Can you give me some suggestions for inducing labor?

Jeannie

I am wondering whether you are asking about medical induction of labor for obstetrical reasons, or whether you are asking about how to possibly get labor started if you are near term. Since I don't know for sure, I'll address both.

Sometimes it is necessary to get labor started before the baby and your body want to do it themselves. Some of the obstetrical reasons for inducing labor include a pregnancy longer than 42 weeks, signs of fetal stress, diabetes, hypertension, poor growth of the baby, inadequate amniotic fluid or a very large baby (with the intent of delivering before the baby gets too big for a vaginal delivery). In such cases, the method of starting labor depends on the urgency of the situation and whether the cervix has "ripened" (softened and/or dilated) at all yet.

If the cervix is unripe, then usually a prostaglandin is given to help soften and ripen the cervix. The prostaglandin may be applied as a gel to the cervix, inserted as a vaginal suppository or given as an oral pill. Often this ripening process takes many hours. If the cervix is ripe, then Pitocin (oxytocin) may be used to generate contractions; this drug is administered slowly through an intravenous line in the hospital. Sometimes, if the cervix is sufficiently dilated already, your doctor may first rupture your membranes (the amniotic sac, or the "bag of waters" that surrounds and cushions the baby) in hopes this will cause contractions to start on their own; if they do not, Pitocin is given.

"Stripping of the membranes," or sweeping a finger around a partially dilated cervix, may stimulate contractions and labor as well; many obstetricians will do this almost routinely at term in hopes of decreasing the chances that the baby will be late. Technically, this latter method is not really induction of labor.

As for helping Mother Nature along on your own, there are several helpful hints. Most of these fall into the category of "old wives' tales," but some may do the trick nonetheless. Intercourse is one method; semen contains prostaglandins and may stimulate labor. However, be sure not have sex once your membranes have ruptured or if you have been diagnosed with placenta previa! Driving on bumpy roads and scrubbing floors are two other tricks. Some women swear by drinking castor oil (I personally would rather carry the baby a bit longer rather than resort to castor oil -- yuck!) or eating certain foods. I've heard there is a restaurant somewhere whose pregnant patrons order a certain salad when they are ready to deliver; where I live and practice, women used to line up for the bean burritos prepared by one eatery (unfortunately out of business now or I'd have one of those burritos myself soon!).

Here is the advice I give my patients who are near their due date and who are getting anxious to meet baby face-to-face: take a drive on a bumpy road, go home and scrub the floors, then eat some spicy food and have sex! It won't hurt, and at least you'll have a clean kitchen and won't be hungry!