The Induction Question

In the past few years, the trend in obstetrics has moved toward using prostaglandin or catheter balloons to ripen the cervix prior to induction of labor. A cervical agent like prostaglandin will stimulate the uterus to contract and comes in gel, pill (often under the brand name Cytotec) and vaginal insert form (generally Cervidil). Such agents soften the cervix and assist the process of effacement and dilatation. Cervical ripening agents are not recommended if the mother has had a previous cesarean birth.

Actual induction of labor will happen 12 to 24 hours later. That's when an IV is placed, an external fetal monitor is applied and a dilute solution of oxytocin (Pitocin) is instilled until contractions are strong and as frequent as two to three minutes apart. If there is any indication of fetal distress or uterine hyperstimulation, the oxytocin is decreased or discontinued.

Most hospitals' protocols dictate a schedule of routine vital sign assessment and fetal monitoring that guides the induction process. Close observation of the fetal response to contractions and of the contraction pattern is mandatory. If the mother's body is unresponsive after several hours and if membranes are still intact, the medication can be discontinued and restarted the next day.

Medical reasons that necessitate induction:
There are some very valid reasons to induce labor, some more critical than others. Care providers will often opt to induce a mother when continuation of pregnancy is seen as a risk to her health or to the baby's survival '- for instance, in the case of hypertension. In such cases, the benefits of induction clearly outweigh the risk in continuing the pregnancy.

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