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Narrator: Sometimes your body needs a little jumpstart to kick into labor.
Today, Cheryl – 39 weeks pregnant – has arrived for her scheduled induction at Abington Memorial Hospital, in Abington, Pennsylvania.
There are many forms of induction but all have the same goal, says Dr. Richard Carapellotti, Cheryl's obstetrician.
Dr. Carapellotti: We actually induce contractions. Contractions hopefully will cause cervical dilatation. As the cervix dilates, the labor progresses and ultimately the baby's delivered vaginally.
Narrator: Your doctor or midwife may choose to induce your labor for a number of reasons:
You are a week or more past your due date, and you show no or slow signs of cervical dilation and labor.
Your water breaks, but your labor doesn't start.
Or you or your baby face medical issues that pose a health threat, which is the case for Cheryl.
Cheryl has an antibody in her blood that could harm her baby, so the induction is a precautionary measure to help avoid any problems.
There are a number of methods available to medically induce or ripen the cervix to get your labor moving.
If your labor needs to be induced, you may be treated with one or more of the following in the hospital:
A foley catheter. Your practitioner may insert a tube with a very small, uninflated balloon at the tip into the opening of your cervix, demonstrated here with this curled-up hand.
The balloon is then inflated, which puts pressure on your cervix and amniotic sac. This stimulates the release of prostaglandins – hormones that cause the cervix to open and soften.
Prostaglandins are also available as a medication in several forms, including a pill and a gel. Your caregiver will insert the medication into your vagina to help your cervix dilate.
Stripping or sweeping the membranes. If your cervix is already somewhat dilated and your body just needs a little help, your practitioner can insert her finger through the cervix and manually separate your amniotic sac from the lower part of your uterus.
Rupturing the membranes, more commonly known as breaking your water. This method can be quite effective in accelerating labor but is only performed when the woman has a partially dilated or effaced cervix.
Pitocin is the synthetic form of oxytocin, a natural hormone your body produces to bring on labor.
Pitocin is the most popular method of induction. It's given through an IV line.
Cheryl is receiving Pitocin today since she's only 2 centimeters dilated, her water hasn't broken, and her contractions haven't begun.
Pitocin is commonly given if:
Your cervix isn't ripe – meaning it isn't softening and thinning or it's showing signs of slow ripening.
Your labor slows down.
Or your water has broken but you haven't gone into labor after several hours.
Pitocin isn't always a quick solution.
Doctor: If mom is having some early contractions on her own, the use of Pitocin will work rather quickly – again, if the cervix is favorable. If it's a very, very unfavorable cervix, we can use low-dose Pitocin for even 12 hours before we see any major effects.
Narrator: The heart rates of both Cheryl and her baby, and the frequency and length of her contractions, will be continuously monitored.
Two and a half hours after starting Pitocin, Cheryl is only 3 centimeters dilated, so her doctor decides it's time to break her water to speed things up.
Induction is generally safe, but it does carry some risk, depending on the methods used and your individual situation. It's a good idea to discuss the pros and cons with your doctor.
Inductions don't always succeed in bringing on labor. When this happens, a c-section will be necessary.
Now, seven hours into her induction, it's taking Cheryl longer than she hoped to advance to active labor.
She decided not to get an epidural and is instead getting medication in her IV line to take the edge off the pain.
Eleven hours after first receiving Pitocin, Cheryl is finally delivering her baby.
Cheryl delivered a healthy 7 pound, 9 ounce girl.
Cheryl says the pain she experienced during labor with Pitocin was intense but no different than her previous natural birth.
She's glad the induction worked. The best part of it was the result – finally meeting her daughter, Madeline Grace.