How labor is stimulated in the maternity hospital: concept, features of conduct, indications for stimulation, pros and cons of the method

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Patrimonial activity is a natural process laid down by nature. It occurs after the mother's body is ready to expel the mature fetus from the uterine cavity. In most cases, this occurs at 38-40 weeks of gestation. If the birth has not come on time, the pregnant woman may need artificial stimulation of labor in the maternity hospital. How this process takes place, what methods are used, what are their pros and cons, read more about this in the article.

Indications for labor induction

In some cases, a woman needs outside intervention to start a natural delivery. And it doesn’t matter if it’s the first birth or the next, whether the pregnant woman had been lying on the floor for a long time before.preservation or entered the department with contractions. It all depends on the individual characteristics of the organism. There are a number of indications for labor induction in the hospital:

1. Overwearing. At 40 obstetric weeks, the baby is considered 100% mature, although labor can begin at 38 or 39 weeks. Each case is unique. Until 41 weeks, doctors, as a rule, still monitor the pregnant woman, recommending natural ways to stimulate labor for this period, but after this period they begin to take decisive action. Overgestation is fraught with aging of the placenta and a change in the consistency and color of the amniotic fluid, in which toxins accumulate. This condition can be dangerous for the fetus.
2. The passage of water without the onset of labor. If 12-24 hours have passed since the amniotic fluid was discharged, and the contractions do not intensify, doctors try not to delay emergency care.
3. Stop contractions. It happens that the labor activity that has begun is suddenly interrupted, the contractions subside, and the cervix does not smooth out.
4. Problems associated with the normal development of the fetus. If the weight of the baby at 40 weeks is less than 2500 g and more than 4500 g, stimulation is performed for medical reasons. In the first case, the child may not receive the nutrients he needs, and in the second case, intervention in the natural process is necessary in order to avoid complications in childbirth, which is associated with a large fetus.
5. Chronic pathologies in the mother. If a pregnant woman has a history of diseases of the kidneys, heart, blood vessels, stimulation is carried out already from 38weeks.
6. Multiple pregnancy. As in the previous case, intervention in labor activity is carried out after 38 weeks, when the babies are already fully mature, have a weight of more than 2500 g and are ready to be born.

Pros of artificial labor induction

In some cases, this method is vital for both the mother and the fetus. But focusing only on the estimated date of birth is not worth it. Before making a final decision, an ultrasound examination is mandatory, with the help of which the doctor assesses the condition of the placenta, the amount of water and other indicators. In the normal course of pregnancy, stimulation is carried out only after 41 weeks.

Pros of doing this:

• reducing the risk to the fetus during hypoxia and intrauterine growth retardation;
• relief of a woman's condition during exacerbation of chronic diseases and preeclampsia;
• resumption or stimulation of labor with weak contractions.

Usually pregnant women have a very negative attitude to interference in the natural process, directly related to the birth of a baby. A good doctor will definitely explain how labor is stimulated in the maternity hospital, and choose the best way for a woman. All manipulations are carried out only in the department and strictly under the supervision of specialists.

Disadvantages of the method

Any interference with natural labor can lead to unpredictable results. That is why it is important to consider not only the pros,but also disadvantages of stimulation. The latter include:

• greater pain than natural childbirth without intervention;
• risk of fetal oxygen deprivation;
• inconvenience for a woman in labor when using an oxytocin dropper to induce contractions;
• high chance of having a baby with jaundice and problems with the nervous system.

Most experts oppose drug stimulation. They believe that it is advisable to carry it out only in case of vital necessity, when waiting for the natural process to start can be dangerous for the mother and fetus.

Ways to induce labor in the hospital

Before intervening in the process of delivery, the doctor carefully examines the exchange card of the pregnant woman. Only after that, a specific method of stimulating labor is determined. How this procedure is done in the maternity hospital directly depends on the chosen method:

• detachment of amniotic membranes;
• foley catheter stimulation;
• use of prostaglandins (suppositories, gels);
• using kelp;
• amniotomy;
• oxytocin drips;
• stimulation pills.

All methods can be conditionally divided into those in which intervention in the process of childbirth is carried out with medication, and others involving a mechanical effect on the cervix. They all have their advantages and disadvantages.

In some cases, combined methods are usedstimulation of labor in the maternity hospital. How such an intervention takes place depends on the methods chosen. For example, kelp and gel can be used to prepare the cervix in a pregnant woman. Combined methods can reduce the risk of cervical rupture during childbirth by 40% and reduce the likelihood of having a child with hypoxia by almost half.

Mechanical methods of stimulation

The methods listed below involve minimal use of medications to start the birth process. These include:

1. Detachment of amniotic membranes. During a gynecological examination, the doctor separates the membranes that connect the uterus to the fetal bladder. This contributes to the production of prostaglandins necessary to activate the birth process. Manipulation is painless for a woman, but can cause her discomfort.
2. Using a Foley catheter. With the help of this urological tool, gynecologists perform the expansion of the cervix before childbirth in the maternity hospital. Stimulation is as follows: a catheter is inserted into the cervical canal and filled with water in a volume of 30-60 ml. As a result, the cervix dilates enough for doctors to begin actively inducing labor. The disadvantage of the method is that contractions very rarely begin on their own. Most often, a pregnant woman additionally pierces the fetal bladder and put a dropper with oxytocin.
3. Stimulation of childbirth with kelp. This mechanical method of dilating the cervix is preferred over the use of a Foley catheter. Dry algae 2-3 mm thick are introduced into the cervical canal. Under influencekelp moisture increases in volume during the day by 5 times, thereby expanding the cervix. The disadvantage of the method lies in the discomfort that some women experience during the introduction of algae into the cervical canal. Despite this, gynecologists very often use this particular method of stimulating labor in the maternity hospital at 41 weeks of gestation.
4. Amniotomy. If the labor activity of a woman is rather weak, while the water has not yet departed, the process can be accelerated by piercing the fetal bladder. The procedure is carried out using a special tool. After piercing the fetal bladder, the waters break and labor activity starts.

Using pills

Very often, the prescription drug Mifepristone is used to induce labor in the hospital at 41 weeks. It is worth noting that it is used not only in this case, but also for early termination of pregnancy, the so-called medical abortion.

A pill to stimulate labor in the maternity hospital is issued strictly in the presence of a doctor. The drug "Mifepristone" can be quite dangerous if taken in violation of the instructions. The regimen is as follows: the first tablet with a dosage of 200 mg is taken immediately, and the second after 24 hours. If after two days labor is not activated, then the woman is vaginally injected with prostaglandins in the form of a gel. If the pill gave the desired effect, childbirth usually begins in a day. At the same time, to speed up the process of the pregnant woman, the fetal bladder is pierced.

If the waters broke, andthe cervix is not yet ripe, the second tablet of Mifepristone is taken not 24, but 6 hours after the first. This is due to the fact that a long anhydrous period can be dangerous for the fetus.

Contraindications

To avoid the negative consequences of artificial interference in the natural process of the birth of a baby, the doctor must discuss with the pregnant patient in advance all the points related to the stimulation of labor in the maternity hospital: how the procedure takes place, what are the advantages of the chosen method and other nuances. It is important to take into account the state of he alth of the woman, take into account the results of the latest ultrasound examination. This will allow timely identification of all contraindications for the procedure:

• caesarean section as a result of a previous birth;
• mismatch between the size of the head of the fetus and the pelvis of the woman;
• improper placement of fetus or placenta;
• unsatisfactory condition of the fetus;
• premature placental abruption;
• diabetes mellitus in a pregnant woman;
• hypertension.

If a pregnant woman has one of the conditions listed above, the woman is not stimulated with medication, but is prepared for the operation.

Effects of labor induction for mother and baby

Any intervention in the work of the body of a pregnant woman is a risk. But the consequences of stimulating labor in the hospital can be much less dangerous than from overbearing the fetus. It must be remembered that while a woman at 42 weeks of pregnancy is waitingcontractions, the child at this time suffers from a lack of oxygen and nutrients due to the aging placenta. The amount of amniotic fluid after 40 weeks also gradually decreases, which does not benefit the baby.

A woman should not be afraid of stimulation if she has indications for this. If at 40 weeks of pregnancy the cervix is immature, the doctor will strongly recommend that you start softening it in one of the ways described above. As practice shows, most women are afraid of droppers with oxytocin. But in most maternity hospitals, this drug is administered after the cervix has matured, while contractions are not effective enough. In any case, the need for this drug is evaluated by the doctor. A pregnant woman should fully rely on his experience and professionalism.

Can I induce labor at home?

After the 40th week of pregnancy, when the delivery has not come on time, a woman can try to start the natural process on her own. Such methods involve increasing physical activity and changing the diet. The fact is that many pregnant women have some experience or have heard from their friends about how labor is stimulated in the maternity hospital, so they try to delay this moment in every possible way or avoid it altogether.

To start the natural process of the birth of a baby at home, you can use:

1. Intercourse without a condom. Scientists have proven that contained in the maleprostaglandins contribute to the smoothing of the cervix in sperm, which is especially important when the pregnancy is coming to its logical conclusion.
2. Nipple massage. It may seem strange, but such a massage really helps to contract the uterus and the early onset of childbirth.
3. Long outdoor walks. They can be classified as moderate physical activity, such as washing floors by hand, stepping over stairs, etc.
4. Warm bath. Moderately hot water, along with aromatic oils, helps to relax muscles and activate labor.
5. Special meals. Women who dream of speeding up childbirth are advised to lean on pineapples, beets, raspberry tea (from the leaves), currants, and fresh parsley. All of these products help to flatten the cervix, that is, they act as natural prostaglandins.

Feedback on labor induction

Many women are familiar with the situation when childbirth did not start on time or this activity was not active enough. In this case, some of them resorted to home methods, while others relied on help from doctors. Judging by the reviews, the stimulation of labor in the hospital is quite easy. Girls note that:

• it hurt, but very quickly;
• next time will also agree to stimulation;
• when the fetal bladder was punctured, it turned out that the waters were dark, so it was decided to induce laboroxytocin drip.

In general, pregnant women respond positively to stimulation when needed. The only negative that they call: very strong and painful contractions, which, however, it is quite possible to survive for the sake of the birth of a he althy child.