Your Induction is on the Calendar: What Comes Next? Understanding Medically Indicated Inductions

Understanding Medically Indicated Inductions

 In case you missed the laundry list of reasons providers have for inducing pregnant moms and discussing the mysteries of the often-debated ARRIVE trial, you can catch up here and here. For todays discussion let's talk about a topic that might feel overwhelming to gain some confidence and clarity: medically indicated inductions.  

Asking the Right Questions

 When facing a medically necessary induction knowledge is your superpower. Start by asking questions, beginning with the Bishop's score. A Bishop's score is a pre-labor scoring system that gauges your body's readiness for labor. A cervical exam evaluates five criteria: 

1. Position: Where is your cervix positioned in the birth canal?
2. Consistency: How does your cervix feel – firm, medium, or soft?
3. Effacement: How thinned out is your cervix?
4. Dilation: How many centimeters dilated are you?
5. Station: Where is the baby's head positioned in your pelvis?

 Plug these findings into the formula, resulting in a score ranging from 0 to 13. A score of 6 or higher is favored for a successful induction according to the American Academy of Pediatrics. 

Unpacking the Induction Toolkit

 Understanding your Bishop's score sets the stage for informed decisions. If induction is on the horizon here's a quick overview of the toolkit: 

Cervical Ripeners

• Oral or Vaginal Pills: Prostaglandin-based like Cervidil (avoiding Cytotec and its black box warning)
• Prostaglandin Gels: Applied to the cervix to promote effacement.

Manual Interventions

• Breaking the Waters (Rupturing Membranes): Aiming for stronger contractions.
• Foley Balloon: Inserted through the vagina, applying pressure to encourage dilation.
• Cook Catheter: Applying pressure from both internal and external cervical canals.

Pitocin

• Synthetic Oxytocin: Jump-starting natural oxytocin flow.

Mindset Matters

If you consent to a Foley bulb, you can request to labor at home. Make sure your preferences are heard loud and clear. 

Hot Tips for a Successful Induction

• Second Bishop's Score: If progress stalls request a reevaluation.
• Gradual Progression: Avoid jumping to the balloon if the cervix remains unfavorable.
• Low-Dose Pitocin: Titrate the amount to find the perfect dose.
• Delaying Increases: Allow time for your body to cope and produce natural pain-blocking hormones.

 After expressing your preferences ensure clarity on your provider's presence during the induction. Consistency is key, and we definitely don’t need any surprises.  Navigating a medically indicated induction can feel like a lot. But armed with information and a proactive mindset, you're empowered to make decisions aligned with your unique needs. Remember, this is your journey, and your voice matters. If the thought of an induction has you nervous join my Anxiety Free pregnancy Facebook group for additional support and resources.  References:Giugliano, E. (2014, April). The risk factors for failure of labor induction: A cohort study. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984641/ https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/inducing-labor/art-20047557