Induction Types

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If a labor induction is decided to be in the best interest of the surrogate, there are a few different options that you may consider. It’s also worth noting that some doctors or hospitals will have their own rules on inductions, some not allowing them prior to 39 weeks for any non-emergency situation. While most doctors will have a preferred method, understanding the different types of inductions can help you feel a bit more prepared to make a decision if a choice is offered.

 

Medical Methods

Pitocin Administration

Perhaps the most common induction method is to administer a drug called oxytocin. This drug, more commonly referenced by the brand name Pitocin, is administered through IV and acts as a synthetic version of the hormone a woman’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.

Membrane Rupture

Also referred to as “breaking the water”, this method is generally only performed on women who are already several centimeters dilated. The 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.

Foley Catheter

In this method the doctor will use a small catheter to insert an uninflated balloon into the 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 be generally be completed without the use of synthetic hormones.

Membrane Sweep

Many doctors will choose to do a membrane sweep in the days leading up to or just past the assigned due date. This process, also called “stripping” the membranes, is completed in the doctor’s office during a normal visit. During the regular cervical check the 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 body to release prostaglandins and jump start labor within a matter of days.

Natural Methods

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, or sexual intercourse. None of these methods have been found scientifically effective.

Risks

Induction of labor is generally a safe practice. In most cases, a doctor will only proceed with an induction if he/she believes that the risks of remaining pregnant outweigh the risks associated with an induction. Even so, you should always ask your doctor about potential risks before moving forward with any induction process.

Who Shouldn’t Induce

Understand that there are instances in which no induction should be attempted due to increased risks. A diagnosis of Placenta Previa, a baby in breech or transverse position, multiples, and presence of genital herpes are occasions in which an induction is not recommended. Your doctor will know your individual medical needs and will be able to make the best recommendation on induction and safe methods.

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: An Essential Guide to Assisted Reproduction (Red Wheel 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.