Induction of labour means having your labour started off artificially.
Labour can be induced for many reasons, but the most common are:
Labour can be induced by using prostaglandin pessaries, or by artificially breaking the membranes which contain the amniotic fluid which surrounds the baby, or by giving the woman an artificial hormone to stimulate contractions.
When labour is induced, often the contractions are stronger and more painful than natural contractions and this can lead to a woman requiring pain relief such an epidural.
A Caesarean is an operation to allow the baby to be born without going through the birth canal.
There are two kinds of Caesarean operation, elective and emergency. An elective Caesarean is one that is planned by the woman and her obstetrician before labour begins. An emergency Caesarean is one where a decision is made (usually when the woman is already in labour) to carry out a Caesarean because an unexpected problem has arisen and the baby needs to be born quickly.
A Caesarean birth involves major abdominal surgery, although this can usually be done with a type of anaesthetic which allows the woman to be awake if she wants to be. After a Caesarean it can take several weeks or even months to recover.
Having a baby by Caesarean does not mean that a woman has to have a Caesarean birth next time.
For more information about Caesarean birth click here.
If for some reason a women is unable to push her baby by herself, she can be helped to give birth without the need for a Caesarean, by the use of either forceps or ventouse.
Forceps are a surgical instrument which come in two halves. Each half is carefully put round the baby's head while it is in the birth canal and the two handles fit together. The doctor pulls at the same time as the woman pushes with a contraction.
A ventouse is a silicone cap attached to a suction pump. The cap is fitted on the baby's head while it is in the birth canal and is kept in place using suction. The ventouse is then pulled as for the forceps delivery, to help the baby be born.
Having an assisted delivery can make recovery from the birth harder. A ventouse delivery is likely to cause less pain and discomfort for the woman afterwards than a forceps delivery, although a forceps delivery may be less traumatic for the baby5.
An epidural is a local anaesthetic which is injected into part of the spine. It numbs the nerves carrying pain messages from the lower part of the body to the brain, and can give complete pain relief.
A conventional epidural also causes the woman to lose the feeling in the lower part of her body and so she is unable to use her legs. This can mean that she is only able to lie on a bed, or to sit propped up. She would not be able to stand or walk around.
Recently, a new type of "low-dose" epidural has been invented which uses an opiate drug mixed with the local anaesthetic. This can allow the woman some use of her legs, although she may not be fully mobile. This new type of epidural is not always available in all hospitals.
Because of the effect of the epidural on a woman's ability to be upright during labour, and also because she may not be able to push effectively, she has a higher chance of having an assisted delivery.
To learn more about epidurals click here.
Pethidine is a drug which is similar to morphine. It is given by injection and can help a woman relax if she is tense during labour. This can allow her to rest and sometimes her labour can speed up as a result.
However it can also make women feel drowsy and sick. Pethidine can also affect the baby, particular if the baby is born soon after the injection was given. It can make the baby drowsy, or have breathing difficulties, or have difficulty feeding.
Other similar drugs used during labour include diamorphine (heroin) and meptid. Diamorphine may work as a better painkiller than pethidine, but also affects the baby's breathing. Meptid is less likely to have side-effects for the baby, but can cause more nausea and vomiting than pethidine.
During labour, the oxygen supply to the baby varies. This is a normal part of labour. Sometimes, the baby may not get enough oxygen and, if this happens, the baby's heart rate will change. For this reason, babies' heart rates are monitored closely throughout labour.
A baby's heart rate can be monitored from time to time ("intermittently") or all the time ("continuously"). If a baby is being monitored intermittently, the woman is usually free to move around. If she is being continuously monitored, she may be less able to move around and may end up lying on a bed for long periods of time.
For a labour where there are no problems, intermittent monitoring is as safe as continuous monitoring.38
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