Induced birth: methods used, indications, advantages and disadvantages

In cases where labor does not start alone and/or there are factors that put the life of the mother and/or baby at risk, doctors may resort to induced labor. Briefly, Karina Tafner (CRM-SP 118066), gynecologist and obstetrician, specialist in Gynecological Endocrinology and Human Reproduction by Santa Casa and specialist in Assisted Reproduction by FEBRASGO, defines induced labor as labor that begins artificially. (unnatural).

When well indicated and successfully performed, induction helps a woman to have her baby without needing a cesarean. Find out in which cases it is indicated, what are its advantages and disadvantages and learn about the main methods used.

What is induced labor

Alberto Guimarães (CRM-SP 66026), gynecologist, obstetrician and precursor of Childbirth without Fear, explains that induced childbirth is one in which there is a need to use external resources to trigger labor.

It is essential that the induction is always guided and accompanied by the doctor. “Any induction method needs to be used with discretion, with good surveillance with regard to maternal and fetal safety and well-being,” he adds.

When is induced labor recommended and when is it not?

But, after all, in which cases is induced labor indicated? In what cases can it be dangerous?

when is recommended

• Post-date: Guimarães explains that induced labor may be indicated when the 40th or 41st week of pregnancy is passed.
• Indication of resolution (early birth): Induced labor may be considered when it is necessary to bring forward the birth, for example, if the mother has diabetes or preeclampsia, if there are signs that the baby has a growth restriction, of a reduction of liquid. “Finally, there are situations in which the resolution of the pregnancy is indicated. So, instead of simply imagining a cesarean section, most of the time, one can resort to inducing labor, with the opportunity to progress to a normal delivery”, says Guimarães.

When it’s not recommended

• When there is fetal distress;
• When the fetus does not have a heartbeat;
• When the pregnancy is of twins or more babies;
• If there is active genital herpes on the mother;
• When the baby is not upside down;
• If the mother has had more than two cesarean sections in previous pregnancies (due to scarring in the uterus);
• If the umbilical cord is prolapsed (as there is a chance that the baby will compress the cord during delivery);
• In case of placenta previa (when it is very low in the cervix);
• If the baby is very large (over 4 kg);
• Whether there is a risk of infection within the uterus.

These are the main examples, however, it is always the doctor in charge who must make the decision whether or not to opt for labor induction, taking into account factors that assess the risk and benefit of this procedure.

Karina recalls that labor induction aims to perform a normal delivery. “When induction is attempted but is unsuccessful, the indication is for delivery to take place and, in that case, cesarean delivery,” she says.

The advantages and disadvantages of induced labor

Induction of labor can be beneficial in a variety of clinical circumstances. Check out the main advantages and disadvantages:

Benefits

Karina explains that induced labor avoids a cesarean, if the woman wishes, when the pregnancy has an indication of resolution but the pregnant woman is not in labor.

Disadvantages

“According to the WHO, this procedure increases the likelihood of epidural anesthesia during labor, admission of the newborn to a neonatal ICU, removal of the uterus, cesarean delivery and, consequently, a longer recovery period”, comments Karina.

For Guimarães, the disadvantage of induced labor is precisely the increase in the rate of cesarean section.

Methods of inducing labor

The methods used in labor induction can be divided into natural stimuli, mechanical stimuli and pharmacological stimuli. Find out how they work:

Methods in the hospital

• Mechanical methods: when mechanical techniques are used, such as rupture of the membranes (through a touch exam, in order to release prostaglandin, a hormone that favors the dilation of the uterus) or probe (placed behind the cervix to release to prostaglandin). “To define the best option, we take into account the characteristics of the cervix and the patient’s clinical condition”, comments Guimarães.
• Medications: the gynecologist and obstetrician explains that there are some medications (prostaglandins) that help prepare the cervix and can trigger labor. They are usually placed in the vaginal canal.
• Oxytocin: Guimarães comments that this is probably the most used method to trigger labor. The substance is applied with serum into the pregnant woman’s vein in order to produce contractions. It is a method that has a good indication if the cervix is ​​favorable.

natural methods

• Acupuncture: Guimarães comments that acupuncture can contribute in some cases, mainly in terms of stress, fear, and helping to release some hormones.
• Physical exercises: in addition to promoting relaxation due to the release of endorphins, movement can make the baby’s head press on the uterine cervix, helping with the fitting and triggering of labor.
• Sexual relations: Karina explains that sex can help due to the uterine stimulation caused by orgasms, the release of oxytocin and the prostaglandin in the semen.
• Nipple massage: Guimarães comments that all measures that stimulate the production of oxytocin can help, as is the case with nipple stimulation.
• Hot bath: there are situations in which a hot bath helps by relieving muscle contraction that can occur due to fear and/or pain.

The truth is that there is no ideal method of inducing labor. For each case, there will be the more or less indicated method. In any case, highlights Guimarães, any method must be used with discretion. “A good surveillance of maternal and fetal well-being is necessary (for example, when contractions increase and/or they become more intense, it is necessary to pay attention to some protective measures for the baby)”, he says. It is worth emphasizing that even natural methods should always be guided by the doctor.

Guimarães emphasizes that, in parallel with any method for inducing labor, it is very important to prepare this woman for the duration or need for an induction. “It is essential to explain what is being done, making it clear that they are measures to trigger labor, leaving her as calm as possible”, concludes the gynecologist and obstetrician. Enjoy and learn about the different types of delivery.