Anxiety over birth
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Alison Ross

Registered Midwife, DipHe, BSc (Hons) Was a midwife at Kingston Hospital and Specialist Midwife in Perinatal Mental Health.
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Birth and labour

What are the dangers of going overdue?

After 42 weeks of pregnancy, the placenta becomes less efficient and the risk of still birth increases.
In Short
Induction means artificially prompting labour and it will be offered to you if you reach 41 weeks pregnant, because of the risks described above.

Your healthcare team will discuss the options available and the pros and cons of 'waiting it out'.

The first step would be a cervical sweep - and this is described below.

If you are confident that your baby’s due date is accurate and the length of the pregnancy matches your other pregnancies you can ask for more Doppler scans to assess the efficiency of the placenta.

Is there a natural way to stimulate labour if I am (a little) overdue?

There are some non-medical techniques that some people believe help to encourage natural labour. They include eating foods, such as pineapple or spicy foods. There’s very little evidence to suggest these will actually induce labour. Raspberry leaf tea has been documented to make the uterus contract more effectively, but it’s not proven to induce labour.

Making love with your partner or having them stimulate your clitoris or nipples may help as the prostaglandins in semen can help ripen your cervix and the stimulation will boost oxytocin levels which will help with contractions.

We would recommend you talk to your birth team if you are going overdue, and get their advice.

Cervical sweeps

If you decide you’re happy for intervention to get your labour started, your midwife will probably initially suggest a cervical “sweep”. She will insert an index finger into your vagina and make a circular, sweeping motion beyond your cervix, around the wall of your uterus. This can stimulate the hormones to start the cervix softening and labour to start naturally within the next week or so. Around 50% of women having a sweep will go into labour in the next 2 days. Sweeps can be repeated if you haven’t gone into labour within a week.

Evidence does suggest that with first-time mums it does take 2-3 cervical sweeps to get labour going. Sweeps are more effective when women are showing early signs of labour. Cervical sweeps can be offered from 39-40 weeks gestation with your consent. Cervical sweeps can be performed either in the hospital or a community setting.

What if the sweep doesn’t work?

If the sweep doesn’t work, medical induction will be suggested.

Alternatives include:

  • Prostaglandin
  • Membrane rupture
  • Oxytocin
Prostaglandin

This is a naturally occurring hormone which triggers the softening of the cervix. It is delivered in gel, pessary or tablet form, by a midwife in the hospital. You then need to go home (if you are low risk and there are no concerns regarding your or your baby after the prostaglandin is inserted) and wait. If after gel or tablet your labour hasn’t started within 6 hours, you’ll be asked to return for another dose. 2 doses is the most you can have. If you have the pessary, you’ll be asked to return after 24 hours. If your cervix was already starting to soften, a prostaglandin induction can start labour within 24 hours.

Membrane rupture

If prostaglandin doesn’t work for you, you might then be offered membrane rupture.

This technique is also known as ARM or the artificial rupture of membranes, and amniotomy. The midwife breaks your waters to get labour started. This happens in the hospital since there is a risk of infection.

Women generally go into labour within 24 hours of membrane rupture.

Oxytocin

Your body produces oxytocin naturally when your baby’s head starts pressing down on your cervix – and this triggers labour.

This is another option if prostaglandin hasn’t worked and is the most common form of labour induction in the UK. It is usually given through an intravenous drip.

What if none of these work?

If none of these work, you will probably be offered a C-section, but you will be involved in any decision making.

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DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.