Child Developement

Week 38-40 in normal pregnancy rings in the ideal time for the arrival of your bundle of joy. While for most it will be a natural process, some may need help through induced labour to get started. For expectant mothers in Singapore, we answer all your queries about induced labour.

Pregnancy beyond week 40 can become uncomfortable, to say the least. The high humidity levels in Singapore makes the wait extremely difficult and makes you wish you could give birth as soon as possible. 

For some of you, nature takes its own course and makes it a smooth-sailing journey. While for a few others, a gentle nudge may be required to set the labour ball rolling. This is known as induced labour.

What is induced labour?

An induced labour is one that is started artificially. It is fairly common - about one in five labours are induced every year.

How is labour induced?

Labour is initiated artificially with a synthetic form of oxytocin (Syntocinon or Pitocin) that stimulates the onset of labour pains with an aim of pushing for a vaginal delivery. 

“Contractions can be started by inserting a tablet into the vagina. Induction of labour may take a while, particularly if the cervix needs to be softened. Once the cervix has softened and opened up, the next stage of induction involves breaking the water bag (amniotomy) and putting up a hormonal drip (oxytocin drip) to stimulate the contractions,” says Dr E K TAN, Singapore based Obstetrician and Gynaecologist. 

When is labor induced?

Both maternal and fetal reasons play a vital role in determining the occurrence of induced labour. With the pregnancy stretching beyond the due date, labour is induced to prevent the baby from growing out of the protection given by the mother’s placenta. 

Obstetricians in Singapore begin to consider induction of labour when one is past 40 weeks, unlike Europe and Australia where doctors wait till the end of the 41st week.

The procedure is also undertaken when contractions are missing despite the water bag being broken, magnifying the chances of infection to your baby. 

Reduced fetal movement that indicates decreased fetal wellbeing also often results in induction of labour. 

Under what conditions is labour induced?

• You are beyond your due date: Induction is offered to women who do not go into labour naturally by 42 weeks, because there is higher risk of stillbirth if pregnant women go beyond 42 weeks.
• Your waters break early: If your waters break more than 24 hours before delivery, there is an increased risk of infection to you and your baby.
• You have a health condition: You may be induced because you have a health condition like diabetes and high blood pressure. 
• You may also be induced if there are concerns such as your baby not growing well.

Should you opt to induce labor?

While seeking induction may not be the preferred choice, it should not be ignored. “There are various reasons as to why induction of labour is offered to the patient. I would advise the patient to discuss with the doctor, understand the reason/s for the induction and come to an agreed option rather than seeking a second opinion. After all, the attending obstetrician has managed the whole pregnancy and understands the pregnancy related issues,” says Dr Cathryn Chan, Obstetrician & Gynecologist, Astra Women's Specialists. 

Does inducing labor speed up the process?

While induction is meant to jump-start the labour process, it may not necessarily speed it up. The response to induced labour varies from individual to individual. You could be in the hospital for 12, 24 or more hours before your baby is born. 

Does inducing labor pose a risk to the baby?

There are various risks for your baby associated with induced labour including:

• Premature birth causing breathing difficulties for your baby
• Low heart rate in your baby owing to the contraction inducing medicine causing far too many contractions, reducing the oxygen supply for the baby
• High infection risk

Are induced deliveries more painful?

Expert speak: Induced labour could prove to be more painful for some expectant mothers as the contractions are initiated sooner than a normal delivery. However, the intensity of pain is also determined by how ready your body is for delivery when labour is induced.

Parent speak: Sharmistha Sengupta gave birth to her daughter in Singapore NUH hospital in 2014 using induced labour. “I had a normal delivery. After nine long hours when my cervix didn't open as per expectation, the doctor decided to induce labour and I had a positive result in the next four hours,” shares Sengupta. 

Conclusion

While induction of labour may not be the first choice, it is always in your and your baby’s interest to understand why you would need induction in the first place and its associated risks. Natural and surgical inductions are initiated when labour doesn’t begin naturally, keeping in view the health of the mother and the child. 

https://www.healthhub.sg

http://www.nuhgynae.com.sg/cos/o.x?c=/wbn/pagetree&func=view&rid=1040051

www.heartknowsbest.com.sg

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