Coming up to your due date? Do you have an important event to attend? Or perhaps the holidays are coming up and speeding up the birth suits the obstetrics and gynaecology team.
Not one of these is a good reason for augmenting or inducing your labor. The risks definitely outweigh the benefits in this case.
Augmentation and Induction should be considered seriously before making a decision that could affect your health. It might be medically necessary to make such a choice, in which case the benefits might outweigh the risks.
What is an augmentation of labor?
If the intervention has occurred after labor has commenced, it is referred to as an augmentation.
Augmenting labor is a method that’s often used to try to speed up the progress of labor or as a result of other medical conditions. The World Health Organisation (WHO) recommends augmenting labour with oxytocin as appropriate and should only be performed after conducting a clinical assessment to exclude cephalopelvic disproportion.
What is labor induction?
Induction of labor usually involves trying to start labor from the very beginning. You might or might not have ruptured the amniotic membrane, or amniotic sac.
Some women might require labor inducement for particular reasons, such as high blood pressure or preeclampsia. In such cases, a medical induction is recommended as the risks these conditions pose to mother and baby are too high.
What is the difference between augmentation and induction of labor?
Augmentation can be used to force the progress of labor, whereas induction involves forcing the body to start labor when there are no uterine contractions or active labor.
Informed consent – augmentation and induction of labor
Remember, your baby’s lung maturation is the key factor that determines when labor commences. It sends a signal to tell your body that the baby is ready to come into the world.
Informed consent is vital. If you don’t have trustworthy, evidence-based information it might be difficult for you to give informed consent.
Most likely this information will come in the form of a document. Look at it with a trusted support person and make sure you are happy you understand completely what you are signing up for.
Recommended readings:
When Doctors Don’t Listen: Informed Consent and Birth
Your Rights At 42 Weeks Of Pregnancy.
Cascade of intervention – augmentation and induction
The cascade of intervention is well documented. It simply means that once one intervention has occurred there is a higher chance that another, and then another, will occur.
Starting with what you might think is a simple augmentation can eventually lead to a c- section.
Recommended readings:
The Cascade Of Intervention – What You Need To Know
Gentle C-Section | 11 Ways To Have One.
How do you augment labor?
Augmentation of labor occurs in much the same way as an induction of labor. Certain techniques and/ or medication are used to speed up labor.
Augmentation of labor might include:
- Sweeping of the membranes to make the uterus contract
- Synthetic oxytocin (Pitocin) infusion
- Artificial rupture of the membranes
- Use of essential oils – for example, clary sage
- Acupuncture.
You might be interested in our article What Is A Membrane Sweep? Facts You Need To Know.
How do you induce labor?
Attempting to induce labor can be a slow and unsuccessful process for some women and might include:
- Vaginal insertion of a balloon catheter filled with water (Foley catheter). The midwife or doctor inserts it to stretch the cervix and force it to open
- Prostaglandin gels, to force cervical ripening, where the cervix softens and is more likely to open
- Breaking of the amniotic sac, to make the uterus contract and the amniotic fluid drain out
- Inserting an IV cannula (narrow tube) into the vein, to begin the synthetic oxytocin (Pitocin) infusion. The chemical helps trigger contractions (to more than four contractions over 10 minutes) to increase labor.
- You and your baby will be constantly monitored throughout the entire process.
You might like to read 5 Things Oxytocin Does That Pitocin/Syntocinon Doesn’t.
What are the risks of augmentation and induction?
It’s not recommended to augment or induce labor unless you or your baby is experiencing a medical problem. This is because the risks are high. Birth is an instinctive and natural event that can’t be managed, as it’s different for every woman and baby.
Some of the risks of induction and augmentation might include:
- Fetal distress. The baby’s heart rate goes too high or too low
- Increased risk of caesarean section, due to the cascade of intervention
- Postpartum haemorrhage
- Uterine infection
- Increased risk of assisted birth
- No opportunity for water birth or labor.
Recommended readings:
Induction of Labour – What Are The Risks Of Being Induced?
Baby Birth Stories: Induction & Augmentation.
Pain relief – augmentation and induction of labor
Any interference with the natural rhythm of labor will increase the pain you feel in labor. This happens mostly because your body is not ready for it and there might not be a steady progress of labor.
The synthetic hormone Pitocin makes the contractions more painful, so you shouldn’t feel as though you have failed if you need pain relief.
Some types of pain relief you might require are:
- Epidural
- Narcotics
- Analgesia
- Sterile water injections
- Nitrous oxide (gas).
Recommended readings:
Epidural During Labour – Everything You Need To Know
Convinced You Want Drugs in Labour?
Support and plan for augmentation and induction of labor
Having a good support team will be your saviour when it comes to birth, regardless of how it eventuates.
Discuss your concerns with your team and have a plan or strategy to help you with the labor, birth, and postnatal phases. You can never have enough support. Think about having a doula for labor as well.
Recommended readings:
