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I think I might get induced and I’m a little nervous. What should I expect?

Induction can be a scary word. Many patients do not know what to expect. If your doctor decides to induce, that simply means that she or he has determined that the baby would do better on the outside than on the inside.

There are many medical reasons for a labor induction. The most common reason is that the pregnancy has gone well beyond the normal gestational age of 40 weeks and it does not seem as if labor will come about in the natural way. Other reasons can include problems with the growth of the baby or medical problems worsening in mom as the pregnancy progresses, such as hypertension or diabetes. Rest assured, your doctor will discuss these reasons with you.

Usually the doctor will call ahead to the hospital and make a reservation for the induction. You should bring the same bag as you would if you were in labor. If your cervix (the bottom part of uterus that gradually opens as labor ensues) is closed, it will be necessary for your doctor to give you a “ripening agent.” There are a few different ways to “ripen” a cervix, but usually it involves a prostaglandin. When the cervix opens a little and softens (sometimes this is described in medical terms as having “a good Bishop’s score”), your doctor can start a medicine called oxytocin, sometimes called pitocin or “pit.” The cervical ripening can take place the day prior to the actual induction.

The pitocin should bring about contractions, which are painful. You and your doctor should discuss a plan for when pain medication may be necessary. Some physicians wait until a certain dilatation of the cervix is reached and some feel comfortable offering pain medications whenever the patient requests it. It is important to discuss your feelings about pain management during labor early in the pregnancy with your doctor or midwife and find out about his or her approach to managing labor pain. Ideally, you should be on the same page.

You also want to know about the hospital. For example, is there a dedicated anesthesiologist for labor and delivery in-house 24/7, or does the anesthesiologist have to cover the entire hospital or be called in from home? Does your doctor or midwife offer intravenous pain medications during labor (which can cross the placenta) or are epidurals the main form of pain management? Are alternative therapies such as massage, water therapy or hypnosis available?

Knowing the answers to questions like these can relieve a lot of the anxiety associated with an induction.

Answered by Dr. Wendy Wilcox