What happens during an induction, and how it can be a positive experience

posted in: Pregnancy, Suffolk Babies | 0

When I first started my career as a midwife the induction of labour rate was around 12-15%, now it’s 30-35%! This is due to a whole range of reasons. So it’s a topic now that every expecting couple should know about and more importantly know the choices available to them if an induction of labour is offered to you and you decide to go ahead with having one.

I thought I would share my experience of induction of labour as a midwife and as a patient. I never had it in my mind that I would need to be induced, as having gone into labour at home with my first pregnancy, I had planned a water birth at home second time around. But as I am a midwife I should have known better: pregnancy has one certainty – it’s unpredictable. So back in the box my pool went and my preparation for an induced labour began. 

I was still determined to have the same experience I had hoped for at home – just in a different postcode, IP Deben Ward. I arrived solo to Deben ward, (pre-planning some major nap time) and met the midwife who would begin my assessment for induction. This is one of the misconceptions of induction, you get offered a date and most people think, “Brilliant that’s the day I will be having my baby.” Well, the actual reality is that it’s more likely that you can add 2 – 4 days on to that date. Induction of labour is slow, but that’s what the latent phase of labour is all about. Slow and steady, allowing the hormones and endorphins to rise and prepare for birth. Hence why I planned some major napping.

The ward was too busy to start my assessment until late in the evening. This does happen, mainly because, as I already said, things in midwifery are unpredictable. One minute you have all the delivery rooms free, the next, half of Ipswich want to give birth. But I took this time to relax, nap and create my birthing environment. What is so important about induction is you need to think about all the things your positive labour hormones need before you even start labour. This may help the hormones work during the process, keep you calm and positive and keep the adrenaline away. Just because you have been offered an induction doesn’t mean your choices for a positive birth go out of the window.

Calm, dark, private, quiet, nest.

By the time the midwife came to examine me I was relaxed and well slept. What the midwife is checking for is something called a Bishop score, they feel for how soft your cervix is, the position, how long the cervix is, how dilated, and how low the baby’s head is in your birth canal. While this is being done the midwife will then recommend which induction is the most suitable. Here are the options:

• Propess: Looks a little bit like a thin tampon that is placed into the vagina. It’s coated in a hormone called prostaglandin that is released slowly over 24 hours. The aim of this is to efface (thin) your cervix before you start to dilate. This is for first pregnancies only.

• Prostin: is similar to Propess but is a small tablet placed into the vagina and is released over 6 hours and you may be offered 2 in 24 hours. 

• ARM: artificial rupture of membranes, which is basically breaking your bag of waters surrounding the baby. This releases prostaglandin and oxytocin to help start your labour. The cervix has to be dilated and thin for this to be offered and your baby’s head has to be low in your pelvis. This can be offered after Prostin or Propess.

• Syntocinon: this is an artificial form of your labour hormones introduced to your body by a small tube (cannula) in your hand or wrist. It works with your own hormones to allow your body to have regular surges (contractions). The hormone isn’t designed to make the labour more intense, but adrenaline may contribute to a raise in discomfort. It’s important to focus on techniques and help to support your breathing and endorphins. Your waters have to already be broken for Syntocinon to be offered.

Everyone’s induction journey is different as you can see. You may be offered one of these options or may experience all four. 

My labour slowly began after Prostin and an ARM then progressed quickly. I had the positive birth I had hoped for and the beautiful healthy baby I had dreamed of. I think I was able to have such a positive, empowering experience because I knew I still had choice, I had a voice, my choices weren’t questioned or mocked. That’s not because I am a midwife, it’s because I had informed choice, which everyone should be offered.

There are some exciting changes happening in Ipswich maternity to make the experience for induction as positive as possible, so watch this space.

As ever we are happy to answer any questions you have or signpost you to the right help.

More resources on induction

Ipswich Hospital’s information leaflet on the assessment for and induction of labour

Ipswich Hospital’s information leaflet on the pre-labour rupture of membranes

Ipswich Hospital’s web page on your labour and birth at Ipswich

Tommy’s Charity’s information page on having labour induced

NHS web page on inducing labour

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