All About You
Have you discussed hospital procedures, including birthing facilities, IVs, shaves, monitors, pain relief, and enemas, with your caregiver? Do you know you have choices about many of these things? Look for answers to your questions (or ask one of your own!) in our Ask the Expert section. This is the best action you can take to insure you and your family will be in control of your birth experience.
If you'll be using a diaper service, arrange for predelivery. They'll help you determine how many diapers you'll actually need (it's probably quite a bit more than you think!) What about help after the baby is born? You don't have to be supermom. Ask a family member or friend to help out the days following your delivery or if you can afford it hire a domestic service. Childbirth is overwhelming and exhausting—take the time you need to recuperate (especially if you've had a C-section and enjoy this special time in your life.
You're one week shy of full-term status. Your once small baby bump is now the size of a basketball—or bigger. Your internal organs are cramped as they make room for your nearly full-sized baby. Heartburn, indigestion, and flatulence may be constant problems as your stomach has less room to hold in, and digest, your food. You're probably finding it difficult to move, walk, and sleep now that your baby is almost ready to be born.
Doctors still aren't sure exactly what causes labor to begin. The prevailing theory is pregnancy hormones, which are active throughout pregnancy, increase around the time your baby is due. Most often, the brain releases the hormone oxytocin, which signals the body to start contractions and the cervix to begin dilating. Yet for some women, labor needs to be jumpstarted.
Reasons for Inducing Labor
The baby's health: Your healthcare provider will carefully monitor your baby-to-be's health throughout pregnancy. If your provider suspects something threatens your baby's progress—for instance, the placenta doesn't seem to be providing enough nourishment—he or she may recommend an induced labor.
The mother's health: Several high-risk conditions—such as gestational diabetes—may make it necessary to induce. Again, your doctor will monitor your pregnancy for potential problems.
One condition which sometimes necessitates an early delivery is preeclampsia (also called toxemia or pregnancy-induced hypertension [PIH]). This complication occurs in 10 percent of pregnancies according to the Preeclampsia Foundation. "The specific risk in preeclampsia is that the hypertension can progress to cause seizures and other severe neurologic complications, including stroke," explains Dr. William Camann, MD, director of obstetric anesthesia at the Brigham and Women's Hospital in Boston, Massachusetts, and coauthor of Easy Labor.
Dr. Camann goes on to explain, "For baby, as the mother's blood pressure goes up [with PIH], the blood flow to the uterus and baby can go down. Thus, the baby can have consequences from too little blood flow and decreased oxygenation."
Past due date: If it appears your baby-to-be is labor-shy, your doctor may suggest inducing.
Labor doesn't progress: When you are already in labor, but it appears your labor isn't progressing, your doctor or midwife may choose to give you certain medications to spur your body into more active labor. For example, if your water has already broken, but your cervix isn't dilating, you may be induced.
How Healthcare Providers Induce Labor
There are two main ways doctors try to help labor along. If you're near your due date, your doctor may "strip the membranes" of the cervix to help the lining thin and move you closer toward labor. This can be done during an office visit or at the hospital. Stripping membranes can be painful and is not a surefire route toward labor.
When doctors need to medically induce labor in the hospital, the drug of choice is oxytocin (also called Pitocin). This medication mimics the naturally occurring oxytocin the brain releases to stimulate labor.
Beyond medical induction, there are several homeopathic methods to spur labor. Dr. Camann cautions expectant women against trying any of these methods without first consulting with their healthcare providers. Popular do-it-yourself induction choices such as cohosh and castor oil can have potentially harmful side effects like severe diarrhea, says Dr. Camann.