What to Expect with a Medical Induction
There are a number of reasons that your doctor might suggest an induction, ranging from going past your due date to concerns about the health of you and/or your baby. Whatever the reason, here's a rundown of what you can expect if you're going to be induced! Every induction is different, but here are the most common inductions methods I've seen & what to expect!
**I always recommend talking with your care provider more about these various induction methods, but I hope this article can help give you a basic understanding of induction methods & ideas about what questions to ask!
Cervidil is a vaginal insert placed in the vagina near the cervix that helps to "ripen" the cervix. It looks almost like a tampon, with some gel medication on the end of it near the cervix. Cervidil is usually the first step in induction if the cervix is still not very dilated or effaced. It usually remains in for up to 12 hours, but can be removed earlier if strong contractions begin or at the discretion of your care provider. Sometimes cervidil can cause your cervix to begin dilating, or can even kickstart contractions. It can also help your cervix to soften & become more effaced, which is the first step to inducing labor.
Cook Balloon / Foley Balloon Catheter
The cook balloon is a mechanical method of induction. It is inserted into the cervix & there are 2 balloons, one inside the cervix and one outside the cervix in the vagina. The balloons are filled with sterile fluid to put pressure on the cervix and help encourage dilation. The balloon can be left in for up to 12 hours, but may fall out on its own (or the nurses/care provider may try gently tugging) once you are about 4-5 centimeters dilated. For some women, this will kickstart contractions and get labor started. For others, it may cause some cervical dilation but no contractions. This link has a great video that shows how the cook balloon is inserted & inflated.
The Foley Balloon Catheter is a very similar concept, except it only has one balloon that's inserted into the cervix instead of having two balloons (one inside the cervix and one outside).
After cervidil and/or the balloon, your cervix has been mechanically dilated but your body may not have quite figured out that it's time to go into labor (no contractions or irregular contractions). Pitocin is used to create strong & consistent contractions.
Pitocin is a synthetic form of Oxytocin, which is naturally produced by the body and often nicknamed the "love hormone." Oxytocin is produced while nursing/snuggling/having sex and helps to produce strong contractions. Pitocin is administered through an IV alongside fluids. Once pitocin is administered, most care providers will require continuous fetal monitoring & regular vitals checks on mom to make sure that mom & baby are tolerating the new medication.
Pitocin stimulates contractions. It is usually started at a very low dose, and increased every 30 minutes until contractions are about 2-3 minutes apart.
I think this article from MamaNatural does a great job explaining the benefits, risks, & alternatives involved with pitocin.
Breaking your Water
Once you are sufficiently dilated (usually at least 6 cm), if contractions aren't consistent & strong, or if dilation has "stalled," your care provider may offer to break your water. The idea here is that it removed that cushion between baby's head & your cervix, causing increased pressure directly on your cervix, which can cause faster dilation & strong contractions.
The procedure involved taking a sterile plastic hook (looks sort of like a crochet needle) and inserting it into the vagina to make a very small incision in the amniotic sac. Most people say that it doesn't hurt because there aren't any nerves in the sac, but some may experience some from the insertion.
I always recommend speaking with your care provider before trying anything on your own to encourage baby to come, but this article has some options & I think does a good job of explaining the benefits & risks of various methods.
It Takes Time
Most inductions take some time (over 24 hours) because your body isn't quite ready to go into labor on its own. So make sure to rest as much as you can, watch some good movies, stay hydrated & eat some good high-protein meals. As a doula at inductions, I usually stop by the hospital to say hello & make sure you're settled, and then go home for the evening until you call me to come back. It's important that everyone conserves their energy to feel strong & alert once things get moving!
All of these induction methods have benefits, risks, and alternatives. Have a conversations with your care provider about your options so that you can feel confident making a decision that feels best for you!