Keep in mind that induction shouldn't be advised except in a case of medical necessity, especially before 39 weeks. That said it is still important to know what factors make some inductions go more smoothy and others end in complete disaster and major surgery.
It depends on how close you are to going into labor on your own, the drugs used, the dosage, patient reaction to said drugs, and also the ability to chage positions, relaxation, etc.
If induction is advised, a checklist called the "bishop score" should be used to determine labor readiness. The higher the score the more likely the induction will go well, the lower the score the more likely it will not because the body is not ready.
WARNING: A cervix that is not favorable for induction will need to be ripened with drugs. AVOID at all costs a drug called CYTOTEC (also called Misoprostol). It is an ulcer medication. It is NOT approved for use on pregnant women an the label has a warning against that use! Furthermore, it can not be dosaged properly, can not be halted once administered, and has been known to cause hyperstimulation of the uterus, uterine rupture, and hemmorage. They have a safer drug availalbe called Cervadil. Demand they use it, if they must use something.
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This is the table used to determine how successful an induction of labour might be. It is recommended
that the Bishop's Score be greater than 7 (9 is optimal if using the midwifery model of the Bishop’s score
which is included below) for it to be successful.
To ensure your own induction's success rate, inquire about your Bishop's Score or better yet learn each
part of the score and figure it out for yourself. The unfortunate reality is that there are inductions being
performed with scores as low as 2 that make induction very difficult and success rates low. More than 1
in 5 births were induced in 2001! This is significant since in 1991 the induction rate was 1 in 10 births!
Induction with low Bishops scores decreases a woman's coping ability with the increased pain of
induction and the increased length of labour. This can be combined with AROM (artificial rupture of
membranes, breaking your water using an amniohook) to supposedly increase the success rate early in
the induction, but in fact this far too often leads to cesarean births as ruptured membranes increases
the chance of infection for both mother and baby. Make informed decisions for both you and your baby!
BISHOP's SCORE
Points Assigned: 0-1-2-3
Total Score = Sum of All points for each parameter
Meaning of Score:
7 or less: Do not attempt induction without ripening the cervix first.
9 or more: Favorable to attempt induction
12 or more: She is quite ready for labour or in early labour; a little encouragement should get
her going.
PARAMETERS
Position of Cervix
0 - Posterior (towards the back)
1 - Midposition
2 - Anterior (towards the front)
3 - NA
---
Consistency
0 - Firm
1 - Medium
2 - Soft
3 - NA
---
Effacement (%)
0 - 0-30
1 - 40-50
2 - 60-70
3 - >80
Dilation (cm)
0 - Closed/0
1 - 1-2
2 - 3-4
3 - >5
Baby's Station
0 - -3
1 - -2
2 - -1 to 0
3 - +1, +2
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The following criteria are additionally used by midwives and not by OBs. These items were added byadded by Anne Frye, Holistic Midwifery Volume II , and have been proven helpful from a
midwifery model perspective.
+Cervical Sensations
0 - None
1 - Slight
2 - Strong and Frequent
3 - Coordinated with some or all toning contractions
+Vaginal Secretions
0 - No increase
1 - Increased Mucus
2 - Increase with bloody mucus
3 - NA
+ Toning contractions
0 - None to Slight
1 - Mild
2 - Strong, sporadic, frequent
3 - Almost regular, visible on abdominal observation
Modifiers:
Add 1 point to score for:
1. Preeclampsia
2. Each prior vaginal delivery
Subtract 1 point from score for:
1. Postdates pregnancy
2. Nulliparity (Never having borne children)
3. Premature or prolonged rupture of membranes
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If you are unsure of any of the terms listed, please inquire with your doctor as to their meaning
or look in a good reference book such as Pregnancy, Childbirth and the Newborn by Simkin et
al., or TheThinking Woman’s Guide to a Better Birth by Henci Goer
Sources: Modified from Romney S et al, editors: Gynecology and Obstetrics:
The Health Care of Women, ed 2,
312-805-5280, 856-740-4858 .This handout for Informational purposes only, please consult your care
provider with any questions or concerns. Do not reproduce for profit and do give credit to sources cited.
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Mila Kunis' Weight Gain Is No Cause for Concern
Dude, ALG, with all this info you're learning, you should totally study to be a midwife!! You know so much already, it would be a breeze!!
=D
- sweetheart1985
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