Induction rates have been steadily rising over recent years. Rates vary per hospital but overall currently around 1 in 3 births in the UK are induced.
It is worth noting what NICE (National Institute for Clinical Excellence) which govern the conduct of labour say in their guidelines;
‘Induction of labour has a large impact on the birth experience of women and their babies and so needs to be clinically justified. It may be less efficient and is usually more painful than spontaneous labour. Epidural analgesia and assisted delivery are more likely to be needed if labour has been induced.’
‘From 42 weeks, women who decline induction of labour should be offered increased antenatal monitoring consisting of at least twice weekly cardiotocography (CTG) and ultrasound estimation of maximum amniotic pool depth.’
Don’t book in for an induction from 41+3 as ‘standard’. Get off the conveyor belt and avoid the production line.
I don’t mean to P you off (especially in your later stages of pregnancy when you might well be feeling like enough is enough and you are SO READY TO MEET YOUR BABY!) But you’re not booking a weekly Ocado, Morrisons, Tesco (insert supermarket) food delivery slot here. The phrase ‘a watched pot never boils’ springs to mind. Time pressure is a MENTAL INTERVENTION that will contribute to any stress and anxiety, making it harder for you to relax and produce the labour hormones you need for spontaneous labour to start. Adrenaline reduces the likelihood of spontaneous labour starting. We produce adrenaline when we feel stressed, pressured, anxious or scared. If it comes to pass that you truly do need an induction, you will get one without a booking slot.
Understand WHY you are being offered or recommended an induction
Is it clinically justified? Induction of labour is commonly offered for many reasons, for example; post-dates (being ‘overdue’) diabetes, reduced movements, suspected ‘big’ babies, IVF babies and to women whose waters break 24 hours before contractions start. Some are medically valid and others are not. Sometimes it’s not clear cut! Understand the evidence for why you PERSONALLY are being offered or recommended an induction. Do your research, look at ALL the factors and make an informed decision. Sara Wickham’s Inducing Labour and Rachel Reed’s Why Induction Matters will help you do this.
Knowledge is Power
Foresight is far better than hindsight! Properly prepare for your labour and birth in advance. Preparation is key! Your baby’s birth is a major life event. It deserves to be treated as such! You deserve for it to be empowering. Yes, birth can be unpredictable but that doesn’t necessarily mean risky. It certainly doesn’t mean you have to forego your positive birth experience. You can fully prepare yourself for any scenario AND focus on the birth you ideally want. Any change can then be navigated with confidence and control. Hypnobirthing informs and prepares women and their birth partners in every aspect of labour and birth, it is recognised in promoting better birth outcomes and experiences.
Stay in control of your pregnancy, labour and birth
You have grown your baby successfully for around 9 months now, you are also an adult who can be trusted to make her own decisions. If you do this you will feel better emotionally and retain ownership of your birth, it belongs to you! In hypnobirthing we teach the acronym B.R.A.I.N as a tool to successfully navigate the decision making process. Look at the benefits, risks and alternatives of every scenario. Could you opt for extra monitoring and/or a scan instead? Your informed decisions should always be respected and informed consent is legally needed from you before any procedure takes place. Communicate Effectively
Communication and building good relationships with your health care providers is actually another tool for you use to get what you want and need in labour. Knowing how to navigate the NHS system and advocate for yourself is an important part of preparing for birth. Don’t be afraid to ask questions, and keep asking until you are satisfied and feeling emotionally supported to achieve the birth you want. Discuss and agree things in advance as far as possible so you don’t have to do it while you are actually in labour. Get it in writing if need be.
Read positive induction stories and positive birth stories
They are out there! Positive births occur all the time. Women who feel informed, prepared, respected, supported and in control of their births and decisions generally have positive experiences, however and wherever they happen. Insight and suggestions from such stories can help you prepare and shape your own positive birth experience. Learn your induction options in advance
Find out your options and set terms for the initial induction process. Basically, you don’t necessarily have to settle for standardised care. What wiggle room or leeway is there within your hospitals policies? Is there the option of choosing between a pessary or a balloon? Do you know the differences and benefits and risks of these? Has the potential timeline and process of each been discussed with you? Could you initially go home or to a birth centre with a balloon or pessary rather than stay on the induction suite? If not, why not? Remember that feeling safe, being in a quiet environment and feeling unobserved will help you relax and produce the hormones that will help the progression of labour. Who will be allowed to stay with you in hospital and from what point? Is wireless monitoring available, are you still able to use water? A birth pool, a shower? Do you understand the process of your waters being broken and the reality of the drip? Have you discussed pain relief options and the speed of their availability if and when you want them? Do you understand the types of epidural available, how they might benefit you and the potential risks? Plan ahead for what you might want. Because you agreed to ‘A’ doesn’t mean you automatically consent to ‘B’ or ‘C’
Remember that just because you agreed to starting the induction process doesn’t mean you have to agree to anything or everything else further down the line. Remember to use your B.R.A.I.N tool throughout and treat every stage and every suggested intervention as a new decision making process. You may want to opt for a c-section rather than continue with induction for example.
Encourage Hormone Production
In hypnobirthing we teach about the importance of hormones, the effects they have and how they interact. Oxytocin is the love hormone (also known as the shy hormone). It helps contractions to start and progress optimally. Keeping an awareness of the environmental factors that can help and hinder labours progression and using hypnobirthing techniques will help you remain calm and relaxed, both physically and mentally and therefore help to maintain oxytocin.
Endorphins are hormones that offer us natural pain relief several times stronger than morphine in much lower concentrations. Staying calm and relaxed in labour helps us produce the right amount of endorphins for oxytocin levels to remain optimal. Stress and anxiety in labour can cause too many endorphins to be produced and may lower oxytocin levels, causing labour to slow down. If this happens ask yourself, “what has altered environmentally or mentally/emotionally?” How could this be changed or adapted to get things back on track? TENS machines, soft touch massage, stroking from your partner and the use of water can all help your body’s production of endorphins.