Induction is like the word no one wants to hear when it comes to giving birth. 1 in 4 women in the UK will be induced and 75% of those will be for 'post dates'. This post is for anyone who has made the choice to have an induction, whether that is for medical reasons or post dates. Whatever the reason is, we hope that it is the right decision for you, but even if the induction is necessary, chances are you've heard horror stories and may be a bit worried.
Induction is by no means the easy way out, it can be a long, uncomfortable and tiring process. It comes with its own set of difficulties, but it is likely you've discussed these with your caregiver and concluded it is the best thing to do for you and your baby. We are going to tell you how you can work towards making induction a more positive process for all involved.
1. Know your stuff. It is so important to make sure that you have used your BRAIN (benefits, risks, alternatives, instincts, nothing) to make the decision to have an induction in the first place and you are aware of all the options you have within that - because there are a lot! It isn't a one size fits all process. If you understand what is going on, exactly WHY you are having this, when things might happen and ask questions along the way, it is likely you'll feel more confident and empowered to make your own mind up. For example, there are hormonal methods, mechanical methods, you might be able to go home after its started, who can be with you...
2. Keep yourself occupied. Induction can sometimes take a while, especially if it is your first baby or you are being induced before your due period, as the body isn't 100% ready for birth yet. Pack things to keep you occupied, make you feel more at home and don't have high expectations that you will enter the ward, begin your induction and give birth 2 hours later (THAT would be a dream).
3. Have some totally awesome support. The period before going into active labour is tiring and emotionally draining too, because it is a lot of waiting around. Have people around you who will keep you calm and grounded. Your birth partner will usually be able to stay with you on the antenatal ward through the entire induction process. You could also look into hiring a doula. They need to be looked after too, though. Be aware that this is hard for them also and they too are in it for the long haul! Ensure that your birth partner remembers to take care of themselves and is also informed about the whole process.
4. Go outside. Remember that this process can take time, so avoid sitting on the bed all day. The more upright and mobile you can be, the better. I'd recommend getting off the ward, going for a walk, or seeing if your hospital support outpatient inductions. Sitting in hospital is pretty depressing. Using a birthing ball is also great, or having a bath if you can. Get the baby down and keep your blood pressure low - sitting on a ward is anxiety provoking in itself. Fresh air is awesome, being outside will pass the time and stop you feeling like such a recluse.
5. Get comfy. Whether that's a TENS machine, massage, hypnobirthing, water, or being offered analgesia e.g. pethidine, diamorphine, epidural, take it if you need it. Work your way up slowly and utilise everything you have available. We totally advocate that hypnobirthing works amazingly for comfort, but know you have other things there for you and it isn't a massive fail if you feel you need the stronger stuff, which is exactly what we would say for any birth. It may be more uncomfortable, because its synthetic. Be ready for that, but don't be scared of it. There are always methods to reduce discomfort that can be given quickly.
6. Nap when you can, especially in the early stages. Although we said stay active, you should rest when you get a moment too. You don't want to peak too early, you need energy for active labour. This would also include eating and drinking regularly.
7. Make the environment your own. This goes for all births, but for an induction it is vital. Your body is unlikely to be producing its natural birth hormones, so get relaxed to encourage them. Also, it may be more medical which can be anxiety provoking. Keep the room dimly lit, quiet, put on music, have your birth partner use light touch, make your midwife aware you wish to keep the environment calm.
8. Give yourself time. When you are being induced, it is often the case that the doctor may say 'right, you've got 4 hours to get going'. Why 4 hours? What if everything else is ok? Why are we rushing? Just because something is hospital policy, it doesn't mean you have to agree. Your body is not running on a stop clock, your baby doesn't know the induction protocol. You do what feels right - if that is asking for more time, that is your right.
9. Get off the bed. You'll probably be recommended to have continuous fetal monitoring, which you may have had before, straps around your abdomen to pick up baby's heart rate and your surges. Many women feel tied to the bed with this, which can effect the way your baby moves through the birth canal, as space is restricted. You can still be upright with this monitoring though! Choices - see if they have wireless monitors so there are no wires. Or, get up. Move the bed around, get a birth ball or chair. You might have some restriction on space due to the machines, but there is still room to move. This will have HUGE benefits to the course of your labour.
10. Remember, it is your birth. Just because it may feel like power has been taken away by medical intervention, take it back. You have made the informed decision to have an induction for whatever reason (if you don't want it then immediately back to the doctor to question why you are doing this), so you have choices throughout. You haven't handed over your autonomy. You haven't handed over your body. You are a capable woman. This is simply a change of path, it doesn't make you a patient. You have options. Grab your birth with open arms. You can do this.
We think it is also important to consider the research into induction, in terms of its outcomes. There is no evidence to suggest that induction leads to a higher chance of caesarean. There is some research stating it increases your chance of an instrumental birth (ventouse/forceps), but it is unknown whether this is due to the actual process, or other considerations such as your position or monitoring of baby. This is why it is vitally important to optimise your physiological functions in terms of promoting hormones and using your body to its advantage for birth. Remember everything you have learnt about 'normal birth' and implement it more than ever! Induction is still labour and birth. Yes, different starting point, but same outcomes.
11 September, 2019