There is quite a bit of information on labor inductions out there. With many people opting for elective inductions or medically indicated inductions, I think this is a great time to talk about what I have seen as a doula at labor inductions and what I wish everyone knew going into one to help have the most successful outcomes.
NOTE: This is not a post about shaming anyone for choosing an elective induction or for being induced AT ALL! As a birthing person, you are preparing yourself by making the best decisions possible for you, your baby, and your family.
To give an overview, here are some quick statistics on inductions:
- As of 2014, around 30% of labors in the United States are medically induced, which is close to 1 in 3 labors that are medically induced.
- According to ACOG in 2005, 23.4% of medically indicated inductions and 23.8% of elective inductions end in cesarean sections for First-Time Birthing People.
- For a reference point, the cesarean section rate in the U.S. is close to 32% which is also 1 in 3 labors that result in a belly birth.
Around 75% of my clients will tell me that one of their birth goals is to avoid a C-Section. To work through that goal, we discuss the process of a cesarean, how they can take steps to preventing an unnecessary one, and create a portion of their birth plan that touches on wishes they might have in the event of a cesarean.
Very few of my clients tell me that a birth goal of theirs is to avoid a medical induction of labor unless absolutely necessary. But when I read statistics like the one above and accompany my clients to their induced labors, I wonder why that isn’t a topic of discussion. Based on the above information, it is about as common as a cesarean birth, yet there isn’t much knowledge about the process of inducing or augmenting labor. So when my clients are assessing their options and speaking with their providers about an induction of labor, they can be somewhat caught unawares of their options.
One of my jobs as a birth doula is to facilitate communication between medical providers and my clients. Another job is to provide evidence-based information to my clients to help them make the most informed decisions.
Here is my best NON-MEDICAL advice on labor inductions:
You may have time!
The average first-time birther goes into spontaneous labor around 41 weeks and couple days gestation. Your Estimated Due Date is just that: an estimate. So if you are beginning to feel pressured (by yourself, your family/friends, random strangers, and provider) and anxious about moving beyond that 40-week mark just remember: You most like have time!
There is no one-size-fits-all.
Medically induced labor is different for everyone, including the methods and medications that are used to augment your labor. Because of this, it is extremely important that you speak to your provider about their preferred method of induction and come up with a game plan TOGETHER that will best suit your needs and safety during your birth.
Inductions are not always fast.
A large misconception of induced labor is that it will be a similar length to spontaneous labor. The average length of labor for a first-time birthing person is 12-24 hours. Inductions can take around 24-48 hours. THIS IS NOT ALWAYS A NEGATIVE THING. Your body is not ready to have a baby when you are being induced, so it takes time to safely move through the stages of labor without exhausting your body and your baby. Don’t get me wrong, I have definitely had a few clients with inductions whose babies were born within a couple hours (especially with subsequent births), but more often than not, inductions take some time. Yes, your baby’s birthday may be earlier, but it is not always faster.
A shower can do wonders.
Many inductions begin with an overnight hospital stay of cervical ripeners to prepare your cervix for the day ahead. If you are someone who is not comfortable sleeping in a hospital, it is important to make your space as comfortable and comparable to home as possible. You may be anxious for the day ahead and sleep is not coming easily. I always suggest following your normal bedtime routine when you arrive. That way you are moving with your schedule and keeping things as normal as possible. In the morning, take a shower and eat something or even take a walk outside (if you can) before your next steps. This will reset your brain and help you start the day anew so it doesn’t feel like you have been in a hospital all night and are about to labor in one all day.
Your birth plan is NOT ‘out the window’ or obsolete!
It always breaks my heart when I hear my clients say that they want to chuck their birth wishes now that they are in the hospital to be induced. Depending on your hospital many of your birth wishes are still very possible to achieve! Saline Lock? Mobility? Wireless Monitors? These are all possibilities that can be discussed with your providers before and when you have arrived at the hospital on your induction date. This is still your birth. YOU ALWAYS HAVE OPTIONS.
Treat yourself before you arrive.
I love this one. This definitely relates back to the length of your hospital stay. Take the time before your birthing date to enjoy this little bit of pregnancy joy with your baby and partner. Go for a walk outdoors, have a nice filling dinner, maybe throw in a little sex if that’s an appealing option. Do all of the things a couple without babies does because soon your only responsibility will be to healing and caring for that little love. As someone once told me during pregnancy, “They (your baby) are the most portable now than they will ever be”.
Know your Bishop Score!
A Bishop Score is a great tool for assessing the success of a vaginal delivery with labor augmentation. It takes into consideration your cervical position, effacement (how flat), dilation (how open), Consistency (how soft) fetal station (how low the baby is in your pelvis). The results give you a good understanding of the vaginal birth success rates of inductions with your current cervical state. This is especially helpful for those wishing to do an elective induction but also for those with inductions that are medically indicated. It gives you an idea of the possible timeline of your labor to discuss with your provider.
Mind Over Matter.
Finally, with inductions more so than any other type of labor I have supported, it is all about mind over matter. Yes, it may take a long time. Yes, you can feel overwhelmed about being in the hospital and any changes of plans or medical interventions. But REMEMBER: YOU are still in charge. YOU are still in control of what happens to your body and your baby. Birth, no matter how it begins, always brings the unexpected. How you move with those changes drastically impacts your emotional and physical outcomes.
DISCLAIMER: I am not a medical professional. This information comes from personal experience, the experiences of my clients, evidence-based research, and anecdotal evidence. If, at any point during your pregnancy or postpartum period you have a question or concern, please contact your care provider for medical support.