Congratulations – you’ve made it to your third trimester! It’s an exciting time, however, it’s also time to start thinking about how medical issues can potentially impact the timing of when you deliver your bundle of joy.
There are a variety of medical issues that can lead to your delivery date being moved up by one to several weeks. Some of these medical issues can include:
- Gestational or pre-gestational diabetes mellitus: This is a type of diabetes that develops during pregnancy (gestational) or that a person had before they got pregnant (pre-gestational). It affects how the body uses sugar for energy.
- Gestational hypertension: This is high blood pressure that develops during pregnancy. It can lead to other health problems for both the mother and baby.
- Preeclampsia: This is a serious pregnancy complication that involves high blood pressure and damage to organs like the kidneys and liver. It can lead to serious health problems for both the mother and baby.
If your baby needs to be delivered early due to a medical issue or simply because you elect to deliver a week early, you’ll undergo induction of labor (IOL).
What Does Induction of Labor Mean?
Induction of labor is when you’re given medications to help jumpstart labor. The medications are meant to mimic hormones your body produces naturally. If medications aren’t working, your obstetrics team can perform bedside procedures to help thin out and dilate your cervix.
In general, you can think of inductions as occurring in a two-part series. In part one, we focus on the cervix. The cervix is the proverbial “door” to the uterus, which is where your fetus is growing. In part two, we work on the uterus.
What Happens to the Cervix During Induction of Labor
For the cervix, the goal is to “ripen” the cervix. In layman’s terms, ripening the cervix means to thin it out so the cervix can dilate more effectively. The following can be used during induction to help ripen, or thin, the cervix:
- Misoprostol, an oral medication. Note: Due to the increased risk of uterine rupture, we do not use misoprostol in patients who are undergoing a trial of labor after cesarean section (TOLAC).
- Dinoprostone, which is inserted vaginally.
- A Cook balloon, which is inserted via a small catheter through the cervix. It inflates small balloons on either side of the cervical canal; the balloons mechanically compress the cervix to help thin it out while also dilating it.
What Happens to the Cervix During Induction of Labor
Once it’s been determined that your cervix has effectively been ripened, we move on to part two of the induction – the uterus. We use a medication called pitocin to make your uterus powerfully and regularly contract. Pitocin mimics oxytocin, a hormone your body produces naturally. If adequate, these contractions cause the cervix to dilate and pushes the fetus down the birth canal.
Once you become 10 centimeters dilated, you can now begin the Olympian task of pushing the fetus down the birth canal, out of the uterus, through the vaginal canal and out into the world! After you’ve birthed your baby, the placenta is delivered. Labor and delivery conclude with the expulsion of the placenta. Lastly, you’ll be given uterotonic medications that further prompt the uterus to contract, which helps prevent postpartum hemorrhage.
Here at the Wynn Hospital, you can expect to interact with caring nurses, midwives and resident/attending physicians who work together to make your scheduled IOL as seamless as possible. Be sure to discuss with your obstetrician or midwife about whether a scheduled medical or elective IOL is right for you.
About the Author
This article was written by Melani Cargle, MD, MBA. She is a second-year OB/GYN resident physician with MVHS.
