
Even with diabetes mellitus during pregnancy, labor is often induced, not least because of the often larger than average children and a reduction in the complication rate during the labor process.
If the urinary bladder ruptures prematurely, labor induction is carried out after the birth has not started naturally to prevent possible infections that may arise in the vagina.

Childhood indications for induction of labor can be, for example, both growth retardation, i.e. insufficient child size development, and the well-founded suspicion of a too large, so-called macrosomal child. The elective induction of labor after the 39th week of pregnancy is also controversial. The pregnant woman's wish to accelerate the birth is fulfilled without any health risks or medical reasons making it necessary to induce labor.

Do you have any further interest in this topic? Read more about this under: Rupture of the bladder - does the birth begin now?

Duration until labor begins

The length of time it takes for labor to actually start after taking contractions is always individual for each woman, regardless of the drug used. It can only be a few hours, but it is not uncommon to wait several days for the start of action.

If it is an acute emergency that requires immediate child development, measures to induce or promote labor are no longer an option. In such cases, the pregnancy must be terminated immediately by means of a caesarean section.

For detailed information on this topic, see: Contractions

WHAT is going to induce labor?

How you start labor depends on numerous influencing factors. These include, for example, individual risks, whether previous operations on the uterus have already taken place, the degree of maturity of the cervix or the time frame in which the birth is sought.

MEDICINAL

Prostaglandin: preparations with the active ingredient prostaglandin can be used for cervical maturation. As the body reacts to the increasing shortening and opening of the cervix, labor may increase.
Uterine contraction: the so-called uterine contraction is another drug that can be used to induce labor. This contains the hormone oxytocin and promotes contraction of the uterus and thus supports the expulsion of the child.

MECHANICALLY

Balloon or double balloon catheter: The mechanical measures include the balloon or double balloon catheter. These are introduced through the vagina and cause the cervix to expand, with the associated release of prostaglandins.

Egg-pole solution: an egg-pole solution, also known as cervical stripping, can support the induction of labor through the manual detachment of the membranes from the cervix and the resulting release of prostaglandins. There is no opening of the amniotic sac.
Rupture of the bladder: Another method of inducing labor that is rarely used today is rupture of the bladder. The amniotic sac is opened with a finger or a small medical instrument. This stimulus can cause labor, but it is risky.

ALTERNATIVE MEASURES

Labor cocktails: alternative medical measures such as taking a labor cocktail can also stimulate labor. It is by no means uncommon for several measures to induce or support labor to be either combined or used one after the other.

Would you like to know more about this topic? Our next article provides more information on this for you: Promote labor

Promote labor with prostaglandin

The hormone prostaglandin, which is inserted into the vagina in the form of vaginal suppositories, tampons or tablets, is one of the drugs that trigger labor.

A distinction is made between two commonly used isoforms. The E2 prostaglandin dinoprostone is approved in Germany, whereas the use of the E1 prostaglandin misoprostol is “off-label use”. This means that there is no official approval of the drug for the purpose of inducing labor, but that it is still widely used.

The use of prostaglandins to induce labor is particularly suitable for the immature cervix, as this makes the cervix soft and prepares it for the birth. Due to the increased risk, induction with prostaglandins is not carried out in pregnant women who have already had a caesarean section.

You can find detailed information on this topic on our website at: Prostaglandins at birth

Promote labor with home remedies

Various non-medicinal home remedies can be used to initiate the birth process.

The so-called labor cocktail is one of the best-known home remedies. This is a drink that always contains castor oil and, depending on the recipe, different juices, often apricot juice in combination with almond juice, which are supposed to improve the taste and stimulate the intestinal activity. In most cases, the labor cocktail has a strong laxative effect and can trigger labor through the constant urge to defecate.
However, stomach cramps and diarrhea often occur as undesirable side reactions. Therefore, the consumption of a labor cocktail should not be taken on your own, but always after consultation and advice of the gynecologist or midwife.

Special herbal infusions in the form of teas can also induce labor. Tampons soaked in diluted clove oil, which are inserted vaginally and left in the vagina for about an hour, should also have a labor-inducing effect. However, strict hygiene and correct handling must be observed, as otherwise there is a risk of health risks in the form of bacterial infections.

Alternative medical measures to promote labor can also be used. These include acupuncture or a foot reflexology massage.

If you want to learn more on this topic, check out our next articles below:

Home remedies that promote labor
Acupuncture and childbirth preparation

Promote labor with teas

Various herbs and spices are thought to have labor inducing effects. These include:

Fighter
Cloves
cinnamon
Verbena
ginger

Often, relatively large quantities in the form of several cups of such tea blends are necessary to achieve the desired effect. The preparation can be done according to different recipes, whereby you should always consult your doctor or midwife regarding the correct intake. Some pharmacies already offer ready-made tea blends to promote labor, but these should only be drunk on medical advice.

You can find detailed information on this topic at: Use tea to stimulate labor

HOW can you induce labor yourself?

Induction of labor can be promoted and supported independently through various behavioral measures.

Physical activity: moderate physical activity, such as climbing stairs or walking quickly, can induce labor. Circular movements of the pelvis can also promote labor.
Relaxing baths: warm and relaxing baths as well as aromatherapy can have the same effect.
Sexual intercourse: if the amniotic sac is still intact, sexual intercourse can also have a positive effect on promoting labor. The female orgasm can cause the uterus to contract through the hormone oxytocin and thus promote labor. The prostaglandin contained in the man's sperm can also support the maturation of the cervix during ejaculation in the vagina, making it softer and shortening it.
However, many women do not feel like having sex, especially in the days before giving birth. Nevertheless, simple physical closeness and togetherness in the form of caresses, kisses or targeted stimulation of the nipples can promote labor. Here, too, the contraction-promoting hormone oxytocin is released.
Massages: Massages, especially those of the abdomen, in combination with essential oils such as clove oil can also have a positive effect on labor.
Relaxation & avoidance of stress: It is important not only to want to induce labor through targeted measures, but also to create the right framework conditions for the beginning labor activity and the subsequent delivery process. Relaxation for the body and soul and avoiding stress are essential for this.

You can read more information on this topic here: Induce labor

What are the RISKS of Induction of Labor?

Like any use of medication, the use of labor inducers is not entirely without its risks.

Overstimulation of the uterus: possible side effects of labor-induced active ingredients can be overstimulation of the uterus, for example. This reacts too strongly to the urge to labor and reacts with too frequent and too strong contractions, a real storm of labor. In the context of too fast contractions, the child can also have incorrect attitudes, which means that the unborn child may adopt a posture in the womb that is incompatible with vaginal delivery. Multiparous women have a slightly higher risk of overstimulating the uterus.

Rupture of the uterus or the caesarean section: in very serious, albeit fortunately rare, cases, the uterus can also tear, known medically as a uterine rupture. The risk is increased after surgery on the uterus, for example. This also includes previous caesarean sections. Since the risk is particularly increased when using prostaglandins that promote labor, this is not used in patients with a previously operated uterus.

Changes in the child's heart tones: Changes in the child's heart tones, which can be represented by means of the so-called cardiotocogram (more commonly known under the abbreviation “CTG”), can be triggered by measures to induce labor. Depending on the severity of these changes, rapid child development may be necessary if there is an impending danger to the unborn child, which can usually only be achieved by a caesarean section.
Other risks: Other possible side effects when using medication to induce labor include nausea, vomiting and digestive disorders, often in the form of diarrhea. An increase in body temperature up to fever can also occur.

Following on from this topic, read our next article below: Complications during childbirth