Induced labor – how long does it take? When is it done?

Induced labour is not the same as natural labour. It also differs from augmented labour, advises Dr. David Kiragu. Induced labour does not begin spontaneously (naturally); artificial means initiate it. In most cases, waters will be broken artificially and drugs will be administered by drip to initiate and sustain the process.

Augmented or induced labour?

Augmentation of labour is not the same as, and should not to be confused with induced labour. The latter occurs when one already has contractions which are not strong enough. In this case, acceleration of labour is achieved through administration of drugs.

Once induced labour has started, the dynamics of that labour are very similar to spontaneous labour. However, it may be more challenging than natural labour in the sense that in many situations the contractions may be stronger. On average induced labour tends to last longer than spontaneous labour.

When is induced labour performed?

Induction is not done for the sake of it; it is done to forestall certain complications. It is a useful medical procedure despite the fact that it brings with it a measure of discomfort that on average, is greater than that experienced during natural or spontaneous labour. Such complications include:

When the foetus is at risk

If one was to carry the pregnancy longer, the foetus would be compromised. Induction is done to salvage the foetus and prevent adverse outcomes.

A pregnancy that is post date

The normal duration of pregnancy is 38 to 42 weeks. After 42 weeks have lapsed and the mother has not gone into labour, then an induction is carried out. This is because a significant proportion of such post date pregnancies have complications. One of the common complications is foetal distress, which can lead to foetal death in-utero.

Maternal high blood pressure

This can lead to adverse maternal complications like eclampsia. If the baby is mature, we would want to deliver and therefore prevent maternal and foetal complications.

Premature rapture of membranes

This is a situation where the waters break before the onset of labour. If membranes stay open for more than 24 hours, one is at high risk of developing infections. This will affect the uterus and its contents, placing the life of the baby and the mother at risk.

If the foetus dies in-utero

The mother has to be induced, because keeping a dead foetus in the womb has adverse consequences on her health.

For social reasons

Even though rare, induction is sometimes carried out for social reasons. For example, if a woman has a pressing need like travel, and cannot do so unless she has delivered- an induction can be considered.

Can induced labour fail?

There is no guarantee that induction of labour will be successful, even though in the majority of cases, it is completed without any complications. If induction fails, an emergency Caesarean section will be performed.

Induced labor – how long does it take?

Generally, it is desirable to conclude delivery within 24 hours because after 24 hours the risk of infection rises significantly.

Drugs to induce labour

Syntocinon (Oxytocin) is the main drug used in the process. Prostaglandin pessarries are often used (put in the vagina), to soften the cervix.

The process of induction starts with an assessment of the cervix; to see whether it is convenient for the induction process. A convenient cervix which is unlikely to end with failed induction is generally soft, short and it might be slightly open. If the cervix is the converse of that, tightly closed, very firm, long, and rigid then the induction is likely to fail.

Therefore, in order to reduce chances of failure some drugs are normally put in the vagina to soften, shorten and make the cervix ideal. This is done by the use of pesarries. If the cervix is optimal you don’t need the pesarries. Pesarries make the cervix more appropriate for the induction process. When the cervix is favourable, it is opened and the membranes are broken artificially so that the water comes out. Then a drip that has some medication in it, known as oxytocin, is administered to initiate the contractions.

When to avoid induced labour

Where a patient has previously undergone a Caesarean section or sections, induced labour is generally not advisable. Reason is that it may lead to uterine rupture.

Indication of foetal distress is another scenario in which induction should not arise, because it can make the situation worse.

In a situation of baby malpresentation, the only option is a C-section.

Other complications associated with induced labour

If the induction takes too long (more than 24 hours) it can lead to infection of the uterus, because of the opening of the membranes. Transmission of the infection to the foetus may occur, leading to a sick newborn.

The mother may also have infection of the pelvic cavity

When inducing for post maturity (because the baby’s delivery is overdue), one of the precautionary measures is to assess the maturity of the baby- before initiating the induction. The main problem with induction for post-datism is that a woman may have wrongly calculated her menstrual dates. Complications of induced labour include prematurity; instead of delivering a full term baby, you get a premature one!

Poorly regulated contractions may lead to ruptured uterus.

If not properly monitored, because of the strong contractions, the risk of foetal distress is high.

END: PG 06/40-41

1 Comment

  1. Livhu on May 25, 2018 at 5:09 pm

    Hello…I heard all you said but what I really what to know is how or what will a woman do to give birth without feeling…that natural pain coz honestly the pain is really bad

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