As induction of labor has become increasingly common in the U.S, mid-wives tend to promote spontaneous labor and physiologic birth. Many of our patients desire to avoid an induction of labor, which is part of the reason they choose midwifery care.
At McKenzie Midwives, we educate our patients about ways to help your body prepare for labor. While more research is needed, some evidence shows that natural approaches like evening primrose oil, eating dates, drinking raspberry leaf tea, and trying acupuncture can help your cervix ripen, meaning prepare, for labor.
However, as much as we may hope for spontaneous labor, there are times when the risks of remaining pregnant become too high and an induction is medically necessary. While this may require an adjustment of your expectations or birth plan, an induction does not have to be a negative experience! There are a lot of “horror stories” on the internet and social media about inductions, and it is important to remember that there is still a very high likelihood of a vaginal delivery. A recent study even found that elective induction of labor decreased the risk of C-section.
There are two main phases of an induction: cervical ripening and labor. Cervical ripening is when your cervix softens, thins out or effaces, and begins to dilate. Contractions with an unripe cervix are unlikely to be effective, which is why ripening is so important and improves your chances of a vaginal birth. However, it is usually the slowest part of an induction and is part of the reason it can feel like such a long process. The two primary tools for ripening are a cervical balloon, which puts mechanical pressure on the cervix to help it dilate, and a medication called misoprostol or Cytotec, which helps soften and efface the cervix.
Once your cervix is ripe enough, Pitocin is usually started through an IV to cause labor contractions. It is started at a low dose and is titrated until contractions are strong enough to dilate the cervix. There is great variation in how someone’s body responds to Pitocin; some need only a low dose to go into labor, and others need higher doses.
If you need or choose an induction, it may be helpful to revisit your birth plan to think through your priorities: for example, will your goals for labor coping change? What preferences are most important for you to communicate with your care team? Remember that it is impossible to control or predict birth, and just as with spontaneous labor, flexibility and surrendering to the process is key.
Megan Lewis, CNM
McKenzie Midwives & Lactations Services
960 N. 16th St., Ste 104, Springfield (541) 744-8660