Augmentation of labor

Overview

Augmentation of labor is a process used to accelerate or restart labor that has slowed or stalled. When childbirth isn’t progressing as expected, healthcare providers may use labor augmentation to help avoid a C-section by enhancing and strengthening uterine contractions. This can involve medications and other techniques designed to make contractions more frequent, stronger, and closer together. If your contractions slow down or become too infrequent, labor augmentation might be necessary to ensure the safety of both you and your baby during delivery. Your healthcare provider may use various methods to assist in facilitating labor and ensuring a smoother delivery process.

Reasons for undergoing the procedure

If your childbirth is stalling or taking too long and you are in natural active labor (as opposed to induced labor), you could require labor augmentation.

Labor failure to progress could be caused by:

• The amniotic sac remains unruptured.
• Irregularor weak contractions.
• Completely stopped contractions

If you have these conditions, healthcare providers won’t augment your labor:

• Your infant is in breech position (butt or feet first), or transverse position (shoulder first).
• You have intrauterine scar tissue, or Asherman syndrome.
• There are scars on your uterus. These can have resulted from a previous C-section or another type of surgery.

Risk

On rare occasions, oxytocin can cause hyperstimulation, leading to overly strong uterine contractions. These intense contractions may cause fetal distress, meaning your baby might not be receiving enough blood or oxygen. Fetal distress increases the risk of complications like uterine rupture. To mitigate these risks, your healthcare provider can adjust the oxytocin dosage. Additionally, electronic fetal monitoring is used throughout labor and delivery to track the strength of your contractions and monitor your baby’s heart rate, helping to reduce potential complications.

Another procedure, an artificial rupture of the amniotic sac, carries a small risk of chorioamnionitis, a bacterial infection. Bacteria can enter the amniotic fluid surrounding your baby, increasing the risk of newborn sepsis. You may also face risks such as sepsis and blood clots. To address these concerns, you and your baby will be prescribed antibiotics after childbirth.

A further risk associated with amniotomy is umbilical cord prolapse. This occurs when the umbilical cord slips into the cervix and vagina ahead of the baby, potentially cutting off the baby’s oxygen supply. In such an emergency, a C-section will be necessary.

Before the procedure

Before you deliver, you and your healthcare provider will discuss pain relief options during delivery. You may choose to get a type of anesthesia called an epidural. A provider called an anesthesiologist inserts a catheter (thin tube) into the epidural space. This is between your spinal column and the outer membrane of your spinal cord. The catheter goes into your middle or lower back. It stays in place throughout childbirth. It allows your anesthesiologist to offer you pain relief as needed.

During the procedure

Healthcare providers both induce and induced labor using comparable assisted methods for delivery. By using these methods, the cervix becomes more open for childbirth. Your unique delivery conditions will determine the course of treatment.

Among the methods for labor augmentation are:

• Amniotomy: The amniotic sac that covers your baby is ruptured by your healthcare provider using a device inserted into your cervix. This can be known as breaking the water. The head of your baby may press more directly against your cervix as a result of this amniotic fluid leak. It opens broader as a result of this. Stronger, more frequent contractions are another possibility.
• Balloon catheter: Your healthcare provider will implant and inflate a catheter into your cervix that has a balloon on the tip. The balloon expands and spreads your cervix. The catheter and balloon come withdrawn when the cervix has sufficiently expanded.
• Medications: An IV is administered containing a synthetic medication similar to oxytocin (Pitocin®) that imitates prostaglandins. Your cervix expands and contractions are triggered by this hormone-like substance.

Outcome

Augmentation of labor can facilitate vaginal delivery and save you from needing a C-section. The healthcare provider makes a surgical incision in your abdomen and uterus to deliver your baby during a C-section. It usually takes longer and hurts more to recover following a C-section.

Several factors affect your recovery. The following conditions could cause you additional problem and take longer to heal:

• C-section birth.
• Episiotomy.
• Vaginal tear.

Seek medical attention with your healthcare provider if you experience any of the following:

• Chest pain.
• Dizziness
• Fainting or syncope.
• Foul-smelling vaginal discharge.
• Heavy vaginal bleeding.
• Infection.
• Nausea and vomiting.
• Severe pain.
• Shortness of breath (dyspnea).
• Swelling (edema) in your legs, arms or face.