This is why we always recommend finding a care provider you truly feel supported by and who understands you and your preferences.

Weighing the pros and cons and having all of your questions answered can make all the difference in any situation that arises during pregnancy or labor. The most important step is hiring a care provider who will do all of these things for you. Whether inductions are planned or come up suddenly, it is important to know what options are available for the highest rates of a vaginal delivery (most birthing people’s preference).

Consider your Bishops Score as a first step. The Bishop Score is a tool utilized by care providers to determine the likelihood that labor will either begin soon and the likelihood of a successful induction. The Bishop Score identifies your cervical ripeness, dilation, effacement, fetal positioning and fetal station. Each factor will contribute to an overall score. Your care provider will determine your score by performing an exam that will provide a number between 1-10. 

If your Bishop score is above 8 it is conclusive that labor will begin soon or that an induction is very likely to be successful. If your number is 6 or 7 labor may not start soon and the likelihood of a successful induction is about half. If it is 5 or less it is unlikely that labor will spontaneously begin soon or that an induction will be successful. While your care provider is performing the score they can also do a membrane sweep or strip your membranes. 

Your care provider will sweep their (gloved) finger between the thin membranes of the amniotic sac. This motion will separate the sac and stimulate prostaglandins, compounds that act like hormones and can control certain processes in the body. In this case, that process is labor.

It is also possible for your care provider to gently stretch or massage the cervix to help it start to efface and dilated. This can be done as often as your cervix is checked by your care provider. You are likely to experience light bleeding, cramps and contractions following the sweep. Once the sweep is over and you obtain your Bishop Score consider the methods of induction that are available. 

We always recommend that our clients plan for a slow induction as the success rates tend to rise with patience through the process. It is important that your cervix is effaced (stretchy and thin) so dilation is possible. If you are not effaced much starting your induction with a cervical ripener is best. Talk to your care provider about the different methods available and determine which fits for you. 

Sometimes the ripener can work quickly and even cause contractions but most often it takes a full round or even two of cervical ripener before the process of dilation can begin. If you begin your induction with a cervical ripener anticipate that process ranging anywhere from 12-24 hours. You likely will be able to sleep, eat, read, watch tv etc. through most of it. Make sure you are staying in contact with your doula so they are able to answer your questions and give you tips throughout the process. 

The next step is to start contractions so dilation progresses. Often times the chosen method is pitocin or rupturing of membranes. Research and talk to your care provider to determine which method is best for you. Note: If pitocin is the best option for you find out what level it will begin being administering on and what the increase will be if needed. Pitocin can be administered on a scale of 1-20. It is most common that it is administered at a starting point of 2 and increases by 2 every half hour/ hour. If it reaches level 20 it is possible that it has caused over saturation of receptors and will need to be turned off for a half hour and restarted at the lowest level again. 

If contractions are patterned and causing change, it is possible to turn off the pitocin and allow your body to labor without medication once the pattern is established. All of this should be discussed prenatally or before it has been administered if prenatally isn’t an option. For either of these methods it is recommended that your doula either join you or will be ready to join you quickly as active labor can begin rapidly and intensify. 

When your doula arrives they will help you move through your contractions and apply coping techniques throughout the duration of labor and birth as well as determine when the best time is to utilize pain medication if that is your plan.Congratulations on your growing family!

Jennifer Tullo- Gentle Seed Doulas