There has been a lot written about induction of labour recently. The new highly controversial NICE guidelines are due to be published in the coming weeks. The guidelines are due to recommend routine induction at 39 weeks for all women, with a higher BMI, women who have had IVF or AFT’s, Women of Black, Brown, Asian, or other Ethnic family backgrounds. It is also proposed that all women should be induced by 41 weeks gestation.
You can read Dr Sara Wickham’s response here [www.drsarawickham.com/?s=10+reasons+induction+nice]. I am not a researcher and tend to go with my gut feelings about what is right and what is not. These new guidelines do not feel right to me! Sara Wickham’s response echoes the thoughts of the birth workers that I have been reading over the last few weeks and I would encourage you to have a look at some of the responses to the draft guidelines that have been written in the last few weeks.
So induction of labour. It is not disputed that for some women whose pregnancies have run into difficulties Induction of Labour is a really good thing. So what can we do to make the process more bearable?
Thinking about, and making a birth plan is a really good idea.
- Think about who you will have supporting you during this time. Do you want your partner with you, or your mum, or a trusted friend or Doula? What are the arrangements on the ward for visitors and birth partners? Do you want your partner to stay overnight or be at home resting?
- What will your plans be for keeping comfortable? Will you want to mobilize or bounce on a birthing ball, snuggle up in your pillow from home? Have another thing about pain relief. In the earlier stages things like gas and air and epidurals are not available, but, Pethidine and other oral forms of pain relief, may be? Will you want to have a shower, or bath? Water can be a great help. Think about bringing in a couple of your things from home. Battery twinkle lights, aromatherapy sprays for your pillow. Your partner’s t-shirt can be a comfort if you are on your own. Little things like these can make a big difference to how you feel about the space you are in.
- We know that listening to your birth affirmations and visualisations make a really big difference to how you cope with induction of labour. Being peaceful and calm gives you the best chance of the drugs taking effect.
- What about monitoring your baby’s heartbeat? Once labour gets going continuous monitoring will be recommended, however, this is your choice, would you prefer intermittent monitoring, or telemetry where there are no wires and you may be able to use the pool?
- We know that mobilizing in labour is important, what strategies are you going to use for staying off of the bed? Using upright, forward and open positions that are good for helping the baby rotate in the pelvis. Upright positions for birth are also great to use, leaning over the back of the bed, or hands and knees. Standing by the bed. Avoiding sitting on your tail bones allows the pelvis to open and the baby to descend.
- After your baby is born, you will be able to spend time skin to skin.
- Talking through your options with your antenatal team will help you understand how induction of labour works and how it progresses to the birth of your baby.
Undergoing and induction of labour is a big decision to make and should not be taken lightly, but with a deep understanding of the risks (and benefits) that come with bringing a baby into the world before both you and your baby are ready.