The mystique of induction & labour

How is induction done? Do I need one?

You have heard this term many times, but what does it mean?

Induction of labour (IOL) is a medical intervention that stimulates the onset of labour contractions. We still hope for a natural delivery.

Do I need an IOL?

Yes, if you have hypertension, small baby or diabetes. This may necessitate an early delivery before due date. Only when there is no immediate danger to you or baby, IOL is safe.​ Post-date pregnancy is another common indication. There are also mothers who request an induction for social reasons, but do discuss the risks and benefits carefully with your doctor.

What are my risks of IOL?

• Hyper-stimulation of womb — Excessive contractions may stress the baby.

• Womb rupture — this serious complication is very rare. The main risk factors for rupture are previous C-section and parity.

• Emergency C-section — If IOL fails, a c-section is recommended to deliver the baby safely. 

How is an IOL performed?

Labour starts when the cervix initially softens and dilates. This is achieved by prostaglandin medication vaginally. In Singapore, Prostin (single dose for 6 hours) or Cervidil pessary (slow-released prostaglandin for up to 24 hours) is usually used for induction of labour. Sometimes, two prostin pessaries may be needed for inducing first-time mothers. Mechanical induction is also possible with balloon dilation.

Once the cervix is adequately dilated, the membranes (fore-waters) can be ruptured and an oxytocin infusion is then used to maintain labour contractions. 

Myths of IOL

#1 The woman suffers unnecessary pain

This is not necessarily true. Some patients may experience mild cramps while the cervix is responding to the prostaglandin medication. She is encouraged to ambulate.

#2. IOL is unnatural

There is nothing unnatural about going through a labour stimulated by IOL. Once labour is established, the same rules on progress of labour apply.

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