If you sail past 42 weeks without going into labor, it's likely that your doctor will schedule you for an induction. And while you'll probably be thrilled to give birth (finally!), you should know that an induction may cause you increased discomfort during delivery.
"Induced labor tends to be more painful than natural labor," says John Gianopoulos, M.D., professor and chairman of the Department of Obstetrics and Gynecology at Loyola University Health System, in Maywood, Illinois. "It initiates strong contractions much sooner, while natural labor begins over a period of days and the cervix tends to be soft and open when active labor begins." Induced contractions also come closer together and with more consistency; in natural labor they can vary in length or strength, letting a woman rest in between.
Because of this, Dr. Gianopoulos warns against inducing labor when pregnant women merely want to meet a schedule, are several days overdue, or are physically uncomfortable. Instead, he argues an induction should occur only if the mother's or the baby's health is at risk, for pregnancies that have lasted 42 weeks or longer, or if the baby is in distress. Women who are diabetic or hypertensive may also need to be induced. If you end up needing a push, here's what you can do to minimize the pain:
Ease into it Most inductions include the use of the synthetic hormone Pitocin, which is administered intravenously to stimulate contractions. If your cervix has not dilated before induction, your physician may use one of several techniques to prepare, or ripen, it, such as a gel suppository or medicated tampon. "Prostaglandins in these medications cause the cervix to absorb water and soften without painful contractions early on," Dr. Gianopoulos explains. Another tactic involves administering a low level of Pitocin at first until the cervix shows signs of ripening, rather than a high dose right away. "This causes contractions that may not be felt by the patient," says Richard Depp, M.D., professor of obstetrics, gynecology, and maternal-fetal medicine at Jefferson Medical College in Philadelphia. Other doctors prefer to manually rupture a woman's amniotic membrane (a.k.a. "break her water"), such as Janice Bacon, associate professor of obstetrics and gynecology at University of South Carolina School of Medicine, Columbia.
Get relief If you weren't planning on having an epidural block ó an injection of anesthetic into the spine ó you may want to at least consider one now. "Mild epidural anesthesia that allows a woman to still be mobile (a "walking epidural") may be the best bet in this case," Bacon says. While the more common continuous epidural also works well, it will confine you to bed during labor, she notes. Low-dose narcotics in early labor are another possibility, and acupuncture, meditation, and Lamaze techniques can also help.
Be prepared You should know that if you are induced before your cervix is fully ripe (in some situations, it may not be possible), there is a greater chance that you will be in for a longer labor or one that could ultimately lead to a cesarean section. Talk to your doctor about her approach to induction to decide what's right for you.