Ways to Induce Labor In the Surrogacy Process

As your child’s due date draws near, your surrogate and her care provider may start talking about the potential need or desire for inducing labor.

While some intended parents desire an induced labor so they can have better odds at being present at the time of birth, most doctors and hospitals have policies about when an induction can be done. Most medical professionals will not allow an induction for non-medical reasons before the 37th or 38th week of pregnancy. An induction will be done when the benefits of birthing the child early outweigh the risks of continuing the pregnancy.

If an induction is advised, your Growing Generations surrogate will have a few natural and medical options. Here’s a look at the types of inductions doctors can use, and what they may mean for your surrogate:

 

Membrane Sweep

One of the more natural methods, this type of labor induction will be done in the days leading up to or just past the assigned due date. This process, also called “stripping” the membranes, is completed in a doctor’s office during a surrogate’s regular cervical check. A doctor will run his/her finger around the opening of the cervix, separating the amniotic sack from the bottom of the uterus. While not guaranteed to result in labor, the process can cause the surrogate’s body to release prostaglandins and jump-start labor within a matter of days.

 

AROM (artificial rupture of membranes)

Also referred to as “breaking the water,” this method is generally only performed on surrogates who are already several centimeters dilated. A practitioner will use a plastic hook to rupture the amniotic sack and spill the fluid. This process is done in the labor and delivery unit, as most doctors require a birth within 24 hours of membrane rupture to lower the risk of infection. If the rupture alone does not jump-start labor, the doctor may begin administering Pitocin as well.

 

Pitocin Administration

Perhaps the most common induction method is to administer oxytocin. This drug, more commonly referenced by the brand name Pitocin, is administered through an IV and acts as a synthetic version of the hormone a surrogate’s body produces on its own during the onset of spontaneous labor. The amount of the drug can be adjusted until the optimum level is found to jump-start contractions and force labor to begin.

 

Foley Catheter

In this method, the doctor will use a small catheter to insert an uninflated balloon into the surrogate’s cervix. The doctor will then slowly begin to fill the balloon with water over the course of the next several hours. This will put weight and pressure on the top of the cervix, usually forcing it to slowly ripen and open. At this point, the body will begin to produce labor hormones on its own. As the cervix continues to ripen and open, the balloon will fall out, signaling that labor has begun. This method can generally be completed without the use of synthetic hormones.

 

Old Wives’ Tales

Some surrogates and intended parents choose to try to stimulate labor through more natural home methods before choosing a medical intervention method. Common practices include nipple stimulation, consumption of Castor oil and sexual intercourse. None of these methods have been found to be scientifically effective.

While induction of labor is generally a safe practice, there are instances in which an induction should not be attempted due to increased risks. A diagnosis of placenta previa, a baby in breech or transverse position, and the presence of genital herpes are occasions in which an induction is not recommended.

The choice to induce is generally made between the surrogate and her doctor. The doctor likely will have preferred methods and may not be open to other options. Intended parents should ask their surrogate well in advance of the procedure so that she can have time to ask her OBGYN.

Learn More About the Surrogacy Journey

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.