Inducing Labor and What to Expect

Alright, let's talk about induction of labor. I think induction gets a really

bad name. People go online and see horror stories and I think that that bad name

is really not earned. I think the key with induction is to be patient. Patience

is a virtue. When a mom comes in for her induction, one of the first things I

say is, “You know what? Your baby's birthday might not be today and it might

not be tomorrow, but that is okay.” An analogy that I think helps for

understanding induction is that your uterus is the baby's house and the

cervix is the door to the house. The cervix, when people start an induction,

oftentimes is completely slammed shut. Picture a really thick metal door that

is trying not to open to let the baby out of the house. One of the first

things that we do is called cervical ripening and it's putting a little

tablet inside the vagina. The idea of that tablet is just to soften and to

open that door so that it's a little bit open. Once we make sure that the cervix

is nice and slightly open and softened, then we can go to

the next step. Usually that's a medication called pitocin. If you look

pitocin up online or you talk to your friends, people act like pitocin is this

horrible drug. It's not. It's actually just a fake version of the hormone that

your brain makes to make the uterus contract. We don't just slam people

with pitocin. It actually starts at really tiny doses and we keep increasing

the dose just slightly until we make sure that the uterus is in a really nice

contraction pattern. There are a few other tricks of the trade that we might

use along the way. One of them is called a foley bulb. If this is the cervix,

the foley bulb is really just a little balloon that goes inside the cervix. We

blow it up and now with every contraction you actually have a little

ball that's sitting there providing a little bit more mechanical pressure, so

with every contraction you're getting more bang for your buck. It's just gently

helping to stretch the cervix out. Another thing we might do is break the

water. If the baby is happy just dangling inside the uterus, once you

break the water the head becomes well applied on the cervix. It's the same

principle as that balloon. It just helps to gently push the cervix open with

every contraction. One thing to realize with induction is that the

beginning part can go extremely slowly so you could do cervical ripening for up

to a day. That’s okay. Once you get into

active labor and you're five or six centimeters or so, then it becomes a

little bit more predictable. We expect that you should dilate a centimeter

every one to two hours or so. Then have it be hopefully within a six to

twelve hour time frame. Moms often ask me to predict when the baby is going to

come. I never fall into that trap trap because I don't know. If I knew the

answer to that question, I'd have a crystal ball and I'd be a millionaire.