The Induction Process

Usually, conversations around inductions focus on their reasons, risks, benefits, and when to schedule them. That doesn’t leave much time to discuss how they are done, and share expectations on how long they may take, or whether they’ll work at all. Toni Golen is here to walk us through the details. Check it out.

What we talked about:

• Common reasons for an induction
• How long could the induction process take?
• Is it guaranteed to work? How often does it not work (25% -Mayo Clinic)?
• Ways of inducing, and other procedures that may come into play
• It’s all about the cervix
• Misoprostol and Cervidil – common protocols
• Do they affect the pregnant person’s ability to walk around, or eat?
• What is the purpose and expected outcome when using prostaglandins?
• The Foley bulb
• The Bishop Score
• Inductions and VBACs
• What is Pitocin? How does it work (or not)?
• Is it always needed?
• What if the induction is not working?
• What are some good questions that expectant parents can ask their care provider to better understand what they will go through, and their options?
• Once the process is started, what level of input does the pregnant person have in terms of how the process will continue? What if you are feeling overwhelmed? Can the process be scaled down?

Additional resources and articles:

• Labor Induction, from the Mayo Clinic
• The Listening to Mothers III report
• Childbirth Connection -to find out a lot more about inductions
• Elective inductions and the Bishop Score – what makes an induction likely to work or not?
• Five things Physicians and Patients should questions – ACOG’s thoughts on non-medically indicated inductions
• Inducing Labor – the whys and hows
• Ob-Gyns Redefine Meaning of “Term Pregnancy” – ACOG’s definitions

Related Birthful episodes:

• Inductions, with Dr. Gene Declercq
• Updated: Evidence & Eating During Labor, with Rebecca Dekker
• The Problem with Due Dates, with Gail Hart

Courtesy of Dr. Toni Golen

About Dr. Toni Golen

Toni Golen is a physician specializing in Obstetrics and Gynecology, practicing in Boston. Dr. Golen completed her residency training at George Washington University Medical Center in 1995 and is an Assistant Professor at Harvard Medical School.  She has a special interest in health care quality and patient safety and serves as the Director of Labor and Delivery as well as Vice Chair of the Department of Obstetrics and Gynecology at Beth Israel Deaconess Medical Center.  In these roles, she is responsible for the development and implementation of quality improvement projects that advance the safety, accessibility, and patient-centered focus of care that is provided to women and their families. In 2017, Dr. Golen was senior author of a study published in The Joint Commission Journal of Quality and Safety that showed a significant reduction in cesarean delivery rate after serial quality improvement initiatives. You can contact Dr. Golen at tgolen[at]bidmc.harvard[dot]edu

Title music: “Vibe Ace” by Kevin MacLeod, from the Free Music Archive / CC BY (edited for length).

Sponsorship music: “Air Hockey Saloon” by Chris Zabriskie, from the Free Music Archive / CC BY (edited for length).