Have you been preparing for labor, labor has started, and everything was going well, but suddenly everything slows down? Do your contractions seem to be less frequent and less intense? It's normal for a mother to feel scared and anxious at times like this. But don't worry. In cases like this, when a natural labor slows down or stops, doctors can help you and your baby complete the journey safely by speeding it up again. Today, we're talking about this process, called 'Augmentation of Labor'.
Simply put, what is Augmentation of Labor?
'Augmentation of Labor' is when a naturally occurring labor is not progressing as expected, that is, if the labor is not progressing at the desired pace, then the process is accelerated by external assistance. To be precise, it is about making your uterine contractions, or contractions, stronger and more frequent.
In this, doctors use medications or other methods to speed up labor. This method may be necessary if the time between contractions is too long, or if contractions have stopped completely. Because labor that lasts too long can sometimes be dangerous for both you and your baby.
Are Augmentation and Induction two different things?
Yes. This is where many people get confused. These two methods are completely different.
Induction of labor is the process of artificially initiating labor (by administering medication) in someone who has not yet begun labor.
Augmentation of Labor is a process that speeds up the process for someone who has already started labor, but is slow in the process.
To make it easier to understand, let's look at it this way.
| Characteristic | Induction of Labor | Augmentation of Labor |
|---|---|---|
| Purpose | When the weather has not started, start it. | If the already started movement is weak, strengthen and accelerate it. |
| Opportunity | When the baby is not born even after a full term, or when the mother or the baby has a health problem. | When labor drags on for many hours (failure to progress). |
Who needs this system?
You may need this method if you are in natural labor (not induced) and the process stops or takes too long. Doctors call this condition "failure to progress." This means that labor has not progressed sufficiently after 18-24 hours of labor.
This can be due to several reasons:
- The amniotic sac has not yet broken.
- Weak or irregular bowel movements.
- The complete cessation of the flow of water.
What are the situations when this method is not a good idea?
Sometimes doctors don't use this method. The reasons are:
- Baby's position: If the baby is in a complex position (e.g. breech, transverse lie) rather than head down.
- Problems with your uterus: If you have scar tissue inside your uterus (Asherman syndrome).
- Previous cesarean section: If you have scars on your uterus from a previous C-section or other surgery, this method may not be recommended because there is a risk of damage to the scar tissue when the uterus contracts excessively.
How to speed up labor?
Before this procedure, your doctor will talk to you about pain management options during labor. In most cases, you can get an epidural. Then, depending on your condition, your doctor will choose the most appropriate method.
There are mainly three methods:
1. Breaking the bag of waters (Amniotomy):
This is what we've all heard of as "breaking the bag of waters." What happens here is that the doctor uses a small plastic hook-like device to gently break the amniotic sac that surrounds the baby. As the amniotic fluid is released, the baby's head can push directly on the cervix. This pressure causes the cervix to open further, and contractions will start to come more frequently and more intensely.
2. Medications:
Here, you will be given a medication through a saline drip (an IV drip). The most commonly used medication is Oxytocin (brand name Pitocin®). This is a synthetic form of a hormone that is naturally produced in our bodies. This medication works by stimulating the uterus to contract and strengthen the uterus.
3. Balloon Catheter:
This is also a method used to open the cervix. Here, a small balloon with a thin tube (catheter) is inserted into your cervix and inflated. It's like blowing up a small ball. The pressure from this balloon causes the cervix to dilate, or open. When the cervix is open enough, the balloon will automatically fall out.
What are the advantages and risks of this method?
The main advantage is that a cesarean section (C-section) can often be avoided. This is a great help in achieving a natural birth. Because the recovery time after a C-section is longer and the pain is more.
And, like all medical procedures, there are some risks involved. But don't worry, these risks can be minimized because the medical team will be monitoring you and your baby very closely.
- Hyperstimulation of the uterus: Sometimes, the medicine `(Oxytocin)` can cause contractions to be too intense and frequent. This can cause some pressure on the baby (`fetal distress`). This means that the amount of blood and oxygen the baby receives can decrease. However, this can be controlled because the doctor constantly adjusts the dose of the medicine and continuously monitors the baby's heartbeat (`electronic fetal monitoring`).
- Infections: After artificially breaking the bag of waters, a bacterial infection (chorioamnionitis) can very rarely occur. To prevent this, you and your baby will be given antibiotics.
- Umbilical Cord Prolapse: This is also a very rare condition. This means that after the water breaks, the umbilical cord slips into the vagina before the baby's head. This can cut off the baby's oxygen supply. This is an emergency and requires an emergency C-section.
Recovery and when to see a doctor
Your recovery time depends on how the birth took place. If you had a C-section, an episiotomy, or a vaginal tear, it may take longer to heal and you may experience more pain.
If you have any of the following symptoms after giving birth, call your doctor immediately.
- Chest pain
- Dizziness or fainting (syncope)
- Very severe pain
- Excessive, foul-smelling vaginal discharge
- Excessive bleeding
- Nausea and vomiting
- Difficulty breathing
- Signs of infection, such as fever and chills
- Swelling of the legs, arms, or face (edema)
These methods are only used when medically necessary, for your and your baby's safety. So if there is a delay in labor, don't panic and talk to your doctor to decide on the best option for you.
Take-Home Message
- `Augmentation of Labor` is a procedure that helps speed up a labor that has started naturally but has slowed down along the way.
- This is different from the `Induction of Labor` method, which starts labor from the beginning.
- Breaking the bag of waters, administering medication such as `Oxytocin`, and using a `Balloon Catheter` are the main methods used here.
- The main benefit is that it helps prevent a C-section and facilitate a natural birth.
- Although there are some risks, there is no need to be afraid as the medical team will monitor you and your baby very closely.
- If you experience any unusual symptoms after delivery, notify your doctor immediately.
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