Induction

More information Obstetric interventions Augmentation Active management Prostaglandins Artificial membrane rupture Fetal monitoring Forceps delivery Ventouse Episiotomy Caesarean section Cascade of Intervention Reference Material A Guide to Effective Care in Pregnancy and Birth Pursuing the Birth Machine Obstetric Myths versus Research Realities Care in Normal Birth The Thinking Woman’s Guide to a Better Birth Other Resources Useful Websites

When is it necessary?

• If the mother's health or life would be endangered by continuing the pregnancy, for example:
  • severe pre-eclampsia (also known as toxaemia or pregnancy induced hypertension)
  • kidney disease
  • heart condition
  • diabetes

• If the baby's health or well-being is being compromised by remaining in the uterus. For example:
  • signs of placental dysfunction, when the baby is not being properly fed by the placenta
  • membranes ruptured for more than 48 hours with no contractions, and signs of developing infection.

• Less clear-cut reasons, such as:
  • being overdue
  • social reasons
  • doctor's or mother's convenience.

How is it done?
A drip line is attached to a vein in the back of the hand, and synthetic oxytocin (Syntocinon) is steadily released into the body via the drip. The drip is attached to a device which monitors the rate of flow and this rate is gradually increased until contractions are established, lasting one minute and coming every two minutes.

Effects on the mother
Advantages:

	1.	A usually reliable method of bringing on the labour when life or health is at risk
	2.	Social reasons: being able to organise the birth when help is available for other children or the partner can be present

Disadvantages:

	1.	A more painful and stressful labour should be anticipated
	2.	Increased need for analgesic drugs, for example pethidine, epidurals
	3.	Unless the cervix is ready to dilate, the progress will be slow and may lead to a Caesarean section for failure to progress
	4.	If the mother is immobilised in bed she will be less able to find comfortable positions for labour. It should be possible to provide a mobile drip stand; however the attachment of the drip into the back of the hand is often inconvenient
	5.	If an epidural is needed, or exhaustion results from a long, painful labour there is an increased risk of forceps delivery
	6.	Greater chance of early separation of mother and baby due to adverse effects of drugs used or routine following an assisted delivery
	7.	Over-riding of the body's natural production of oxytocin causes decreased sensitivity to naturally released oxytocin in response to the suckling of the baby at the breast. This can lead to difficulty establishing lactation in the first few days post-partum

Effects on the baby
Advantages:

	1.	A usually reliable means of bringing on the labour when the baby's health may be at risk
	2.	The baby can be born at a time when specialist attention and facilities are available, for example, paediatrician for at-risk' babies

Disadvantages:

	1.	The strength and length of contractions may cause fetal distress due to lack of oxygen, and necessitate further intervention
	2.	Increased likelihood of jaundice developing caused by the presence of drugs, (e.g. Syntocinon, pethidine) in the baby's system after birth which have to be metabolised and eliminated at the same time as the extra red blood cells all babies have after birth
	3.	An assisted birth and/or large amounts of analgesia, especially pethidine, may cause baby to have breathing difficulties and a weak sucking reflex
	4.	Early separation of mother and baby if any of these problems are severe
	5.	Increased risk of prematurity if the baby's birth is before term