Induction of labor is a process where medical intervention is used to start labour. It is usually recommended when there is a medical need to deliver the baby or if the pregnancy has gone past the due date. In Saskatchewan, there are several types of induction methods available for pregnant women, including membrane sweep, foley bulb, cervidil, water breaking, and syntocin.
Membrane Sweep: A membrane sweep is a procedure that can be performed by a healthcare provider, typically a midwife or obstetrician, to encourage labor to start. During this procedure, the healthcare provider will insert their finger into the cervix and sweep it around to separate the membranes surrounding the amniotic sac from the cervix. This can release hormones that help to ripen the cervix and start contractions.
Foley Bulb: A foley bulb is a small, inflatable balloon that is inserted into the cervix to help it dilate. Once the balloon is in place, it is filled with saline solution to put pressure on the cervix, which can encourage it to dilate. Once the cervix has dilated to a certain point (usually 3cm), the balloon will fall out, and labor can begin. Usually, the foley bulb is followed by syntocin.
Cervidil: Cervidil is a medication that is placed on the cervix to help it ripen and start contractions. It is a synthetic version of prostaglandin, a hormone that helps to soften and thin the cervix. Cervidil is typically inserted into the vagina by a healthcare provider and left in place for up to 12 hours.
Prostaglandin Gel: Prostaglandin gel is similar to cervadil except it is in gel form. It is used less frequently because it it harder to remove if it is not tolerated well.
Water Breaking: Water breaking is a procedure where the amniotic sac is artificially ruptured to start labor. This procedure is typically performed by a healthcare provider using a special tool called an amnihook. An amnihook looks a lot like. a long crochet hook. Once the sac is ruptured, the baby's head will put pressure on the cervix, which can help to start contractions.
Syntocin: Syntocin is a synthetic version of oxytocin, a hormone that helps to stimulate contractions during labor. It is typically administered through an IV and can be adjusted to increase or decrease the strength and frequency of contractions. This method is usually used if other induction methods have failed or if labor is progressing too slowly.
It's important to note that induction of labor is not always necessary and should only be done when there is a medical need. It is also important to discuss the risks and benefits of each induction method with your healthcare provider and to make an informed decision based on your individual circumstances.
One of the tools used to decide which induction method to start with is the BISHOP score. The Bishop score is a numerical grading system used by healthcare providers to assess a woman's readiness for labor and delivery. The score is based on five parameters: cervical dilation, cervical effacement, cervical consistency, cervical position, and fetal station.
Cervical Dilation: Cervical dilation refers to the opening of the cervix. The Bishop score assigns a value of 0 to 3 based on the amount of dilation present. A score of 0 indicates that there is no dilation, while a score of 3 indicates that the cervix is fully dilated (10 centimeters).
Cervical Effacement: Cervical effacement refers to the thinning and shortening of the cervix. The Bishop score assigns a value of 0 to 3 based on the amount of effacement present. A score of 0 indicates that the cervix is not effaced, while a score of 3 indicates that the cervix is completely effaced.
Cervical Consistency: Cervical consistency refers to the firmness of the cervix. The Bishop score assigns a value of 0 to 2 based on the consistency of the cervix. A score of 0 indicates that the cervix is firm, while a score of 2 indicates that the cervix is soft and pliable.
Cervical Position: Cervical position refers to the location of the cervix within the vagina. The Bishop score assigns a value of 0 to 2 based on the position of the cervix. A score of 0 indicates that the cervix is posterior (toward the back of the vagina), while a score of 2 indicates that the cervix is anterior (toward the front of the vagina).
Fetal Station: Fetal station refers to the position of the baby's head in relation to the pelvis. The Bishop score assigns a value of -5 to +5 based on the position of the baby's head. A score of -5 indicates that the baby's head is high in the pelvis, while a score of +5 indicates that the baby's head is low in the pelvis and ready for delivery.
Each of these parameters is assigned a score between 0 and 3 (or -5 to +5 for fetal station). The total score ranges from 0 to 13. A higher score indicates that the woman's cervix is more favorable for induction of labor and delivery. A score of 8 or higher is typically considered favorable for induction.
The Bishop score is just one tool used by healthcare providers to assess a woman's readiness for labor and delivery. It is important to remember that every pregnancy is different, and the Bishop score should be used in conjunction with other clinical and subjective factors when making decisions about induction of labor.
In Saskatchewan, pregnant women have access to a range of induction methods to help start or speed up labor. By understanding the different options available and discussing them with their healthcare provider, women can make informed decisions about their labor and delivery.