You're nearing the end of your pregnancy and your consultant or midwife says you need an induction. You're not really sure what an induction is, the process or why it is being suggested for you. You're thinking you should probably ask some questions, but you may not be sure what!
You start asking your friends about induction and start searching the internet for information. Yikes! You read horror story after horror story and wonder if an induction is the best thing for your family. With more information and knowing what to expect along the way, you are more likely to make an informed decision that feels right for you.
Let's start with what an induction actually is! An induction of labour, or being induced, is when attempts are made to start or stimulate labour with forms of medical or natural intervention. Most often when people say they are being induced, they are referring to medically induced labour with pharmaceutical drugs.
An induction may be recommended for a variety of reasons and may include but are not limited to:
A mother going past her baby's estimated birth date
An early rupture of membranes with no sign of contractions starting
A medical condition (such as choleostasis) which may affect the mum and/or baby
Because an expectant parent requests it
It is important to remember that some of the common reasons for induction are medically indicated, while others are not. Knowing the difference can help you decide what feels best for you.
There are many ways to induce labour which may include the use of a foley bulb, gels, artificially rupturing the membranes, a syntocin drip (also known as Pitocin) and more. They are all meant to help the uterus contract, your cervix to respond and dilate so you can meet your baby.
While some people believe these methods can help parents avoid a caesarean birth, there is research showing these interventions are more likely to increase the risk of surgical birth.
YOUR BISHOP SCORE & INDUCTION
If an induction is being recommended, you can of course ask why and also enquire about your Bishop Score. This is an internal assessment of your cervix and helps determine how "favourable" you are for induction. In other words, this exam looks at how likely it is that the tools and techniques used to induce labour will be effective. Research has shown that first time moms with a low Bishop Score have especially higher rates of caesarean birth. A Bishop Score measures the following:
Position- the cervix may be pointing toward the back (posterior), front (anterior) or somewhere in the middle (midway)
Ripeness- the cervix may be firm, medium or soft
Effacement- how thin the cervix is, usually described in percentages "75% effaced"
Dilation- how open the cervix is in centimeters
Baby's position- measured in relation to the pelvis, how deep into the pelvis baby is
Other questions you may like to ask:
How do you intend to induce me?
What is the hospital's standard protocol?
What type of monitoring is recommended during induction?
How much syntocinon (Pitocin) do you start with and how frequently is it increased?
Will syntocinon be stopped or turned down if there are signs of hyperstimulation of my uterus or foetal distress?
Under what circumstances would you recommend moving to a caesarean birth?
Asking questions and becoming more informed can help you decide if an induction feels right for your family. Some choose to go ahead while others would like to delay an induction date to see if they go into labour spontaneously. Many expectant parents take things one day at a time and regularly reassess how they feel.
Ultimately, the choice is yours! This online Bishop Score calculator may be of interest!
