Induction of Labour

Induction of labour is the artificial starting of labour, which may be deemed necessary in particular births. Indications and contraindications that labour may need to be induced include:

 Pregnancy-induced hypertension .
  Premature rupture of membranes .
  Chorioamnionitis .
  Postterm pregnancy.
 Isoimmunisation.
 Other evidence of hostile intrauterine environment.
 Diabetes mellitus.
 Other selected maternal diseases (see here ).
  Foetal demise .
  Placenta previa .
  Cord presentation .
 Floating presenting part .
  Abnormal foetal lie .
 Active genital herpes .
 Invasive cervical carcinoma .
 Pelvic structural deformities.
 Prior classical uterine incision (as in caesarean section ).

The main methods of inducing labour include:

  Breaking the Water . This is where the membranes containing the foetus and amniotic fluid are ruptured artificially in the hope that labour may then be stimulated. However this is not always he case and risks include causing an infection of the amniotic sac and possible prolapse of the umbilical cord . This could need a caesarean section in order to be remedied.
  Oxytocin or Pitocin . This is a hormone and an artificial version of that hormone, respectively. It is given via an IV and causes contractions. Usually the amount is gradually increased until contractions are strong and regular. However, this method may cause foetal distress. For just this reason, the U.S. FDA declared that this drug was only to be used if necessary and not for convenience or scheduling reasons. Other risks include hyperstimulation of labour, hypotension, water intoxication (intoxication of the amniotic fluid) and uterine rupture.
  Prostaglandin Gels/Suppositories . These are generally used when the cervix is dilated less than 3 centimetres, hard, posterior, not effaced, or barely effaced, or any combination of the above. By using Bishop's Score your practitioner will decide if this is the best place to start. This can be used alone, or more frequently will be done 12 or more hours prior to the use of Pitocin. Frequently it will be given more than once over the course of an evening/night. A suppository will be placed in or near the cervix during a vaginal exam. Risks include hyperstimulation and uterine rupture.
  Misoprostol . This is a pill that can either be ingested orally or placed near the cervix. It is used in circumstances like those described in the point above.
  Amniotomy . Amniotomy is the artificial rupture of the amniotic sac with an amniohook or an amnicot .
  Nipple stimulation , intercourse and certain foods may also induce labour.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. Pregnancy & Birth at About.com: http://pregnancy.about.com/
2. University of Iowa Family Practice Handbook, 3rd Edition, Chapter 8: http://www.vh.org/
3. Bayfront's Health Adventure, A Woman's Way to Health: http://www.bayfront.org/