How labor is induced in the maternity hospital. Drugs to induce labor in the maternity hospital. Natural stimulation of labor in the maternity hospital

Induction of labor, in what cases is it necessary, risks, types of procedure

Every expectant mother is closely monitored by obstetricians and gynecologists during the prenatal period in order to avoid risks to her health and the life of the baby.
In the practice of specialists, there are many cases of premature birth, or timely (at 39-40 weeks), but with the uterus unprepared for this process. To ensure the safety of the child and mother, it is necessary for her to be fully matured by the time contractions begin. A pregnant woman herself cannot determine this; only specialists can assess the situation through a gynecological examination.

If the uterus does not open in a timely manner to allow the fetus to pass through the birth canal, and the moment of delivery is already close, obstetricians resort to stimulation methods.

Consequences of labor stimulation in the maternity hospital

Labor after stimulation can begin quickly and pass without dangerous consequences for many women. However, there are other situations when stimulation ends sadly for the woman in labor and complicates the birth process. Let's take a closer look at what complications can arise from induction of labor:

Contractions will be much more painful. Because of this, you may need to take additional painkillers.
A woman may experience a lot of discomfort due to stimulation, especially if an IV is used. She cannot take the position in which she is comfortable.
The child may suffer from hypoxia, which will negatively affect his development and health.
Stimulation may simply not produce any results, which is why one has to resort to surgical intervention.

In general, a doctor must weigh the pros and cons many times before prescribing induction of labor to a woman, because it can not only help the woman give birth, but also harm her and her child.

What is stimulation

Stimulation in the work of obstetricians and gynecologists involves inducing labor using artificial methods for medical reasons, or activating labor directly during the natural process in order to intensify pushing and contractions.

The optimal time for the birth of a baby is 40 weeks of the mother's pregnancy. During this period, examinations by doctors become more frequent to exclude the development of pathologies and risks. The child’s life support is monitored using an ultrasound examination, which makes it clear what condition the fetus is in, how it is located, and size indicators.

Artificial induction of labor is recommended when the baby is small in size or very large (weighs more than 4.5 kilograms). If this does not happen, he will gain weight, which will complicate natural delivery.

Most often, indications for such actions arise in expectant mothers suffering from chronic diseases, with a complicated pregnancy, or the development of pathologies.

How does Mifepristone work in the body?

The drug is a synthetic hormone, a steroid from the group of antigestagens; Externally, mifepristone is a yellow powder with a greenish tint. The action of the drug is based on suppressing the synthesis of progesterone, one of the main hormones of pregnancy; we can say that mifepristone is a progesterone antagonist.

Use the product for:

artificial termination of pregnancy at an obstetric period of up to 42 days;
stimulation of labor when the pregnancy is full term;
contraception after unprotected sexual intercourse (within three days);
therapy for uterine leiomyoma, a benign tumor.

How the drug will help induce labor

In order for labor to begin, the level of progesterone, the pregnancy-protecting hormone, naturally decreases in the female body; for nine months, progesterone helped the fetus grow and develop, and prepared the mother’s body for childbirth. And when it’s time for the baby to leave the womb, the mature placenta stops synthesizing the hormone. He completed the task.

But sometimes the amount of progesterone does not decrease before childbirth; the woman is at risk of post-term pregnancy. In such a situation, mifepristone will help, which will block the production of progesterone and provide the hormonal background necessary for the onset of labor. Under the influence of the antigestagen, the muscle activity of the uterus increases and the labor process starts - the mucous plug comes off, followed by water; Contractions of the required intensity begin.

According to medical statistics, in four out of five patients who were given Mifepristone, labor began within two days after the start of therapy.

When is it prescribed?

The hormonal drug is used to stimulate labor in women whose pregnancy is 41 or 42 weeks, and there is no sign of the onset of labor; Doctors have not yet diagnosed a post-term pregnancy, but it is time to give birth.

When pregnancy exceeds 40 weeks, and there are no signs of the onset of labor, the likelihood of drug stimulation of the process increases

However, the need for a speedy delivery also arises at earlier stages - for example, when staying in the womb threatens the death of the fetus . An important condition is that the pregnancy must be full-term.

Mifepristone may be prescribed to those who:

insufficiently mature or completely immature cervix;
prolonged and too weak contractions, causing suffering to the woman in labor;
there were contractions, but they stopped;
amniotic fluid has broken prematurely;
Rh conflict in the body; occurs when the Rh factor is negative in the mother and positive in the fetus; the structure of the child’s blood is disrupted, hemolytic disease develops;
the placenta has begun to exfoliate, the fetus is threatened by hypoxia - oxygen starvation; More often in such a situation, doctors resort to caesarean section, but sometimes, if the condition of the woman and the fetus is normal, a natural birth with stimulation is possible;
fetal death occurred in the womb.

Before birth, the cervix becomes shorter, softens, and acquires elasticity, as if creating “comfortable” conditions for the baby’s advancement; such a neck is called mature. But it happens that childbirth is approaching, but the muscular organ is still long and hard. Mifepristone is designed to stimulate cervical ripening.

The waters have broken, but contractions do not begin - this condition is dangerous for the life of the fetus; without amniotic fluid, as water is also called, the baby can remain in the womb for a maximum of 12 hours; Then irreversible changes occur in the baby’s body . Stimulation with Mifepristone is designed to speed up the birth of the baby.

Preterm abruption of the placenta can be caused by gestosis, a severe pathology that occurs exclusively in pregnant women. An antigestagen for such symptoms is prescribed if gestosis is sluggish; when the disease develops rapidly and progresses to the stage of preeclampsia or eclampsia (convulsions, sometimes cerebral hemorrhage, coma), Mifepristone is contraindicated.

An insufficiently mature cervix, an incorrect position of the placenta, when it partially covers the uterine os, and a breech presentation of the fetus lead to weak contractions. The result is the same - the woman suffers, but the baby still does not come out.

With a breech presentation, the baby is positioned with the buttocks or legs towards the entrance to the small pelvis; this often complicates childbirth

Every tenth case of labor complications is associated with sluggish contractions; During the first birth, the frequency of their occurrence is higher than during repeated births.

A number of doctors in such a situation rely on Mifepristone, which should affect the muscles of the uterus and soften the tissue of the cervix. The drug does not cause contractions themselves. It is possible, of course, that they will become more intense, but if not, they resort to other methods - for example, they give the woman in labor an IV with Oxytocin.

It is prohibited to use the drug on your own in the hope of bringing the long-awaited birth closer; Mifepristone is used exclusively in hospital settings, where there is modern equipment, including intensive care, and the condition of the mother in labor is monitored by medical staff. An antigestagen is prescribed after a thorough examination of the patient; the doctor first considers the possible negative consequences and correlates them with the benefits for the woman and the fetus.

Why is Mifepristone dangerous?

Not every specialist approves of using the drug to induce labor; The fact is that Mifepristone was originally developed as a means of contraception and termination of pregnancy in the early stages. As such, the medicine underwent clinical trials. Only later did scientists realize that reducing progesterone production would also help induce labor more quickly if the pregnancy was prolonged; But there is not yet enough scientific work on such use of the drug.

The main disadvantage of Mifepristone is its unproven safety for the mother and unborn child. However, no harmful effect has yet been discovered; In general, the medicine is considered controversial.

Other medical claims about the antigestagen:

a number of scientists claim that expectant mothers who were given the drug more often had increased blood pressure and tachycardia; the fetal heartbeat also changed - but the matter did not reach pathological consequences;
the drug acts aggressively on the placenta, exfoliating the membranes too quickly, and this threatens rapid labor, resulting in injuries to the baby and ruptures of the woman’s perineum;
due to the unstudied effect of the substance mifepristone on the baby’s body, it is not recommended to breastfeed the baby in the first two weeks after birth, since the drug passes into breast milk; a woman has to pump; however, the manufacturer claims that the drug is cleared from the body in 2–3 days.

If the expectant mother considers that induction of labor with Mifepristone is not suitable for her, she has the right to refuse the drug; no doctor can force a patient to take medicine.

When is stimulation applied?

Stimulation by medical workers in the maternity hospital is used to ensure that a woman’s uterus opens to allow the fetus to come out as quickly as possible, since it is no longer safe for the child to be in the womb and the pregnancy is coming to an end.
This event is implemented by specialists both planned and unscheduled.

As planned

Planning to artificially induce labor occurs if the child has problems with intrauterine development during pregnancy, there are pathologies, or the mother has a painful condition. If a woman is seen by a doctor regularly, this procedure can be planned based on the medical indications for its use.

In case of irregular visits to the gynecologist, but there are reasons for planning stimulation, the woman in labor risks both her health and the life of the child.

Unscheduled

More often in the practice of obstetricians, unplanned artificial delivery occurs. It is used in the following cases:

if labor does not begin within the prescribed period (the 41st week of pregnancy has begun);
the woman’s water has broken, but the uterus is not dilated, and the birth process does not begin more than 24 hours after this moment;
contractions have begun, and the baby cannot leave the womb due to incomplete dilatation of the uterus.

Typically, problematic issues arise with women in labor who do not feel that the baby is ready to come out at 40-41 weeks. This means that the degree of maturity of the cervix has not yet reached the desired state for the natural process.

This difficult moment is dangerous because there are no indications for labor yet, but the condition of the placenta should be assessed, since it may stop performing its functions - delivering nutrients, providing oxygen to the baby’s blood circulation. If this happens, and the internal organs are not yet ready for birth, unscheduled stimulation will be mandatory to save the baby’s life.

Natural methods of inducing labor

In addition to medical methods of stimulation, there are natural ones that many women use without even knowing it. Such methods can be used at home if the baby and the mother’s body are already ready for childbirth. Most often, such methods are recommended by a gynecologist during post-term pregnancy. You should not use natural stimulation without first consulting a doctor.

The simplest, most accessible and, of course, enjoyable method is sex . A man's semen contains prostaglandins, which relax the cervix and promote its contraction. Orgasm stimulates contractions of the uterus, which triggers the onset of labor. In addition, during sexual caresses, the synthesis of natural oxytocin increases. Thus, sex is a natural and complex stimulation of labor.

Taking castor oil . This is a rather controversial method, since it does not directly act on either the cervix or the uterus. By providing a laxative effect, the intestines act on the uterus, which provokes labor. But this method can cause nausea, poor health and weakness. This will negatively affect the woman’s condition during labor and can deprive her of much-needed strength.

Light physical activity can also trigger the onset of labor. Most often this is simple walking, washing the floors (without a mop), cleaning the closet. Such an activity will not only activate labor activity, but will also satisfy ambitions for improving the premises ("nesting" syndrome).

Required conditions for stimulation

Stimulation is carried out by specialists if certain conditions are met for this procedure. They are:

mature state of the cervix;
necessary and optimal duration of contractions;
sufficient strength of contractions.

If the dynamics of these indicators are weak, we can talk about possible difficulties during childbirth, since the woman actually does not have enough strength to push the fetus through the birth canal.

Cervical dilatation

This organ of the reproductive system of the expectant mother is responsible for a successful and safe delivery, since the entire process depends on how timely its maturation occurs and the timing of dilation.

In the practice of obstetricians and gynecologists, it is generally accepted that preparation for the rejection of a baby begins around the 32nd week. The uterus begins to soften, this lasts until the 38th week. After which, the fetus descends down the abdomen, it additionally puts pressure on it, naturally stimulating it to open. During this entire period, the expectant mother must be observed by a doctor, who will diagnose how close the onset of labor is in terms of the degree of dilatation.

If the doctor tells a woman that the dilatation is 1 finger, you can think about and evaluate the anticipation of childbirth based on your own feelings. But this state of affairs only signals physiological readiness; subsequent opening begins during contractions.

The optimal state of readiness is considered to be the moment when the cervix has dilated by 3-4 centimeters. Many doctors, when observing pregnant women, rely not on centimeters, but on the size of their fingers.

What week can you start stimulation?

Typically, this measure is resorted to at 40 weeks of pregnancy, since this period is optimal for bearing a child.
Nowadays, the natural process of childbirth is encouraged, excluding the influence of drugs on the condition of the mother and baby. It is not used before 42 weeks, if the woman does not have swelling, the amniotic fluid is light according to ultrasound radiation, and she feels normal.

Stimulation is sometimes used before the specified period, but only for medical reasons, in case of a threat to the life of the fetus or the expectant mother.

Catheter Care

Even though the Foley catheter is only installed for a few hours, there are some guidelines that need to be followed. Installation of a catheter does not affect the ability and ability to urinate and defecate. After insertion of the tube, the woman should, if possible, remain in bed to avoid spontaneous loss of the catheter. Often, the catheter is installed before bedtime, for the convenience of the woman in labor. It is not recommended to touch the device with your hands, move it, or try to remove it yourself. If you experience the slightest discomfort, burning sensation or pain, you should inform your doctor. The catheter does not require additional antiseptic treatment after insertion.

Recently, mechanical methods of preparing the cervix for childbirth are used less and less. Their effectiveness is much lower than modern methods.

Reviews from various sources

Ulyana 06/23/2017

The pregnancy proceeded perfectly, without complications. But at 39 weeks my water suddenly broke. I was in shock, at first I didn’t understand what happened... There were no contractions or discomfort. I called my doctor, he told me to go to the maternity hospital immediately. After examination, they said that the bladder had burst and we needed to give birth, but the cervix was stiff. The opening was only one finger. They said they would open it artificially and insert a catheter. If it doesn't help, use medications. I was terribly scared, but I couldn’t do anything. I was more afraid))) Not the most pleasant procedure, but absolutely tolerable. Literally an hour later contractions started, I called the doctor and said that I needed to get the catheter, but she reassured me and said that it was not time yet. After 5 hours, she examined him again and reported that he had fallen out of the cervix on his own. The contractions by this time were terrible. And after another half hour, I began to struggle. In the end, everyone is healthy and everything is fine! Thank you to the doctors for not doing a caesarean section, but for inducing labor and helping me give birth on my own.

Christina 03/07/2017

First pregnancy, at 38 weeks my water started to break. I arrived at the maternity hospital, they said that they can’t maintain a pregnancy at this stage and that you can give birth, but you’ll have to induce it. There is no dilation of the uterus, its position is incorrect for childbirth, and there were no contractions. They offered to install a foley catheter, but they said there was no other way, because... the waterless period is already more than 3 hours. It took a long time to insert it, it was terribly painful. I lay with him for about 6 hours. During this time, small contractions began. The doctor came, looked and said that the catheter had fallen out, and the cervix had dilated by 2 cm, which is very little, because the anhydrous period had already been almost 12 hours (((They began to urgently administer oxytocin. An hour later, strong contractions began. After suffering for another couple of hours, I gave birth ) I don’t know if the catheter helped me... maybe I should have started right away with oxytocin. Thank God, the baby is healthy.

Katerina 04/25/2017

They inserted a catheter because she was overdue. I was already at 41 weeks. They installed it early in the morning and said that it should stand for a day. There was slight pain, and then slight bleeding began. I almost died of fear. The midwife said that this happens and there is nothing to be afraid of. Out of fright, of course, I didn’t really believe it. She left with foley until the next morning. He didn’t fall out on his own, as they said. The doctor took it out, then punctured the bladder and began to inject oxytocin, since the cervix was dilated by only 2 fingers. By lunchtime I was fully dilated, but it turned out that I had a facial presentation and the baby had not descended into the pelvic floor. They did an emergency caesarean. Now everything is fine with us. I hope to give birth to the next one on my own) My neighbor also had a foley - it didn’t help, the cervix didn’t dilate at all, they also had a Caesarean.

Maria 05/13/2017

They admitted me to the pathology department in advance for childbirth, because... the period was already 42 weeks. On the very first day they did an ultrasound and CTG and established oligohydramnios, they said that it was necessary to stimulate and give birth faster. They inserted a foley catheter at about 5 pm and warned that the bladder would be pierced in the morning at 7 o'clock. An hour later, my back began to numb, and it turned out that this was the beginning of contractions. After some time, my stomach began to cramp. I called the nurse, she said that the catheter stimulates the dilatation of the cervix well. As night approached, I could no longer sit or lie down. I wandered through the corridors, waiting out the contractions. The catheter fell out on its own. The nurse took me to the examination room, my cervix was dilated by 4 cm. She said that I could call the doctor already. She gave birth at 7 am, on her own, but with anesthesia. Girls, don't be afraid of stimulation!)

Anya 08/14/2017

This Foley catheter did not help at all! I suffered terribly while they inserted it. At the same time, bleeding began, the doctors assured that this was normal. They tied it to my stomach, which made it uncomfortable to sit! The result was an emergency caesarean section. And he didn’t help the other girls from the ward. Childbirth should take place naturally, without stimulation!

Is it safe to induce contractions without dilating the cervix?

Activities that involve stimulation are aimed at opening the cervix, so inducing contractions helps a woman go through the labor process faster than would happen naturally. They are used for medical reasons, if the pregnant woman requires it and the child does not push herself out of the womb.

Inducing contractions if the uterus has not yet opened has its own risks, since this is a surgical intervention in the natural process of birth, but without these actions when it is immature, there is another threat - harm to the fetus or the woman in labor.

How to care?

A woman who has a Foley catheter is usually told how to properly care for it throughout the day. The rules are explained by the doctor who installed the device. You need to follow them strictly if you want to give birth to a healthy baby and quickly bounce back after childbirth .

First of all, a woman needs to remember about hygienic requirements. The skin around the installed medical device must be clean. Each time, before touching the external genitalia, you should thoroughly wash your hands with warm water and soap.

It is prohibited to wash the perineum in the area adjacent to the inserted catheter. A woman can wear underwear, but only made from natural cotton fabrics.

There is no need to remind you once again that panties must be exceptionally clean. Briefs should not compress or deform the catheter . It is important to ensure that this does not happen during movements. But it is usually not necessary to rinse or reinstall the catheter when inducing labor - its use in obstetrics is one-time only.

For more information about what a Foley catheter is, see the following video.

medical reviewer, psychosomatics specialist, mother of 4 children

Hi all! Girls, on Friday the doctor admits me to pathology and will insert a balloon to dilate the cervix, preparing for childbirth, so to speak. The plug came off 2 weeks ago and the opening of 1 finger also took 2 weeks. The deadline by Friday will be 41+2! Share your experience: who was stimulated like this? How quickly did you give birth? Does it hurt?

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They opened it manually for me, the pain was hellish, but the doctor couldn’t do anything. As a result, labor began with 1 finger dilating, injections were given and within three hours there was complete dilatation.

Also stimulated at 41 +4, opening 1 finger. It’s more unpleasant than painful, you can tolerate it, the main thing is to relax as much as possible. Weak contractions began 6 hours after the balloon fell out. In the future there will be strong private fights. all is good.

This is called “go away until Friday, maybe you’ll give birth at home in your usual microbial environment” and “echoes of the military-industrial complex conversion” (EXPANDER UNIT). If the tone and gaping are removed by beta2-agonists, then in some cases the start of labor can be carried out with beta2-blockers or less selective ones under heart rate control. Pain that is more than “peristaltic” is a defect in labor management. Sometimes, of course, the doctor doesn’t have time to figure it out, but nevertheless, there is a defect in the functioning of the gastrointestinal tract and then RD (infections, deficiency conditions, less often overdose).

Is it possible to induce labor at home?

Many women, when approaching the 40th week, worry that there are no signs of labor in their condition.
Having consulted a doctor, they receive a recommendation to go to an inpatient department to carry out this process in artificial mode. Some women in labor prefer the option of inducing labor without the use of drugs that can have a negative impact on health - at home using light physical activity, food, and other procedures (bathing, massage).

Gymnastics

Moderate physical activity for a pregnant woman under the supervision of a doctor is a good method of inducing contractions, since movements can provoke dilatation of the uterus, which will start the process of natural delivery. Activities that are not contraindicated for women in labor include:

walking outside (fresh air combined with movement has a beneficial effect on fetal development);
cleaning at home (you can wash the floor not with a mop, but by hand, squatting);
if a woman does not live on the 1st floor, climb to the required floor using the stairs in a sideways position;
yoga has a good effect on the stimulation process by balancing breathing;
charging in light mode using squats.

A light or moderate load on the body is encouraged; if a pregnant woman overdoes it with exercise, the birth process may be difficult and muscle tension will be present.

Foods that provoke contractions

Nutrition for an expectant mother is one of the important aspects of the well-being and harmonious development of the baby.
She must understand that the products she consumes are beneficial and do not cause harm. The following are considered products that can trigger labor:

spicy food (it stimulates the intestines, as a result of which the uterus begins to contract and open). You need to be careful with this method and consult a gynecologist about its use (in most cases, women do not tolerate spicy food, as it causes heartburn and unpleasant taste sensations);
tea that contains raspberry leaves or ginger pulp (not everyone can use it, it is not recommended for women in labor with special features in the structure of the pelvis, as there is a risk of rapid labor);
pineapple pulp (it contains bromelain, which softens the uterus and prepares it for opening);
products containing fiber (for example, seaweed) have a relaxing effect.

At home, you cannot use medications to speed up labor; such procedures are carried out only by obstetricians in a hospital setting.

Gel for intimate hygiene

In the practice of doctors, a procedure for introducing a specialized gel into the vagina is often used.
The woman in labor is seated on a gynecological chair, the vagina is filled with gel using a syringe, after which she is left lying down for 30 minutes to prevent leakage of the drug. The volume of medication that can be administered at one time does not exceed 5 mg.

Within 4-5 hours she feels mild cramping pain that spreads and gains strength. If this does not happen, the procedure can be repeated 6 hours after the first attempt. After repeated administration, there is a high probability of accelerating the process, since the concentration of stimulating substances in the body increases.

Indications for artificial induction of labor

Induction of labor is carried out according to the following indications:

Post-term pregnancy
. It is carried out after 41 weeks or earlier if there are indirect signs of post-maturity;
Multiple pregnancy
if it persists beyond 38 weeks;
Premature rupture of amniotic fluid
in the absence of labor development;
Acute or chronic diseases of the mother
that prevent further pregnancy;
Conditions of the fetus
that threaten its health and life with further prolongation of pregnancy;
Marked weakness of labor
in the first and second stages of labor;
Immature cervix during full-term pregnancy;
Absence or slowing of cervical dilatation in the first stage of labor
.

Types of stimulation

Gynecologists in their practice use stimulation measures, both without surgery and with its use. If previous actions - gymnastics, yoga, consumption of foods that influence the induction of contractions - do not help, specialists resort to more serious methods of stimulation.

Amniotomy

This event refers to the rupture of the membranes, which keeps the amniotic fluid from coming out.
It can be pierced or cut with special tools. After which, fluid pours out of the uterus. It is carried out only for certain medical indications, taking into account the fact that there is no risk to the fetus and mother. It is prescribed by an obstetrician; it is simply not performed at the request of women in labor without the presence of conditions.

The event is subject to the following conditions:

the fetus lies head first;
bearing 1 child;
period of at least 38 weeks;
the baby's weight is no more than 3 kilograms;
the birth canal is ready for delivery;
pelvic size is normal;
There are no scars on the uterus after operations.

If these conditions are not met, then there is no indication for the procedure.

Oxytocin injections or drips

Inducing contractions is practiced using the hormone oxytocin, which is administered to the patient by injection or IV.
It is responsible for muscle contraction and starting the lactation process. After 30 weeks of pregnancy, its natural content in the body increases. In situations where there are deviations from the norm, the hormone is not produced in an amount effective to initiate labor, so it must be administered artificially. When the contents enter the bloodstream, the activity of the uterus increases within 5 minutes. One injection is effective for up to 3 hours.

Prostaglandins

One of the current and safe ways to stimulate labor is the use of substances containing prostaglandins. Exactly the same components are produced by the female body when the process of delivery proceeds as planned without deviations. After their use, the concentration of substances occurs near the uterus, they soften it, force the muscles to contract, causing contractions.

The contents are administered only in a hospital setting by an obstetrician through the cervical canal. According to practice, the effect begins after 4-6 hours from the moment the gel is introduced into the woman’s body.

Rules for taking the drug

Mifepristone is available in tablets for oral administration (by mouth); one piece contains either 50 or 200 milligrams of the active substance. Take the pills with water, and the instructions emphasize that a doctor should be nearby.

Dosage, duration of action

So, in the hospital, in the morning, the pregnant woman is given one tablet (the one with 200 milligrams). Sometimes the antigestagen causes labor just a few hours after administration (the highest concentration in the blood occurs after 4 hours), then a second pill is unnecessary. If there is no change in the woman’s condition during the day, she takes the second tablet exactly one day after the first use, the last one, since the maximum dose of the drug to induce labor is 400 milligrams.

A lot of expectant mothers have heard about the effectiveness of Mifepristone; the expression “two magic pills” is even used among pregnant women. However, some patients are disappointed - the notorious “magic” does not help.

A single Mifepristone tablet is enough to start labor

It happens that the medicine works later - after two or three days; if 72 hours pass and labor does not begin, it means that Mifepristone did not lead to the desired result. The doctor evaluates the patient's birth canal; The cervix still began to soften - then therapy can be continued. Prescribed if necessary:

medications with prostaglandins (a gel containing the substance dinoprostone is injected into the cervical canal) or droppers with Oxytocin; after Mifepristone they usually give the desired effect;
kelp - dense sticks of algae are inserted into the cervical canal; under the influence of plant matter, biochemical changes occur, the neck softens and opens;
Foley catheter - a tube with a small balloon; inserted into the cervix, water is pumped into the balloon; a container of water expands the uterus, increases its motility; The method was found to be painful and not effective enough.

It happens that the cervix is completely ripe with the help of medications, but labor does not develop; then they resort to amniotomy - puncture of the amniotic sac.

If the cervix does not respond to therapy at all, doctors, with the written consent of the patient, perform a cesarean section. You can refuse, because natural childbirth will eventually begin - it will only turn out to be long, difficult and “bloody”; It is possible that the baby will suffer a birth injury or suffocation.

Who should not take Mifepristone?

Drug stimulation is excluded for those expectant mothers for whom natural childbirth is generally contraindicated; This group, for example, includes pregnant women:

with a narrow pelvis (the baby’s head cannot squeeze through the bones);
with complete placenta previa, when the temporary organ completely blocks the exit from the uterus; with incomplete presentation, natural childbirth is also possible;
with oblique or transverse presentation of the fetus; with breech presentation, most women are also indicated for cesarean section;
with a post-term pregnancy - as a rule, the fetus is already too large and will not pass through the birth canal.

Other contraindications for taking the drug:

intolerance to the substance mifepristone;
severe gestosis - a condition of preeclampsia, eclampsia;
long-term therapy with glucocorticoids - hormonal drugs that are used for insufficient adrenal function;
impaired renal and liver function;
the presence of a scar on the uterus;
fibroids (benign tumor) of the uterus;
porphyria is a hereditary pathology, accompanied by the appearance of blisters on the skin and photophobia;
inflammatory processes in the genital organs;
increased or decreased blood clotting;
severe anemia;
A low level of hemoglobin in a pregnant woman provokes anemia, most often expressed in a perversion of taste preferences; in severe cases of pathology, labor cannot be stimulated with Mifepristone
premature pregnancy (before the 37th week);
multiple pregnancy;
fifth, sixth and so on births in a row.

Also, women over 35 years old should not take antigestagen when they smoke - but it is unlikely that among reasonable expectant mothers there will be smokers, and even in later stages.

A number of pregnant women are advised to take Mifepristone with caution - this group includes those who:

bronchial asthma;
chronic obstructive pulmonary disease;
persistently elevated blood pressure;
heart failure;
cardiac arrhythmia.

Adverse drug reactions

A number of articles mention heavy bleeding that occurs every now and then after using Mifepristone, but such a reaction accompanies only artificial termination of pregnancy - abortion.

During stimulation of labor with pills, the following are possible:

dizziness, headache;
feeling of weakness;
discomfort in the lower abdomen;
aching pain in the lumbar region;
nausea, vomiting;
diarrhea;
increased body temperature;
skin rash (if you are allergic to the drug).

One of the consequences of taking Mifepristone can be rapid labor, due to which both newborns and women in labor often suffer injuries (women experience perineal ruptures).

Interaction with other medications

In addition to taking glucocorticoids, when using Mifepristone it is not recommended to take non-steroidal anti-inflammatory drugs, for example:

Nurofen;
Ibuprofen;
Diclofenac;
Indomethacin;
Voltaren.

In combination with Mifepristone, they weaken the effect of the antigestagen. However, according to the instructions, all these drugs are prohibited in the 3rd trimester.

How long does it take for labor to begin after stimulation?

The duration of action of stimulating procedures depends on the characteristics of the patient’s body, the amount of active content, and the mechanism of the event. The birth process begins in different ways:

if the expectant mother independently tries to induce contractions with the help of physical activity, nutrition, gels, the onset of labor depends on the body, the degree of impact, may occur in a few hours, or the result will not be achieved and surgical intervention will have to be used;
when stimulated by injections and droppers, the release of hormones into the blood provokes contractions within 5 minutes;
the method of introducing prostaglandins through the cervical canal gives results on average in 4-6 hours;
in case of amniotomy, the effect is observed within 3-4 hours.

Medication methods can be considered more effective methods, since the action of drugs and hormones quickly stimulates delivery.

After what period does Miropriston begin to act to induce labor?

There is no clear answer to the question of how long it should take before Miropriston works; opinions differ. In the presence of a gynecologist, a woman takes a tablet with 200 mg of the active substance (mifepristone). After 24 hours, repeated administration of the medication is indicated. After 2-3 days, the doctor must examine the expectant mother in a gynecological chair and assess the condition of the birth canal; perhaps, the amniotic sac will be punctured. If Miropriston has not shown any effectiveness, specialists use other means to induce labor (oxytocin, prostaglandins).

Based on reviews of young mothers who took Miropriston to stimulate labor, we can conclude that the speed of action of the drug depends on the individual characteristics of the body of each woman in labor. Some begin to give birth within 12 hours after taking the pill, others take up to 400 mg at a time, repeat after a day and still do not observe any significant changes.

Risks to mother and fetus

Many women try to induce contractions naturally because they believe that medical intervention can harm the baby.
In most situations, the procedure goes without difficulty, because without it, the woman’s situation may worsen, leading to a caesarean section. When implementing incentives, the following risks are noted:

infection of the fetus (as a result of surgery, an infection may occur that has a negative effect on the baby);
oxygen starvation of the child;
requires the administration of painkillers with the risk of effects on the fetus;
the occurrence of complications during childbirth (placental abruption, uterine rupture).

Natural birth is preferable, since this method is a natural process that does not involve the introduction of drugs or instruments into the uterus.

Contraindications to the use of a Foley catheter

In some cases, the use of a two-way catheter can complicate the course of labor or even cause intrauterine infection of the fetus, and therefore Foley is not used in the following situations:

the presence of an infection in the vagina that causes inflammatory processes - cervitis (in the cervix), vaginitis (in the vaginal mucosa, etc.),
low placenta previa,
internal bleeding,
rupture of the amniotic sac.

If you have been prescribed induction of labor with a Foley catheter, then you can purchase them in the online store Sterilno.com. Our advantage is direct cooperation with all manufacturers presented in the catalog. And also leave feedback about your experience using this method of inducing labor. Your feedback will be important and useful for expectant mothers!

How does labor proceed when stimulated?

In the case of stimulation, the process of delivery differs from natural. Firstly, a woman experiences more pain and needs medications that can relieve pain. Secondly, failure to dilate the uterus on time suggests difficulties with the birth of a child, and thirdly, there are risks of infection.

Mothers who gave birth this way are observed longer in the maternity hospital until their condition is completely restored. In this case, obstetricians are more attentive to patients, since they have a greater risk of negative consequences, but with correctly applied procedures and professional management of pregnancy, they are minimized.

Restoration of the body

After the birth of a baby with artificial stimulation, the body’s recovery occurs as usual.
All vital systems return to normal within 3 days. Hormonal levels are fully restored only after the baby has finished breastfeeding. If oxyotocin was used, the mother may feel pain in the form of abdominal cramps during lactation. Menstruation can be restored within 1 to 1.5 months, depending on the characteristics of the body. The uterus shrinks and returns to its prenatal state within 6 weeks.

The birth process, especially with stimulation, requires special attention from obstetricians, whose main task is to maintain the health of the child and mother. If indicated, a woman must fully follow the recommendations of specialists so that her birth takes place without difficulties and critical problems leading to irreversible consequences.