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Induced labor is generally accomplished with intravenous Pitocin, a synthetic drug. This medication will make the uterus contract and maintain labor contractions. The cervix must be soft, or “ripe,” in order for the induction to be effective and the cervix to dilate. Your healthcare provider can tell the status of your cervix upon vaginal exam. Normally, prostaglandins will start the ripening process (shortening, softening and dilating the cervix) in a painless fashion in the last weeks of pregnancy. In some women, though, the cervix stays long and thick. If your healthcare provider feels that an induction is necessary and the cervix is not ripe, you may receive a suppository that is placed in the vagina. These suppositories contain prostaglandin and assist in the preparation of the cervix for induction.

Augmentation Of Labor

Augmentation refers to the process of administering Pitocin intravenously to “restart” or enhance uterine contractions. This occurs when there is a lull or decrease in productive labor contractions that are necessary to dilate the cervix. On other occasions, an amniotomy may help facilitate labor contractions. The natural form of stimulating contractions is through nipple stimulation. This form of starting labor is not used frequently. Nipple stimulation before giving birth will sometimes be a test your healthcare provider may order to see how the baby reacts to the stress of contractions. This should not be done unless the baby is being monitored with one of the electronic devices. Nipple stimulation is not a safe technique to induce labor at home!

Urinary Catheters

A distended bladder can complicate labor, birth and postpartum. When you are in labor you should empty your bladder frequently. Your labor partner should remind you of this often. If you are unable to empty your bladder on your own, a catheter may be used. It is not uncommon following the birth of your baby that your bladder may not empty by itself. Do not let this concern you.

Shave

A complete shave of the pubic hair is no longer performed routinely. Talk to your healthcare provider about admission orders so you will know what to expect. Some healthcare providers will order the hair around the perineum to be clipped if the hairs are long.

Enema

If you have not had a bowel movement in the last 24 hours, a small enema may be ordered to cleanse the lower colon. If you have had a bowel movement or loose stools, this will be taken into account, and most likely an enema will be excluded from your admission orders.

Chapter 5 – Labor Guide 73

Every mother must be evaluated on admission, and then decisions will be made as to the best plan of action for her particular situation.

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