Women

I'm Past My Due Date Do I need to be induced? (part 2) - Fetal monitoring in labor & Types of induction When your baby is overdue

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Fetal monitoring in labor

During labor in the hospital, you may spend some time on an external fetal monitor. This monitors your contractions and your baby's heartbeat to check whether your baby is showing any signs of distress in labor. Two straps are placed around your waist. One records the movement of your uterine muscle and the other measures your baby's heart rate. The machine you are attached to produces a graph of the two readings so that the midwife or doctor can review the progress of you and your baby. If your labor is straightforward and the monitor readings show no problems, then you can be unstrapped and disconnected from the machine so that you are free to move around. Your doctor or midwife will then want to monitor you and the baby again at regular intervals throughout labor.

Monitoring you and your baby:

An external monitor checks the baby's heartbeat and your contractions, producing a printout of the readings. This may be used intermittently, or more frequently if there are any concerns about you or the baby.

NOTE

Bear in mind that doctors will be considering the welfare of your baby when they recommend an induction of labor

Types of induction When your baby is overdue

Induction, when labor is started artificially, may be necessary for health reasons (your health or your baby's) or if you are past your due date. If the baby's health is at risk, your obstetrician may consider it better for your baby to be born rather than stay in your womb. For instance, a scan may show that your placenta is not working properly and your baby not growing—in this case it would be better for your baby to be born and fed orally.

Q: How will I be induced?
A: There are several methods that can be used to induce labor. To start with, your cervix needs to ripen (soften) and begin to dilate. You can be given gel or suppositories of prostaglandin for this to happen. These are placed at the top of your vagina so that the drug can work on your cervix. Most units keep you in the hospital after this, since the nurses will be regularly recording the baby's heartbeat on the external monitor to ensure that you and your baby are dealing well with the induction drugs. Occasionally the cervix does not ripen; if this happens, you may be given a second gel or suppository in six hours.
Q: What happens next?
A: If the gel still does not work, the midwife or doctor will break the bag of water around the baby (artificial rupture of membranes, or AROM), which may cause discomfort. If you still don't have contractions, an V will be inserted into your arm and a synthetic hormone, Pitocin, is given to start contractions. Your baby's heartbeat will be monitored while you are on the IV, since there is a risk that you may contract too much and the heartbeat be affected. Some women find this type of labor more painful and may need more analgesia, such as an epidural. If none of these works, you will be offered a cesarean.
Monitoring the baby:

The baby's heartbeat may be monitored closely on a cardiotograph (CTG) since the contractions can be strong and sudden following an induction, increasing the chance of your baby becoming distressed.

Pitocin IV:

If the suppositories and artificial rupture of the membranes fail to start contractions, you will be given the synthetic hormone syntocinon via an intravenous drip inserted into a vein in your hand or arm.

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