Sometimes, even with spontaneous onset of labor, labor might stop or have slow progress. It’s also possible you might have premature rupture of the amniotic sac with no labor. This doesn’t always mean you need to have labor augmented.
You might need to rest, or use relaxation techniques and expectant management. If you have other medical complexities, the augmentation of labor could be the safest option.
Think informed consent and seriously consider whether or not to augment labor, as there are maternal and perinatal mortality risks factors involved.
What is labor augmentation?
Augmenting labor means using techniques or medication to speed up the progress of the labor process.
Usually, for augmentation of labor, you have been in active labor or in labor spontaneously with uterine contractions prior to labor augmentation. Sometimes augmentation occurs due to prolonged labor or maternal exhaustion.
You might like to read Baby Birth Stories: Induction & Augmentation.
Is augmentation labor induction?
Inducing labor generally means starting the labor from the beginning where there has been no spontaneous labor. Augmentation of labor is used in clinical practice, mostly when uterine contractions have occurred and the woman has a prolonged second stage.
What are the risk factors of labor augmentation?
As with any intervention or procedure, there are risk factors, for you and your baby, that must be considered.
Some of these might be:
- Uterine hyperstimulation
- Uterine rupture
- Postpartum hemorrhage
- Higher risk of cesarean section.
You can read more in our article Induction of Labour – What Are The Risks Of Being Induced?
How do you augment labor?
Augmentation of labor requires you to have an IV cannula inserted into the vein. If you are having an epidural with the augmentation of labor you will also require an indwelling catheter into your bladder as you might not be able to feel when you need to pee.
You might also need:
- Intravenous oxytocin infusion, called oxytocin augmentation
- Artificial rupture of membranes
- Fetal heart rate monitoring
- A digital vaginal examination.
Cascade of intervention – labor augmentation
The cascade of intervention during labor is well documented. It simply means that once one intervention has occurred, there is a higher chance that another, and then another, will happen.
Starting with what you might think is a simple augmentation can eventually lead to a c- section.
Informed consent for labor augmentation
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 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.
Pain relief for augmentation of labor
All labor interventions can mess around with the normal rhythm of labor; this makes the uterine contractions more painful.
Given augmentation of labor means artificial labor and a more intense contraction pattern, most women will require some form of pain relief to cope.
Some examples of way to relieve pain during labor are:
- Epidural analgesia
- Nitrous oxide (gas)
- Sterile water injections
Will the labor augmentation affect the birth?
Where you might previously have been deemed low risk, the decision to augment labor now puts you in a higher risk category.
In Australia, women deemed ‘risky’ are discouraged from physiological birth. It’s important to discuss your wishes with your primary care provider and come up with a plan that suits you.
- Active management of the third stage (birth of the placenta)
- No water for labor or birth
- Continuous fetal heart rate monitoring, in case of fetal distress
- You might or might not have a vaginal birth (there is an increased risk of emergency cesarean section)
- You will be closely monitored (heart rate, contraction pattern, blood pressure).
Your baby might or might not cope well with augmentation of labor and birth; therefore, the pediatric team might be present at the birth to assist, if required.
Having a birth plan is important. We’ve made making one much easier.
Take a look at Birth Plan – Why Write One? Free Birth Plan Template.