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Induced labor occurs when a doctor or midwife starts a pregnant woman’s labor artificially. An induced labor can be either elective to accommodate the mother's schedule, which is becoming more common, or performed in response to a medical emergency. Although induced labor is not necessarily a dangerous practice, the American College of Obstetricians and Gynecologists recommend that induced labor should not be done electively prior to 39 weeks gestation.
Any number of medical conditions can call for induced labor. Complications endangering the woman’s health, including preeclampsia, hypertension, heart disease, bleeding or gestational diabetes, are some of the more common reasons to induce labor. If the baby is in danger because he or she cannot get adequate oxygen or nutrients, or is small for his or her gestational age, labor may be induced.
Induced labor must occur if the amniotic sac has broken, but labor hasn’t started naturally within 24 to 48 hours. Occasionally, the mother will develop chorioamnionitis, which is a uterine infection. For others, labor is induced when the pregnancy goes beyond 42 weeks, although some doctors take pity on a woman who has reached 40 or 41 weeks with no signs of labor in sight.
Induced labor is accomplished most often by administering one or two main medications used for this purpose. Pitocin or Syntocinon, which are brand names for oxytocin, is administered through an intravenous drip (IV). Oxytocin is a naturally produced hormone that stimulates the contractions associated with labor. When this hormone is given artificially, it can speed up labor, but can also make it progress more quickly than pain management can work or be administered.
Prostaglandin is another hormone that is administered artificially in the form of a vaginal suppository. It is usually inserted in the evening to stimulate labor by the morning. The benefit of this type of induced labor is that women are not tied to an IV.
The second way labor is induced, without the use of artificial hormones, is by breaking the bag of waters. This is called artificial rupture of the membranes (AROM). If all goes according to plan, when the bag is broken, production of prostaglandin naturally ramps up, stimulating contractions. AROM is performed by brushing a small hook, inserted into the vagina, just inside the cervix, on the sac.
AROM allows the doctor to monitor the baby through the canal and examine the amniotic fluid. One drawback is that it can cause a prolapsed cord, in which the cord drains out first, with the fluid. If labor and delivery do not occur within 24 to 48 hours, infection can set in.
While inducing labor is generally very predicable, how a woman responds to it varies greatly. Some women go into labor and experience a delivery quickly with little to no complication. Others are more resistant to the intervention and labor takes longer to get going.