Induction of labor: natural and medicinal. How does the process of inducing labor occur in the maternity hospital and at home in the last weeks of pregnancy, what are its pros and cons

They do not occur on their own, but medical indications force doctors to stimulate their onset. Induction of labor is a phrase that all pregnant women fear. Let's figure out if it's so scary.

Induction of labor in the maternity hospital

The most common scenario for the development of events when labor is induced is the woman’s hospitalization in the pregnancy pathology department. It is there that, after examination and examination, a decision is made on the indications, timing and methods of stimulation.

Indications for stimulation of labor

The reasons why obstetricians are forced to provoke the onset of labor are divided into maternal and fetal.

Reasons from the mother:

The presence of complications of pregnancy, in which its continuation is dangerous for the life and health of the woman: gestosis, eclampsia, severe gestational diabetes mellitus, liver damage, coagulopathies caused by pregnancy;
Exacerbation of severe chronic diseases: bronchial asthma, diabetes mellitus, arterial hypertension, kidney disease, cardiovascular pathology;
Increasing polyhydramnios;
Pathological preliminary period, when the general condition of a woman and her sleep are disturbed;
Acute situations: acute appendicitis, cholecystitis, cerebral aneurysm, trauma, bleeding. Although in this case such stimulation of labor does not occur. In such situations, doctors go for early delivery by cesarean section, since sometimes the count is not in hours, but in minutes;
Post-term pregnancy beyond 42 weeks according to the date of the last menstrual period.

Fetal causes are fewer:

Hemolytic disease of the newborn with Rh conflict;
Intrauterine infection of the fetus and amniotic membranes;
Fetal growth retardation with good results of CTG and fetal biophysical profile.

If a child, for one reason or another, suffers in utero, it is preferable not to have an excessive burden of artificially induced labor, but to undergo surgical delivery. Induction of labor in the interests of the fetus is carried out only after a thorough examination using ultrasound, Doppler and CTG.

Methods of stimulating labor

Initially, one or another method of inducing labor is selected based on the readiness of the pregnant woman’s body for childbirth. If the birth canal is well prepared, the “mature” cervix can be used:

Kelp sticks. This is a fairly ancient method in obstetrics. Kelp is seaweed that has been dried and pressed into pencil shapes. Several of these sticks are inserted into the slightly open cervix. In a humid environment, the algae swell and mechanically open the cervix, stimulating the onset of labor;
Balloon dilatation of the cervix is similar to the previous method. Instead of kelp, special balloons are used for mechanical stimulation, gradually filling them with air or liquid;
Amniotomy or artificial opening of the amniotic sac. When amniotic fluid breaks, the volume of the uterine cavity decreases, the fetal head descends and puts pressure on the lower segment of the uterus. These factors trigger the onset of labor.

Drugs to induce labor

If a woman’s body is not ready for childbirth, the cervix is immature, using non-drug methods is impossible and even dangerous. In such cases, more careful preparation of the woman and the use of special drugs are necessary:

Oxytocin is a hormone produced by the pituitary gland and is directly responsible for uterine contractions during childbirth. Oxytocin administered intravenously or in pill form will trigger the onset of labor. However, with an immature cervix, the use of this drug is unjustified. Read more about ;
Preparations of the prostaglandin group (Prostin, Prepidil and others). These are biologically active substances that promote softening, opening and ripening of the cervix. This group of drugs is the best for preparing and stimulating labor. Prostaglandins exist in the form of injections, tablets, vaginal and cervical gels;
Mifepristone is a relatively new drug for inducing labor. Its action is to block progesterone receptors. Progesterone, whose main function is to maintain pregnancy, stops working. Pregnancy remains without hormonal support, and labor begins.

Induction of labor at home

In cases where the due date has already passed, but both mother and child feel well, there is no need for active action. The doctor sends the pregnant woman home, where she immediately rushes to search for traditional methods to speed up the arrival of the cherished day. There are many of these methods, some of them have medical roots and common sense, but some are absolutely devoid of them and are even dangerous.

Dangerous methods include hot baths, drinking alcoholic beverages, lifting weights, jumping, taking decoctions of unknown herbs and dietary supplements, and any vaginal manipulation at home.

Among the permitted ways to speed up the onset of labor:

Exercises that include the notorious walking up stairs and washing floors. Any moderate physical activity can bring neither harm nor benefit. But systematic yoga, swimming or aerobics for pregnant women are very useful for muscle development, proper breathing, weight control and the development of the generic dominant.
Castor oil or the well-known castor oil is considered a panacea for inducing labor. There is a grain of common sense in this. Castor oil has a hormone-like effect and can promote cervical ripening when used regularly, such as in suppositories. The laxative effect of castor oil can have a birth stimulation effect only when the birth canal is already ready. A cleansing enema has a similar effect.
Sexual activity is perhaps the most scientifically proven way to induce labor. Sperm contains the same prostaglandins that were discussed. With regular sexual activity, the effect of these substances on the cervix and its mechanical irritation contribute to the onset of labor.

Before using any of these “grandmother’s” methods, be sure to check with your doctor whether he allows such experiments in your particular case.

Alexandra Pechkovskaya, obstetrician-gynecologist, especially for website

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Nature has programmed the body so that a woman gives birth spontaneously, without any outside intervention. In a normal pregnancy, the birth of the baby occurs between 37 and 41 weeks. But there are cases when the process does not begin on time, then the pregnant woman has to induce labor. In what cases is it necessary to resort to stimulation, is it dangerous, what methods exist - these and other questions that concern women in labor will be discussed in the article.

What is labor induction?

For some indications, doctors are forced to resort to induction of labor.

Induction of labor is the artificial induction of labor using various methods. The action can be used at any stage of pregnancy after 27 weeks, if indicated. It is from the 27th week that the baby can survive outside the womb. But most often stimulation is done when a woman carries the fetus beyond term.

Before deciding whether a woman’s body is ready for stimulation, the doctor checks the cervix. If it has shortened and become soft, it means that readiness for an important process has already occurred.

Otherwise, the pregnant woman is first prescribed drugs that accelerate the “maturation” of the uterine pharynx, and only then the appropriate method of inducing contractions is chosen.

If a woman does not have any pathologies, the mother and fetus feel well, then an artificial induction of labor can only be advisory. The expectant mother herself has the right to choose whether to take this step or wait until the process begins spontaneously.

In what cases is stimulation used?

There are many reasons for artificially inducing the birth process:

The decision on the need to induce labor is made only by the doctor, who also chooses the most appropriate method, depending on the situation and condition of the patient.

Methods of inducing labor

All methods of artificially inducing labor are divided into two types:

Medication.
Natural.

Let's look at each in detail.

Methods of inducing labor.

Medication methods

This type includes methods involving pharmacological drugs and medical equipment. The techniques are carried out in a hospital setting, in a maternity hospital, under the careful supervision of a doctor.

Amniotomy (puncture)

When a woman in labor has been having contractions for quite a long time, and the amniotic sac has not yet burst on its own, the uterine os opens very slowly, the doctor performs an amniotomy (puncture of the bladder). The procedure is quick and painless, after which the water breaks and the baby’s head begins to move along the birth canal. The cervix dilates faster and labor begins fairly quickly.

Amniotomy process.

Pills

Today, pharmacology offers artificially synthesized antigestogens in the form of tablets that effectively stimulate labor. The drugs cause the release of the hormone progesterone, which is responsible for the dilation of the cervix and its contraction.

Any medications during pregnancy can be taken only after consulting a doctor.

Doctors prescribe these same pills to women to terminate early pregnancies. At a later stage they act as stimulants.

Such drugs have a minimum of side effects and do not harm the health of the mother and baby. In addition, they significantly facilitate the birth process, promoting rapid and complete opening of the uterine pharynx. The percentage of emergency caesarean sections in women giving birth when taking such pills is very low.

The medicine is taken strictly in a hospital setting under the supervision of a doctor.

Oxytocin is a synthetic analogue of the hormone involved in uterine contractions and expulsion of the fetus. The drug is administered as an injection intravenously or drip. An obstetrician-gynecologist uses the method only as a last resort, when the woman’s water has already broken, but the contractions have begun to fade, the dilatation of the cervix is slow or has stopped completely.

Oxytocin is administered while simultaneously monitoring the baby's heartbeat. The drug acts very quickly and there is a risk that the uterus will begin to hypercontract and the fetus will experience oxygen starvation.

Oxytocin has serious side effects and can cause uterine bleeding. It is not performed on women with a very narrow pelvis or when the fetus is in an incorrect position.

Before administering this drug to an expectant mother, the doctor carefully weighs all the risks.

Oxytocin has a number of contraindications and is administered only as a last resort.

Prostaglandins

Prostaglandins are lipid substances found in our body. They are found in concentrated quantities in amniotic fluid. Lipids, along with hormones, provoke the uterus to contract and open. In pharmacology, the drug is presented in the form of vaginal suppositories or gel. Stimulation of labor in this way is very gentle, with virtually no side effects or negative effects on the fetus.

The substance is inserted into the vagina and after 1-4 hours the woman begins to experience contractions.

Detachment of amniotic membranes

The technique is used for post-term pregnancy. It is done manually by a gynecologist. The woman lies down on the chair, the doctor begins to move his finger around the cervix. The procedure is not particularly pleasant, but painless. During such a “massage,” the amniotic sac begins to gradually peel off, which causes labor. Immediately after the session, bloody spotting may be observed. Nothing wrong with that. If labor does not begin within 24 hours, the doctor repeats the procedure.

Foley catheter

An outdated method that is practically not used in modern clinics. The catheter consists of a long silicone tube with a balloon-shaped tip. The device is used mainly in urology. In gynecology, it was previously used to open the uterine cervix. The process is painful, so today they resort to it only in extreme cases, when there is nothing else, and it is necessary to induce contractions.

Foley catheter.

Natural Methods

The doctor may recommend natural methods of stimulation to the pregnant woman, without the use of drugs. Typically, such therapy is prescribed for post-term pregnancy, when the health of the mother and baby is in perfect order and no threats are observed.

Physical activities

If labor has not yet occurred at 40-41 weeks, the woman is advised to increase physical activity, of course, within acceptable limits. Walking up the stairs, doing housework, light exercise, long walks - all this can have a positive effect on the onset of labor.

Increased physical activity can stimulate the onset of labor.

Sexual intercourse

The more sex a lady has in the later stages, the better. But only sexual acts leading to orgasm count. At the moment of climax, the uterus actively begins to contract, which stimulates the onset of labor. Of course, you should exclude overly violent sex with sudden movements. Male semen contains prostaglandins, which also cause the cervix to dilate. But one dose is not enough; it is advisable to have sex 2-4 times a day.

Bath

A warm bath with the addition of essential oils of cinnamon, cloves and ginger is a pleasant relaxing method that leads to the opening of the uterine os. You should not take a bath if your water has already broken or if you feel unwell.

Enema

A cleansing enema causes contraction of the smooth muscles of the intestines. There is a high probability that this will be followed by uterine contraction. To induce labor, most likely, one enema will not be enough. The procedure will take 3-4 days.

Laxative food

You can eat foods that cause bowel laxation for several days. There is no need to lead to terrible diarrhea; it is enough for bowel movements to occur twice a day. Bowel spasms can stimulate uterine contractions. The method is not guaranteed, but some ladies claim that this is what helped them.

What not to do

When preparing for the arrival of your baby, it is important to remember that some actions can be harmful.

Prohibited:

Whatever method of inducing labor you choose, it is not recommended to do this without consulting a doctor.

Take any stimulating drugs without a doctor's prescription.
Resort to natural methods without consulting your doctor.
Induce labor if the due date has not yet reached 37 weeks.
Do the procedures yourself if you feel unwell and are alone.
Violate doctor's orders.
Use risky traditional methods. On the Internet you can find a lot of advice on taking oils, decoctions and other drugs to induce labor. But all these methods are extremely unpredictable. There is a danger of harming not only yourself, but also the child.

What are the dangers of stimulation?

Even under the supervision of a doctor in a clinic or ward, artificially inducing contractions in a pregnant woman carries with it some negative consequences:

Contractions are too painful. The opening of the pharynx after taking medications occurs faster than during the natural course, so the pain increases.
Some techniques cause discomfort to women. For example, when administering oxytocin, you need to lie under a drip for a long time, and when administering prostaglandins, lie for an hour without getting out of bed.
With accelerated labor there is always a risk of fetal asphyxia.
Possibly a central nervous system disorder in the child.

Contraindications

Artificial induction of labor has a number of contraindications:

Hypertension (most drugs cause increased blood pressure).
Intracranial pressure.
Scars on the uterus.
Chronic oxygen deficiency in the fetus.
Some diseases in a woman in labor.
Incorrect position of the baby in the womb.

How does induced labor work?

Regardless of the way in which the uterus labor was induced, after the onset of contractions everything goes as usual. Labor with stimulation is the same as spontaneous labor, the only difference is that contractions can be longer in intervals and painful. But this doesn't always happen.

During contractions, the cervix gradually opens. When the pharynx is opened by 10-12 cm, contractions turn into pushing. This means that the baby is actively moving along the birth canal and will be born very soon.

Assisted labor is not much different from normal labor.

Is stimulation harmful?

Any interference with body processes that should occur naturally is risky. Is artificial stimulation of labor harmful? Doctors do not have a clear answer to this question. Certainly, when there is a threat to the child or his mother, such a step can save a life.

There is also a risk of an unfavorable outcome of labor in spontaneous cases; in the case of a stimulated process, it increases slightly.

If you look objectively at the statistics, then in 95% of cases, women give birth safely after invasive methods, and children are born completely healthy. Therefore, there is no need to be panicky about such an appointment. It is very important to trust your doctor. If the doctor has ordered induction of labor, then it is really necessary.

Finally

Doctors and psychologists have long established that the course of pregnancy and its outcome largely depend on the psycho-emotional state of the woman. The happier, calmer and more confident the mother feels, the more likely it is that the birth will take place as expected: in a timely manner, easily, quickly. Stress, fears, anxiety and other negative emotions create strong blocks in the muscular system. This is reflected in the uterus, and the more tense the body, the more difficult it is for the uterine tissue to begin natural contraction. Therefore, the most important thing is to remain calm, relaxed, joyful, harmonious and simply trust nature, because it is perfect.

In this article:

When the pregnancy has come to an end, and labor has still not occurred or labor is too weak, there is a need to stimulate labor. Induction of labor is a natural or artificial acceleration of the intensification of labor through the administration of medications or certain procedures.

Indications for induction of labor

Induction of labor is used in cases where a woman cannot give birth on her own due to the presence of such factors: excess weight of the fetus or mother, a history of some serious diseases (diabetes mellitus), placental abruption, early discharge of amniotic fluid, etc.

Mandatory stimulation of labor is carried out in case of placental abruption, when there is a risk of bleeding and the life of the fetus is in danger. They stimulate labor when the pregnancy is post-term and labor does not occur. Rare irregular contractions or their complete cessation, cases when a woman is completely exhausted after contractions are also reasons to induce labor. Large pregnancy and polyhydramnios are indications for artificial stimulation, since in this case labor may be delayed and there is a possibility of hypoxia in the fetus.

Artificial methods of stimulating labor

During childbirth, the doctor observes how labor progresses: he palpates the mother's abdomen, determines the frequency and number of contractions, their duration. The most accurate indicator is the dilatation of the cervix. If the cervix dilates too slowly or the dilatation has stopped, then, if necessary, labor is induced.

Induction of labor can be carried out using:

oxytocin;
prostaglandins (gel, suppositories);
amniotomy;
Mifepristone, Pencrofton, Miropristone.

Oxytocin

To dilate the cervix, hormonal analogues are used to promote dilatation and ripening of the cervix. The most effective and common drug is oxytocin. It refers to a method of artificially inducing labor through intravenous administration. It is used for weak labor, to stimulate lactation, and as a remedy for postpartum hemorrhage.

There are some contraindications against the use of oxytocin. So, it cannot be prescribed if a woman has a very narrow pelvis or there is an abnormality in the position of the fetus. There is also a possibility of overdose or side effects due to inaccuracy in dosage. As a side effect, excessive contractions of the cervix may occur, which leads to poor circulation and fetal hypoxia. Bleeding may develop.

Prostaglandins

Prostaglandins are used in medical practice as a means to stimulate labor. They are prescribed in cases where the cervix is not ready to dilate. Normally, prostaglandins are found in amniotic fluid and in small quantities in body tissues.

The safest is the use of a birth stimulant in the form of a gel or suppositories - this method is the most gentle and effective. Labor induction gel, which contains prostaglandins, helps improve hormonal levels and prepare the cervix for dilatation and childbirth. Labor occurs within 4 hours after administration of the gel. Under the influence of oxytocin, contraction of the cervix is stimulated and pain is alleviated.
The gel is inserted vaginally with a sterile syringe into the back wall of the vagina. After this, the woman needs to lie down to prevent the gel from leaking out. If you inject the gel directly into the cervix, there is a possibility of hyperstimulation of labor. If there is no desired effect, the gel is reapplied after 6 hours. The maximum dose of the administered gel is no more than 3 ml in total.

Although the gel, as a labor accelerating agent, has good reviews, there are still a number of contraindications to the use of this gel. These include fetal presentation, a clinically narrow pelvis in a woman, and the presence of indications for cesarean section.

Amniotomy

Traditional methods of stimulation

Traditional methods of stimulating labor include such remedies as castor oil (castor oil), champagne, consumption of kelp, etc.

Castor oil

Stimulation of labor at home can be done using an oil such as castor oil. Castor oil, due to its relaxing effect, can dilate the cervix and hasten labor if taken in large quantities. To stimulate labor, you need to drink 1 tablespoon of castor oil. But still, modern medicine is against such a drug as castor oil, because castor oil can cause diarrhea and lead to dehydration (castor oil is also used as a laxative).

Castor oil is not considered a good or suitable remedy for inducing labor. You can use gentler and more effective methods to induce labor than castor oil or castor oil.

Laminaria

You can naturally speed up the process of childbirth at home with the help of a special diet, which includes foods rich in fiber. In this sense, seaweed (or kelp in other words) is very good. Kelp contains a large amount of iodine. And the vitamins and elements contained in kelp are in no way inferior to expensive vitamin preparations. To have a relaxing effect, just eat a little kelp, and it will have a stimulating effect on the body.

Laminaria during obstetrics are used not only at home in official medicine. In order for kelp to be convenient to use, they are formed into sticks 6-9 cm long. Laminaria absorb moisture well, so when they are placed in the vagina, they expand the cervical canal. In addition, kelp is believed to promote the production of prostaglandin, which dilates and softens the cervical canal.

Laminaria is used in two stages: first, 6 sticks are introduced for 16 hours, and if labor has not begun, then these sticks are removed and another 6-12 sticks are introduced for the next 16 hours.

Alcohol

It is believed that taking a small dose of alcohol has a relaxing effect on the body and leads to a natural acceleration of labor. This is partly true. For example, drinking a little red wine will not harm the baby and will help bring the contractions closer. It is not recommended to drink champagne. Champagne does not have the necessary effect on the body and can only cause harm. Therefore, doctors are against this method.

Useful video

Childbirth is a complex physiological process of expulsion of the fetus from the uterine cavity. After the cervix dilates in the first stage of labor, the baby begins to move through the birth canal due to uterine contractions - contractions. In the second period, contractions are joined by pushing (contractions of the abdominal muscles and diaphragm), as a result of which the baby is born. After which the placenta separates quite quickly and the placenta comes out. Here it is, a happy ending!

To begin normal labor, two main conditions are needed: a mature cervix and sufficient strength and duration of contractions. Typically, the cervix “ripens” (i.e. becomes soft, shortens to 1 cm or less, and dilates more than 1 finger) by 38–39 weeks of pregnancy. As labor begins, the cervix continues to open and efface. This occurs due to contractions, as well as pressure from the fetus on her. An important role is played by the amniotic sac, which “wedges” into the opening of the cervix, facilitating its dilatation. For the successful completion of the first stage of labor, uterine contractions must be strong enough, prolonged and occur with a certain frequency.

In cases where contractions are not intense enough, short-lived or rare, they speak of weakness of labor. This condition is also indicated by a low rate of cervical dilatation (normally 1 cm per hour). This condition is also diagnosed through observation, CTG (cardiotocography) and vaginal examination.

There are primary and secondary weakness of labor. Primary is manifested by contractions of weak strength, disruption of their rhythm and duration from the very beginning of labor. The second option is characterized by the appearance of the same changes, but not immediately, but after some period of time after the development of normal labor.

What is the danger of weak labor?

Many expectant mothers are perplexed - is induction of labor really necessary? After all, you can often hear discussions about how in the old days they gave birth for several days, and nothing - everyone treated it normally. But it is important to understand that this situation is not at all the norm and threatens the development of serious complications. For a baby, the danger of weak labor is an increased risk of developing severe oxygen starvation, which is fraught with neurological disorders and cerebral circulatory disorders in the newborn. In addition, during prolonged labor, amniotic fluid may enter the fetal lungs, leading to inflammation of the lungs and impaired breathing of the child after birth. These consequences often require long-term observation and treatment of the baby in the future.

From the mother's side, there is a risk of birth injuries, and as a result of insufficient contraction of the uterus in the postpartum period, bleeding may begin.

Therefore, in all cases of development of weakness of labor, it is necessary to stimulate it - increasing the strength, duration and frequency of contractions.

Stimulation during labor: let's try without drugs

Most often, the concept of “labor stimulation” in expectant mothers is associated with the use of special medications, but, in addition to this, there are a number of non-drug ways to normalize labor:

The active behavior of the woman in labor contributes to the intensification of labor.
Stimulation of the areolas (nipple circles) and nipples of the mammary glands leads to the release of the hormone oxytocin, which enhances uterine contractions.
Labor activity intensifies when the woman is positioned on her side, the same as the position of the fetus.
Amniotomy (opening the amniotic sac) is an effective measure to activate contractions. This is explained by the fact that after the discharge of amniotic fluid, the volume of the uterus decreases, which allows it to contract more efficiently. In addition, amniotomy activates the formation of prostaglandins - substances that are powerful stimulants of uterine contractions. This manipulation is painless, since there are no pain receptors on the surface of the membranes.

Drug stimulation during labor

Before starting drug stimulation during labor, it is very important to assess the condition of the woman in labor. If she becomes tired, medicated sleep is prescribed, which lasts about 2 hours. The positive effect is due to the fact that during this period labor does not stop, and the cervix continues to open. Often, after a rested woman in labor wakes up, labor activity returns to normal, and the need for labor stimulation may no longer be necessary. If this measure does not help, then, as a rule, the doctor decides on drug stimulation during labor.

Today, prostaglandin group drugs and oxytocin are used for this purpose.

Prostaglandins are biologically active substances that trigger regular labor. They promote the opening of the cervix and increase its contractions. Prostaglandins are used with the development of primary weakness of labor or with the development of secondary weakness of labor, if the dilation of the cervix is not more than 6 cm. These drugs also have side effects - nausea, vomiting, increased blood pressure, increased heart rate, bronchospasm (difficulty breathing due to a decrease in the lumen of the bronchi). Taking this into account, contraindications for prescribing such drugs are bronchial asthma, increased blood and intraocular pressure (glaucoma), severe liver and kidney diseases. These drugs are administered intravenously.

Oxytocin (from the Greek oxys - fast, tokos - childbirth) is a synthetic analogue of the hormone oxytocin, which is responsible for the contractility of the uterus. Since the most common cause of weakness in labor is insufficient production of one’s own oxytocin, the administration of this substance helps correct the situation and normalize the birth process. Sensitivity to oxytocin increases towards the end of the first stage of labor, so it is most effective for secondary weakness of labor and weakness of pushing. It is also administered intravenously.

The administration of these drugs requires constant supervision by an obstetrician-gynecologist and midwife. Careful monitoring of the contractile activity of the uterus and the condition of the fetus is necessary. It is important to prevent an overdose of prostaglandins and oxytocin, which causes uterine hypertonicity, which, in turn, leads to disruption of the uteroplacental circulation and intrauterine suffering of the baby, premature placental abruption.

Along with stimulation of labor, antispasmodic drugs are usually administered to weaken the spasm of the cervix during contractions and soften it. Intensified contractions when the cervix is tight leads to its rupture. To prevent oxygen starvation of the fetus, drugs are prescribed that improve uteroplacental blood flow and increase the resistance of fetal brain cells to oxygen deficiency.

In case of persistent weakness of labor, combined with other diseases, and if natural childbirth is impossible, a cesarean section is indicated.

Conditions for labor stimulation are:

Correspondence of the size of the fetal head to the mother’s pelvis, which shows the possibility of the fetus moving through the pelvic cavity during childbirth;
Satisfactory condition of the baby (according to cardiotocography, ultrasound, Dopplerometry of uteroplacental blood flow). If the fetus is oxygen starved, labor stimulation cannot be performed, as this can lead to vasospasm, disruption of the uteroplacental circulation and deterioration of the child’s condition.
Absence of amniotic sac. Labor stimulation is not performed when the amniotic sac is intact. This threatens with a serious complication - placental abruption due to an excessive increase in intrauterine pressure. Typically, when labor weakness develops, an amniotomy (puncture of the amniotic sac) is first performed, and then the woman in labor is observed for 2 hours. If labor has not returned to normal during this time, drug stimulation is prescribed.

Is it possible to avoid stimulation during labor?

Prevention of the development of weakness of labor is largely a normal pregnancy. An expectant mother needs adequate sleep - at least 8 hours a day, a rational balanced diet, and favorable conditions for psychological comfort. An important role is played by the absence of chronic foci of infection, good physical shape, preparation at school for pregnant women and support from relatives. Gymnastics classes for pregnant women, breathing exercises, swimming in the pool, yoga, and walks in the fresh air are recommended. Also, the expectant mother needs to take vitamins (B6, ascorbic and folic acid), which have the ability to increase the energy potential of the uterus.

Such different concepts

It is important to understand that labor stimulation and labor induction are two completely different procedures. Labor stimulation is always an intensification of existing contractions, when labor began on its own, but then there was a disruption in its normal development, and it began to weaken. Labor induction is carried out when it is necessary to induce labor when there are no contractions yet.

Causes of weakness of labor:

previous abortions, miscarriages, uterine curettage, inflammatory diseases of the female genital organs, uterine fibroids, hormonal disorders and chronic diseases;
the age of the primigravida is less than 18 and more than 35 years;
a large number of births (4 or more);
reasons leading to overstretching of the uterus (large fetus, polyhydramnios, multiple pregnancy), preventing the full contraction of the myometrium - the muscles of the uterus;
hereditary predisposition, which can be traced through the female line;
complications of pregnancy - postmaturity, placental insufficiency (i.e., the inability of the placenta to meet the needs of the developing fetus);
A woman’s fear of pain, lack of psychological attitude towards childbirth.

When can labor stimulation not be performed?

Contraindications for labor stimulation are the presence of a scar on the uterus, incorrect position of the fetus, oxygen deprivation, clinically narrow pelvis (a situation where the size of the fetal head does not correspond to the size of the mother’s pelvis), placenta previa (when the placenta blocks the exit from the uterus), severe gestosis, fatigue women in labor.

Maria Sokolova

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The 41st week is already underway, and the little one is still in no hurry to be born into the light of day... This situation is familiar to every 10th woman. And passively waiting for future fights is not always an ideal solution.

When induction of labor is really needed, is it dangerous, and how is it carried out - we understand the nuances.

Indications for inducing labor – who decides to induce labor and when?

The term “induction of labor” is used when labor has to be induced artificially at any stage of pregnancy.

It is worth noting that in the period from the 37th to the week, induction of labor is not required if there is no indication for it.

It is also not needed in the case of normal labor.

Experts consider indications for stimulation of labor...

True.
Detection of pathological changes in the placenta.
Symptoms of any disorders that are dangerous to the health and life of the fetus.
Late toxicosis (not always).
The water broke earlier (given the high risk of infection through the cervix).
Placental abruption.
Certain chronic diseases of the mother. In particular, diabetes mellitus, hypertension, etc.

Naturally, the decision to induce labor is made by only a doctor and only after a full examination , which will establish that further pregnancy can harm the child or mother.

It is worth noting that post-term pregnancy is not just an extra week or two of discomfort for the mother, it is, first of all, a risk of bleeding in the mother, hypoxia in the baby, as well as weak labor, etc. Therefore, if the doctor decides to induce labor need to follow directions strictly!

If you have any doubts about whether stimulation is worth it, you can contact another specialist to make sure that the decision was made correctly.
You cannot rely solely on the date of birth expected by the doctor (or on your own date) when making a decision. That is why this date is “supposed”. That is, the decision is made only after 40 obstetric weeks - and only according to indications.

Possible complications and consequences of labor stimulation - why is it dangerous for mother and baby?

Induction of labor is far from an “ordinary” phenomenon. This is an exclusively emergency option for childbirth, which, in fact, should be natural and without medical intervention.

Of course, any interference with the natural process cannot be beneficial - but, in most cases, stimulation does not cause significant harm.

However, it is worth mentioning the possible risks for the baby from using this procedure:

Hypoxia.
CNS disorders in a baby after birth.

Risks for mom:

Painful labor: stimulated contractions are always stronger than usual - and with shorter breaks.
It is impossible to move under a drip, which complicates the general condition of the woman in labor.
Stimulation does not work in all cases, and then a caesarean section cannot be avoided.

3 methods of stimulating labor in the maternity hospital

The conclusion - whether post-maturity is taking place - is made by specialists at a certain period (closer to the expected due date) and solely based on research:

Cardiotocography.
Assessment of all parameters (size of the fetus, fluid composition, condition of the placenta, etc.).

If the results of the examination reveal thickening of the bones of the fetal skull, low water levels, aging of the placenta, or other signs indicating post-maturity, then an appropriate decision is made to artificially induce labor.

All methods are classified into 2 groups:

Methods and means that accelerate the dilatation of the cervix.
Methods and means for stimulating uterine contractions.

The most popular medical methods of inducing labor include the following:

Amniotomy. In this case, a specialist inserts a special hook instrument through the cervix and, hooking the amniotic membrane, punctures the bladder, resulting in the release of water and the onset of contractions. Opening the bladder also stimulates the production of prostaglandins, which enhance labor. The method is often used, but is considered risky due to the possibility of infection, especially if the method was not able to start the birth process. Possible risks also include prolapse of the umbilical cord (here, emergency medical care/intervention will be necessary) and damage to blood vessels with subsequent bleeding. The procedure is absolutely painless.
Oxytocin. A drug that is a synthesized analogue of a hormone produced by the pituitary gland. This drug in the form of tablets or solution is used to activate the contractility of the uterine muscles in various cases - to stimulate labor or lactation, with postpartum hemorrhage, with weak labor. To avoid complications, the use of the drug is excluded in case of abnormal position of the fetus, scars on the uterus, placenta previa, as well as in case of a narrow pelvis of the mother. The dosage is usually selected specifically for each situation, taking into account the individual characteristics of the mother. Side effects and risks: increased labor pain, powerful contractions of the uterus (note - there is a risk of impaired blood circulation in it and, as a result, hypoxia of the baby).
Prostaglandins. This remedy is used in cases where the cervix is simply not ready to dilate, although the birth process is already underway. These hormones contribute to the rapid “ripening” of the uterus, which is immature for childbirth, by stimulating smooth muscles, as well as having a stimulating effect on the cervix, on itself, and so on. When administering the drug, specialists strive to minimize the risk of side effects of prostaglandins by using them in the form of a gel or suppositories. It is worth noting that tablets and solutions of the drug are often used for abortion, and the risks of using the drug during childbirth orally and intravenously are quite high: excessive stimulation of uterine contractions (note - with all the consequences), nausea and vomiting, and so on.

Other drugs for inducing labor are also known, but they are used extremely rarely.

It is worth noting that drug stimulation is prescribed only in exceptional cases when there is a threat to the life of the mother or baby.

It is strictly not recommended to induce labor at home, unless you have an obstetrician-gynecologist nearby, or the appropriate recommendations are given to you by your doctor.

Any actions that may lead to the approach of labor - only on the recommendation of your gynecologist!

The main “techniques” that are used at home to induce labor include...

Nipple stimulation. Such a massage provokes the production of oxytocin, which in turn stimulates labor. That is why early latching of the baby to the breast after childbirth helps to speed up the birth of the baby and reduce the risk of bleeding. If you do not plan to give birth ahead of time, then you should be more careful during intimate relationships if they are present at a later date (do not overdo it).
Enema. Contraction of the intestines also promotes the release of prostaglandins.
Proximity. The most well-known method of approaching labor, but very risky in the later stages. It is worth saying that uterine contraction and oxytocin production are guaranteed, and male semen contains prostaglandins that soften the cervix.
"Up down" : Walking up and down the stairs can help a mom whose labor is a little late.
Squats, long walks. Remember that excessive stress leads to placental abruption.
Spicy dishes. Hot spices in food are stimulants of intestinal contractions, and after that, the walls of the uterus.

In addition to those listed, there are other ways to bring the moment of childbirth closer, including funny, dangerous and downright stupid.

Video: Natural methods of inducing labor

But it is important to remember the main thing:

Do not use any means or methods to advance labor if your due date has not yet approached and there are no such doctor’s recommendations. You risk harming yourself and your baby, and the consequences can be unpredictable.
Fatigue from pregnancy is not a reason to induce labor!
Any means to induce labor can turn into a tragedy if there are no qualified doctors nearby, if it’s a long drive to the hospital, if the mother has a narrow pelvis and cannot give birth on her own (in an emergency), if the baby is lying bottom down, and in other cases.
It is strictly forbidden to induce labor on your own at home using medications, including suppositories and acupuncture.

If the results of the examination show that everything is fine with the little one, and the doctor recommends waiting a little longer, do not rush the baby - let him live in his belly. Give him time - he will decide for himself when it is time to be born.

The site reminds us: this article in no way replaces the relationship between a doctor and a patient. It is for informational purposes only and should not be considered as a guide for self-medication and diagnosis.

Pathological symptoms and some physiological conditions of a pregnant woman require direct intervention from the attending physician!