The process of inducing labor involves stimulating the cervix to soften and dilate and the uterus to contract. Many high-risk pregnancies must be induced for the safety of the mother or baby, and many women ask to have their labor induced around 38 weeks, primarily because they are too big, too tired, and too stressed about waiting for something to happen. This is not an acceptable reason for induction. Medical reasons, such as high blood pressure or diabetes, or if you are past your due date, are reasons for induction of labor.
If your cervix is not soft and starting to thin out and open, a Prostaglandin Preparation may be applied directly on your cervix, or a small tablet may be placed at the very back of your vagina.
- Prostaglandin Prep :
(a) Initiate the breakdown of the collagen that is keeping your cervix tightly closed.
(b) Intravenous catheter, better known as an IV, in your hand or forearm. When your cervix is soft, thinning, and starting to open, an IV preparation containing the hormone oxytocin (Pitocin is the brand name) will be started.
(c) Levels of Oxytocin rise, your contractions begin. Continue to increase the amount of oxytocin until your contractions are strong, are two to three minutes apart, and last about sixty seconds. This combination will help dilate your cervix.
Labor is divided into three stages.
1st Stage: Contractions
(A) Early labor= won't need to breathe through your contractions in a focused way.
- Cervical dilation in early labor is from 0 to 4 centimeters.
- Contractions are regular, but still quite far apart.
- Begin and end every contraction with a deep, cleansing breathe
- Try using your belly muscles. Practice by putting your hand on your belly and letting it rise and fall with your breaths. This forces the muscles that instinctively tense with a contraction to relax
- You may want to establish a visualization meditation during your contractions.
2nd Stage: Dilation of cervix. Cervix starts at about 8 centimeters. Takes less than 2hrs for complete dilation to occur once you have reached this point.
(B) Active Phase= The pressure of the contraction inside the uterus increases 100 percent
- pushing stage where you push through to the birth of your baby.
- When you are sitting up, rocking, walking, squatting, or kneeling, your abdominal wall relaxes and allows the top of your uterus to fall forward. This directs the baby's head toward your cervix, increasing pressure, allowing it to stretch, and reducing the length of labor.
- Cervix will dilate from 4 to 8 centimeters.
- Lying on your side is a good position your heart is more efficient, your uterus gets more blood flow to it, and your baby gets more oxygen. Positions that reduce the length of labor but allow the contractions to be most efficient are best for the baby.
3rd stage: Ends with complete cervical dilation & Delivery of the placenta.
(C) Transition Phase= is the last phase of labor before you begin to push out your baby.
- The uterus is working extremely hard, and it is very difficult to relax.
- You may feel nauseated, cold, shaky, restless, discouraged, and scared.
- Notice an increase in bleeding from your vagina and an almost unbearable pressure in your rectum.
- You may find that you want to stop breathing during your contraction and grunt or bear down as with a bowel movement. Let your nurse know what you are feeling.
- Try to stay focused with your contractions, and keep breathing. Only think of one contraction at a time; each contraction is one less than you will ever feel again. If you feel the urge to bear down and push, try blowing quick breaths as if you are blowing out a candle.
- Rest between the contractions, but when the contraction begins, take a couple of deep, cleansing breaths. Try to keep your face relaxed and your eyes open during pushing. All energy should be focused on your bottom. A wrinkled up face, eyes squeezed tightly shut, a mouth losing air through screams all take precious energy that need to be used to push out your baby.
- Premature babies are under much stress at this point, so it isn't a good idea to prolong the pushing phase. If you need to cry or scream, it will be better for both you and your baby to cry or scream between contractions.
- As the contraction grows in strength, take a breath and hold it. Now, while holding your breath, bear down straight into your bottom with all of your might. Hold that push long and strong. It may be helpful to count to ten in your head if possible. Quickly grab more air, hold it, and bear down again, long and strong.
- You may want to have an ice chip and rest, even sleep, between contractions. As your baby's head is crowning, bulging on your perineum, you may want to reach down and touch your baby's head for the first time. If a mirror is available, it may be motivational for you to see your baby's head and even watch it move as you push.