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Labor Induction and Augmentation - Topic Overview

Ways to induce labor

There are several ways to induce labor contractions.

  • Medicine may be used to soften the cervix and help it thin (efface).
  • Medicine may be used to cause the uterus to contract.
  • A balloon catheter (such as a Foley catheter) may be used to help the cervix open.
  • If your cervix is soft and slightly open, sweeping the membranes or rupturing the amniotic sac (amniotomy) may start or increase contractions.

Medicine to ripen the cervix and induce labor

  • Misoprostol (Cytotec) is a pill taken by mouth or placed in the vagina (using a smaller dose). It is a medicine currently approved for treating ulcers. Using it for cervical ripening is a widely accepted but unlabeled use of this medicine.
  • Oxytocin (Pitocin) can be given through a vein (intravenously) in small amounts to ripen the cervix. But it usually is given after the cervix softens, to cause the uterus to contract. Labor that is induced by oxytocin usually starts off harder and progresses faster than labor that starts on its own, especially in first-time mothers. If oxytocin does not induce labor or if the baby's heart rate indicates distress, a cesarean delivery (C-section) may be needed.
  • Dinoprostone (such as Cervidil or Prepidil Gel) can be inserted as a suppository into your vagina (intravaginally). It can also be given as a gel that is gently squirted into the opening of the cervix (intracervically). When the cervix is ripe, labor may start on its own.

The cervix is thought to be ripe and ready for active labor when it is soft, well dilated, and effaced, and when the cervix and baby are positioned low in the pelvis. If the cervix is not ripe enough, medicines may be continued until it is.

Balloon catheter to help induce labor

A balloon catheter, such as a Foley catheter, is a narrow tube with a small balloon on the end. The doctor inserts it into the cervix and inflates the balloon. This helps the cervix open (dilate). The catheter is left in place until the cervix has opened enough for the balloon to fall out (about 3 cm).

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