Jamie Prock, RN-BSN, is an OB Nurse currently practicing within the Indian Health Service.

One of the biggest topics I encounter surrounding labor and delivery is induction of labor. I sit and listen to the process be explained, but I consistently admit patients for induction that remain confused or simply have unrealistic expectations of this process. I am going to break it down for you.

First things first, just like no child you have will be exactly likethe other; no pregnancy will go the same either. Induction and delivery are no exception to this rule. If you have had children previously, I do suspect that you have some knowledge of this process, but please understand that medicine and recommendations are constantly evolving. The process will likely not be the same twice. That being said, let us dive into what exactly induction of labor means.

Induction of labor is simply a process designed to push your body into labor. Labor is achieved in a variety of ways and using different mechanisms. During the natural process, the cervix begins to efface, or thin out, and start to dilate, or open. This process is preparing to allow the baby to travel through the birth canal and be delivered. With an induction, your physician or midwife, and your labor nurseprovide medications to assist in this process.

Depending on where your body is in the process will determine how your induction begins, continues, and progresses. If your body has done some of the work on its own, it is possible that you just need the body to begin having adequate contractions. If it has not, cervical ripening is the starting point. Cervical ripening is a term that refers to the process of effacing. As the cervix effaces, it will also begin to open. This is generally accomplished either mechanically or with medication.

Cervical ripening drugs include cervadil, or dinoprostone. This vaginal insert stays in place for 12 hours. Cytotec is a medication that can be taken orally or placed vaginally during this process. Of note, Cytotec is also given rectally in the case of post-partum hemorrhage. Mechanical means of ripening are a cooks catheter, also known as a Foley bulb. This is inserted into the cervix, designed to mechanically cause dilation and effacement. It will usually come out on its own when the cervix is dilated to four or more. These are the most common forms of cervical ripening.

After ripening has been achieved, Pitocin is usually started. Pitocin is a synthetic hormone designed to mimic the natural hormone, oxytocin, which is produced by the body. Pitocin is started at a low rate and gradually increased until adequate labor is achieved. The purpose of this drug is simply to cause contractions. The contractions will continue to push the baby down and open the cervix until dilation is complete and you are ready to push.

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As you can see, induction of labor is a process. Natural labor is also a process. Both processes can take some time and do not happen quickly. This is one of the most common misconceptions of induction. For the record, there is no magic pill to make you instantly have a baby. This process could be quick, as in hours, or it could take a few days. A long induction does not mean it is not working, simply taking longer. Make sure you are ready, have realistic expectations, and ask questions when you are having an induction.

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Jamie Prock, RN-BSN, is an OB Nurse currently practicing within the Indian Health Service. During her career, she has worked at various locations throughout the Oklahoma and Arkansas region. She obtained her A.A.S. in Nursing from Bacone College in Muskogee, OK. Then went on to receive her B.S.N. from Oklahoma Wesleyan College in Bartlesville, OK. Prior to her education in the Nursing Profession, she attended the University of Arkansas with a Journalism major. After giving birth to her first son, she decided she wanted to be a labor and delivery nurse. Mrs. Prock also teaches nursing students part time at Rogers State University. She is a Fetal Monitoring Instructor for AWHONN. She continues to work on her Masters in Nursing while working full time. She is married to Russell, and together they have six children with a grandchild on the way. In her spare time, she enjoys spending time with her family, listening to music, journaling, and cooking.

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