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Induction – What Should I Ask my Doctor?

Labor induction

You’re 39 weeks pregnant and your doctor says you need an induction. You’re not really sure what it means, why you need it or how it will happen. You only know that you should probably ask some questions but nothing comes to mind!

Your friend was induced 2 months ago and she didn’t have a positive experience… You’re not sure why.

So you take to the world wide web and start searching for induction of labor. But holy shit… you weren’t quite ready for the fear mongering and the horror stories that came with them…

But thank goodness, you are connected to Northeast Doulas and this blog!!! We are going to talk you through induction and give you the language that will put you back in the driver’s seat enabling your empowerment around this new information.

Let’s begin with the definition of induction in relation to labor:

Induction is the process of artificially stimulating labor via medical or natural intervention.

Induction is recommended for a variety of reasons that include but are not limited to:

  • Prolonged pregnancy
  • Ruptured membranes with no sign of labor
  • A medical condition affecting the mother or baby
  • And in some cases, because the patient requests it

There are many ways to induce labor and a variety of medications and instruments designed to help your uterus contract, your cervix to dilate and your baby to pass through your vagina.

These tools, when used properly can give you the opportunity to avoid a surgical birth known as a cesarean section.

The questions you should be asking your obstetrician in relation to induction are:

What is my Bishop Score?

A Bishop Score is an assessment of the cervix done by vaginal exam that is used to determine how favorable you are for induction. In other words, based on this exam, a Bishop Score will tell us how likely these “induction tools” are to effectively induce labor. While the exam is being done, your doctor is determining the following:

  • Is the cervix pointing toward your back (posterior), front (anterior) or somewhere in between (midway)
  • Is the cervix firm, soft or medium
  • Is the cervix thinned out (effaced) 0-30%, 40-50%, 60-70%, 80-100%
  • Is the cervix open (dilated) 1-2cm, -3-4cm, 5-6cm
  • Where the baby is in relation to the pelvis, -3, -2, -1, 0, +1, +2

What is the process and method or methods of induction that you intend to implement? In other words, “How will you induce me?

  • Will you use medication to help soften and efface my cervix?
  • Will you start with Pitocin?
  • How much Pitocin will you start with and how often will you increase it?
  • Will you stop the Pitocin if there are signs of hyperstimulation 

Use the Bishop Score Calculator to determine the likelihood of effective induction and have an educated discussion with your provider!