Delivery at the end of the completion of the pregnancy is a natural eventuality and it is scheduled to occur naturally. Complex processes occur within the woman’s body, connecting the baby’s hormonal signals the placental hormones and the mother’s own hormonal system. Some special instances may mandate adoption of artificial means of labour initiation and this write up will help you understand this.
Leena has now become 38 weeks and is expectantly waiting for the baby’s arrival. Every visit she exhibits concern and is becoming impatient. Is she right ?
The expected date of delivery is established at the very first dating scan and this is at the end of 40 weeks. Many women start becoming impatient from completion of 37 weeks and many before that at 34 weeks itself. Patience is important of course, the baby’s condition should be properly evaluated and reassurance sought.
Last visit I told Leena not to worry and keep a close watch on her baby’s movements and come for the scheduled regular follow ups. Also was instructed to report in case of any signs suggestive of labour, water break or any other concerns. I also mentioned that if she happens to cross the scheduled date a recourse towards ‘induction of labour (IOL)’ will be taken if found to be essential. Both she and her mother nearly jumped out of their respective chairs ‘you will be doing a c- section doc ?” I then realised that they were not aware of what IOL means and this blog is inspired by Leena ………..
What is IOL?
The process of delivery is deliberately initiated by artificial mechanical or medical means to deliver the baby. The ultimate aim of IOL is safety for both the participants the mom and her Baby.
When is IOL done ?
Many instances may need IOL to be undertaken.
When the duration of pregnancy has crossed 41 weeks
When the baby is demonstrating slight jeopardy
When there are maternal disorders e.g raised blood pressure
When the water has broken to avoid infection or protracted delivery
Some unfortunate situations where the baby has succumbed ( intrauterine death of the Baby )
How is IOL done ?
There are various methods used to do IOL. Gels, tablets or foam or tapes impregnated with induction medicines may be used. These medicines are the same ones which are secreted by the body at the initiation of labour. They are given in a controlled fashion to ensure safe beginning of the labour process. Some mechanical methods also may be used such as manual stripling of membranes or insertion of special devices or catheters to help stretch open the cervix ( opening of the womb )
Are these methods harmful or associated with complications ?
Not if used with proper protocols and methods. A woman whose labour is induced, is closely monitored for maternal and fetal well being. Also, highly evolved methods are now available. In any case, nothing is 100 percent safe.
Are there any prerequisites For IOL ?
Yes conditions where it may not be feasible or safe are to be looked for and these are
Large Baby
Small maternal passage
Previous cesarean delivery or any womb Surgery such as myomectomy
Compromised fetal condition
Fetal malpresentation position. Sometimes Baby presents by its buttocks instead of head which is a condition called as breech presentation
The favourability of the cervix to respond is assessed by the Doc to determine the success of induction and the choice of the method for IOL
What if IOL fails ?
Based on the mother’s and the baby’s condition the process may be repeated. If it fails, cesarean section is done and IOL declared to have failed.
Sometimes patients and relatives are adamant about a vaginal delivery. That always is the aim and the eventuality which we all hope for and do everything to ensure that such a thing will happen. But the focus has to be on safety.
This blog has been written to enhance confidence amongst mothers who are due to deliver and their families to be assuring, supportive and encouraging. Happy Baby times to all.
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