Isobel Mary Champion
Birth Concerns #1 with Shelley the Midwife: Induction of Labour
My fabulous guest on my blog this week is Shelley Wilson, founder of Baybee Beginnings, a wellness company that delves into all aspects of pregnancy, childbirth, infant feeding and beyond. Midwife, Lactation Consultant, and creator of the super fab 40-week Squad (which will nuture you throughout the whole of your pregnancy!), Shelley also offers a whole range of postnatal packages.
Shelley is passionate about empowering, nourishing and nurturing parents and babies throughout the beginning of their exciting life journey (and is also a former professional nanny like myself!).
I asked Shelley what concerned new parents the most about pregnancy and birth, and she told me that Induction of Labour was one of the big ones! And with the NHS reporting in 2018 that around one in three births are now being induced, I am not surprised! She very kindly agreed to provide all you need to know about this topic for our blog post together, so here we are - the low-down on Induction of Labour, from the fantastic Shelley herself!
Induction of labour- why does it happen?
Shelly: "When you are given your due date, you are approximately 80-90% likely to deliver within a 20 day period. In about 20% of women, labour may need to be induced. The most common reason for Induction of Labour is a prolonged pregnancy – term +10 days. There is a slight increased incidence of stillbirth after 40 weeks, and this risk goes up after 41 weeks.
Other reasons for Induction of Labour include:
Failure to go into labour after ruptured membranes
Concerns about baby’s growth
Medical problems e.g. obstetric cholestasis/pre-eclampsia
Mum is over 40 years old"
Induction of labour – how does it happen?
Shelley: "Any decision should be carefully considered with your consultant obstetrician or midwife. The benefits are a reduction in the risk of stillbirth. The risks are: an occasional overstimulation of the uterus, an adverse reaction to the drugs, and that the dates are incorrect and the procedure might be unnecessary.
"The method used will depend on how favourable the cervix is. A favourable cervix is one that is soft and starting to open, determined by an internal exam to see if cervix is soft, stretchy, open and baby’s head is down. An unfavourable cervix is firm, long and closed and the head is high - Induction of Labour may be more difficult in this scenario."
What is the Bishops Score?
Shelley: "The Bishops Score is a scoring system used to assess the condition of the cervix to indicate whether induction is appropriate or not:
A score of 5 or less = the labour will not commence without Induction of Labour.
A score of 9 or more = normally indicates that labour will start without any help
A very low score may indicate that induction will not be successful."
Is Induction of Labour more painful?
Shelly: "Many believe that Induction of Labour means a more painful labour and more intervention. It is true that it can be more painful sometimes, but lots of women have a positive experience. Think carefully about what pain relief you would like to try, and discuss with your midwife."
Are there Different Methods of Induction Of Labour?
Shelley: "There are 4 different methods of Induction:
1. Membrane sweep
"This is considered before any drugs or invasive procedures. It involves an internal exam where the midwife will attempt to insert a finger through the cervix and try to separate the membranes that surround the baby and stimulate hormone release.
This works in 1 out of 3 cases
Is normally done 40-41 weeks
Is an uncomfortable procedure
Can provide small amount of bleeding (but it is safe)
If it doesn’t work you may be offered a 2nd sweep
2. Prostaglandin (a drug commonly known as Prostin)
"This is the most common way for labour to be induced. A Prostaglandin gel, tablet or pessary (which is inserted into the vagina) is used. It is not unusual to need 2-3 applications at 6 hourly intervals, so it can be a long-winded process, but some women will go into labour after the first dose. Your baby’s heartbeat should be monitored carefully for the first hour or so after Prostaglandin insertion."
(Quick note from Isobel here - I worked with a mum once who went to the hair salon next to the hospital to have her highlights done after being induced, which gives you an idea of the waiting period you can expect!)
3. Artificial Rupture of Membranes (A.R.M)
Shelley: "An alternative method of induction but used only once the cervix has started to open. This is often performed to speed up a labour which is progressing slowly, combined with the use of Syntocinon (see below) – this is known as Augmentation of Labour as opposed to Induction.
"Once the cervix is open enough the membranes can be artificially ruptured by the midwife using an amnihook, which looks scarier than it is – it resembles a long crochet hook but the hook itself is very tiny. The procedure is uncomfortable and can feel weird but it shouldn’t be painful. The idea is that once the waters have broken there will be a rush of hormones and your contractions should start to speed up.
A combination of A.R.M (above) and an intravenous drug called Syntocinon may be used.
This is delivered via a pump and will commence on a slow rate, gradually getting higher. The rate can be controlled by the midwife and can be lowered or turned off completely if the baby reacts in an adverse way to the treatment.
Syntocinon is a synthetic form of the hormone Oxytocin. You cannot give birth without it. Adrenaline blocks oxytocin so if you are highly anxious this will slow labour down. This requires continuous fetal heart monitoring using a CTG (cardiotocograph).
With the use of syntocinon, labour may be more painful and the use of effective pain relief such as an epidural is likely to be increased. However, I have witnessed many women go through a Syntocinon induction with little or no pain relief-everyone is different."
Wow thank you Shelley! Good to have all info and for parents-to-be to hear it from such a calm and professional source! If you have any more questions, you can get in touch with Shelley via her website Baybee Beginnings, full of lots of great support for parents about pregnancy, childbirth, infant feeding and beyond. And why not join her super fab 40-week Squad (which will nurture you throughout the whole of your pregnancy!).
My Spring Newsletter will be coming soon, full of lots of positive, holistic, and sustainable ways to enjoy the joys of Spring. While you are here why not take the chance to enter my Weaning Giveaway and win yourself (or a friend!) a lovely weaning bundle! For my next blog post I will be focussing on CMPA and dairy (such a common issue for parents these days!), and fingers crossed I will have another post coming up soon featuring more wisdom from midwife Shelley aka Babybee Beginnings!
While you are here, why not read my interview about Step Parenting with the Step-In-Mum Veronika Durham, my Better Sleep and Bedtimes post with guest Sleep Consultant Alexandra Collingbourne, and check out my other posts with the lovely Emma West about weaning, Pre-and Post-Natal Exercise, and Pre- and Post-Natal Nutrition! Visit the rest of my website to find out more about my parenting coaching services, child development, child behaviour, and positive parenting! Get in touch for more information on any of the topics mentioned here or elsewhere on my site, I would love to hear from you!