If you go past your due date, your water breaks, and you have no contractions, or if you have other complications at the end of your pregnancy, your doctor may want to use drugs to induce labor. Some medications to induce labor are given through an IV, and others are inserted into the vagina in order to dilate and thin out the cervix and cause the uterus to contract.
Why Use Drugs to Induce Labor
Many doctors recommend labor induction if:
- You go more than two weeks past your due date.
- Your water breaks but labor has not started.
- There is a decrease in your baby's movements.
- There is not enough amniotic fluid around the baby.
- If you have a placenta abruption which is when the placenta tears away from the uterine wall.
- Your baby has fetal growth restriction which is when your baby's estimated weight is below the 10th percentile for his or her gestational age.
- You develop complications from conditions such as preeclampsia or gestational diabetes.
- There is a problem with the placenta and your baby is not receiving the oxygen and nutrients as he or she should.
- You develop the infection, chorioamnionitis, in your uterus.
- You have other conditions that may warrant an induction such as kidney disease or obesity.
Commonly Used Medicines Used to Induce Labor
If you need to have labor induced, your doctor will explain and eventually recommend one of the following medications:
Pitocin is one of the most commonly used drugs for inducing labor. It's a synthetic version of oxytocin, a hormone that your body naturally produces on its own. Oxytocin is produced by the hypothalamus and released by the pituitary gland. The oxytocin is what stimulates your uterus to have contractions so you can go into labor on your own. If your body isn't producing the oxytocin it needs for labor to begin, the Pitocin will help get the labor process started almost immediately. The contractions are strong shortly after the introduction of Pitocin into the body, and the amount of the drug administered is monitored and controlled by the doctor via IV. It is normally increased every half hour until strong contractions are only about two minutes apart.
Risks here include uterine rupture, fetal distress, infection, and serious bleeding after delivery. There is also the chance you may experience a possible failed induction and a c-section may be necessary.
Dinoprostone, a prostaglandin used to induce childbirth, encourages the cervix to thin out, dilate, and get ready for labor. It is also designed to make the uterus contract as it would during labor. It is inserted vaginally by the doctor until it is touching the cervix and is available in gel, suppository, and controlled-release insert. Make sure your doctor knows about any allergies you have, as well as any health conditions such as asthma, anemia, epilepsy, heart disease, high or low blood pressure, and glaucoma.
If you and your doctor agree on using dinoprostone instead of Pitocin, the use of an IV may not be necessary. With dinoprostone, you should be prepared to lie down for ten minutes to two hours so that the medication can be absorbed and begin to work. Amounts of the drug given will vary by patient.
Other Prostaglandin Suppositories and Gels
There are other prostaglandin suppositories (or gels) on the market. One goes under the brand name, Prepidil. When using this method, one suppository is inserted next to the cervix every six hours until it has ripened enough for labor to begin. If the gel is used, it is inserted using a syringe and catheter.
Another prostaglandin is under the brand name Cervidil. This medication is designed to gradually release the dinoprostone over the course of twelve hours. It can be removed once labors begins or after the 12-hour period.
Misoprostol is also known under the brand name, Cytotec. Misoprostol can be taken orally or inserted into the vagina for the induction of labor. It cannot, however, be used if you have previously had a cesarean section due to a heightened risk of uterine rupture. As with all other similar drugs, you and your baby will carefully be monitored throughout the process. Vital signs, fetal heart rate, and uterine activity should all be watched carefully.
When Drugs Shouldn't Be Used to Induce
Sometimes your doctor will not want to use drugs to induce labor at all, especially if you have active genital herpes, cord prolapse (which is when the cord falls ahead of the baby), or placenta previa (a condition in which the placenta moves down to cover part or all of the cervical opening).
If Drugs Make You Uncomfortable
Be sure to talk with your doctor far in advance if you have an aversion to using drugs to induce labor. Having a plan in place with your OB-GYN long before you approach your due date will keep everyone's mind at ease and promote a healthy, lower stress labor, and delivery.
Your doctor will be able to answer questions, put your mind at ease, and discuss possible alternatives. If the induction isn't urgent, your doctor may have suggestions of natural methods for you to try as well.