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35. Induction and augmentation of labour

By Dr Joe Kabyemela, MD

Introduction
Sometimes it becomes necessary to bring about labour for a variety of reasons. In most cases, it is a result of concern for the fetal well-being if it continues to stay in the womb. This is compounded by the fact that there are good but no foolproof methods of monitoring the well-being of the fetus in the uterus. In such circumstances, it very occasionally becomes necessary to expedite delivery. Unless there are contraindications, induction of labour, aiming for vaginal delivery, is the preferred method.
Occasionally, the induction of labour is done as a result of concern for maternal well-being, for example to allow the treatment of a serious unrelated illness diagnosed during pregnancy. In some instances, such as pre-eclampsia, there is concern for both mother and baby and labour may be induced.



Induction of labour for social reasons ("I am moving house", "I want it before Christmas", "my partner has a business trip" and the like) sits firmly albeit uncomfortably along all these possible indications.
Induction of labour is ideally done as close to term as possible.

Contrary to what many a woman believe, induction of labour is not always a routine affair. It can be a protracted and very unpleasant experience indeed. This is uncommon but the possibility should never be ignored. Moreover, induction can and does occasionally fail. Which leads inevitably to the question of "what next"? The answer may very well be a caesarean section, which in the cold light of day may be seen to have been unnecessary.

There are only a few methods of labour induction of proven efficacy. All these are discussed in detail below.

Are there any DIY methods for labour induction? Not at present, nor in the foreseeable future. However, many midwives could give you tips on how to encourage things along. All are of unproven value but at least they are harmless and may even be fun. We discuss these as well here.  

Ready to pop? Sometimes a helping hand might be required