Induction of Labour in a Hospital Setting Part three

Induction of Labour in a Hospital setting – Part Three

Artificial Rupture of Membranes (ARM)

If your cervix is open enough that the midwife/obstetrician can break your waters, this will bypass the stage before (cervical ripening agent or balloon catheter). You may have an ARM after the balloon or prostaglandin. It is performed during a Vaginal Examination (VE), with either a plastic instrument that has a pointy end, or with a spiky ‘glove’ that goes only over one finger.

Immediate Risks & things to consider:

  • You will usually need to progress on to the hormone drip, as labour may not start from just an ARM.
  • Although it is unlikely, there is an increased risk of bleeding, infection and cord prolapse. The team usually will not perform an ARM if baby’s head is still not engaged in the pelvis to avoid cord prolapse.

Oxytocin Drip

This is a synthetic hormone which is meant to mimic the hormone Oxytocin. Oxytocin is the ‘love hormone’ and the hormone released when you are in labour. An IV drip will deliver this hormone and it will be titrated throughout labour to ensure that you are having the ‘correct’ amount of contractions, as well as strength and length.

Immediate Risks & things to consider:

  • You will need to be on a CTG monitor for the whole labour, as soon as the Oxytocin drip starts.
  • Most hospitals have telemetry CTG monitors that allow more movement, but you will also have a pole with the drip that you will need to move around with.
  • You may have too many contractions, in which case the drip will be turned down or you will be given medication to slow the contractions.
  • The drip can cause stress to baby
  • Higher chance of epidural anaesthesia, caesarean sections (CS) and intrapartum fevers.
  • If the drip does not work, and you do not dilate a certain amount within a certain timeframe, you will be told that you ‘need a caesarean’ (note that you can decline and say you want more time).
  • Higher chance of instrumental birth due to higher chance of epidural and higher chance of stress on baby (abnormal trace).

In conclusion, too many women today have IOLs. This, without a doubt has a cascade of intervention affect. Look at the bigger picture of your labour and birth, because one intervention leads to another and this can result in adverse outcomes, interventions, CS etc. However, in saying that, IOLs are indeed necessary for different reasons.

I believe that it is paramount to do research to determine whether an IOL is the correct route. Try to weigh up the costs and benefits. In order to do so, search online (using reliable sources), talk with different healthcare providers, ask questions such as ‘’if I were to wait another week, what would the risks be?’’ or ‘’what are some other options?’’.


H A P P Y     L A B O U R !