Using a crochet hook looking item called an amnihook, your practitioner will make a tiny tear in the bag of water. This will cause the water to begin leaking out. Since the bag does not have nerves, this should be no more painful than your average vaginal exam. The thought is that once the bag is ruptured contractions will usually begin.
Benefits: No chemicals may be needed, you maintain more mobility than if you were required to have an IV.
Disadvantages: Contractions may not start and then this leads you to other interventions such as the use of Pitocin, it may create an infection of the sac, the cushion for the baby is now removed, and even rarely, but possibly the prolapse of a cord, necessitating an immediate cesarean. It also requires that you have a baby, sometimes within a certain amount of time, depending upon the circumstances and your practitioners beliefs.
This is an artificial version of the body's hormone oxytocin. It is given by way of an IV lineand is used to cause contractions. The amount of Pitocin used will depend on how your body accepts it. Generally, the amount is increased every 15-30 minutes until a good contraction pattern is achieved. Sometimes this is done in combination with breaking the bag of water.
Benefits: A bit easier to control than say breaking the water, because the drug can be stopped by closing off the IV line. This does not commit you to having the baby. It can be turned off or stopped to allow mom to rest or even go home.
Disadvantages: Can cause fetal distress. May not cause contractions. May cause too many contractions or contractions that last too long. Because of the potential risks, the FDA came out and declared that this drug was not to be used for inductions for convenience or scheduling reasons.
These are used more frequently when the cervix is not favorable, meaning that it is dilated less than 3 centimeters, hard, posterior, not effaced, or barely effaced, or any combination of the above. By using Bishop's Score your practitioner will decide if this is the best place to start. This can be used alone, or more frequently will be done 12 or more hours prior to the use of Pitocin. Frequently it will be given more than once over the course of an evening/night. A suppository or tampon like substance will be placed in or near your cervix during a vaginal exam.
Benefits: The more favorable your cervix, the less likely the induction is to "fail." Sometimes this is all that is needed, other times Pitocin is also used. Can be done as an out patient procedure. Does not commit you to having the baby.
Disadvantages:Takes longer to get into active labor, can be nerve bending if your institution's policy is that you have to stay at the hospital during the waiting period. Sometimes mom becomes nauseated or has headaches. This cannot be quite as controlled as Pitocin, but tends to be milder. Some forms of the prostaglandins now have strings attached making them removable if dangerous contractions occur.
This is a pill that can either be ingested orally or placed near the cervix. It is used more often when the cervix is not very favorable.
Benefits: No tethering of the IV line. Can be used alone. The more favorable your cervix, the less likely the induction is to "fail." Not as messy as the suppositories potentially can be. Does not commit you to having the baby.
Disadvantages: May require the use of Pitocin or other means in addition. Can cause a very rapid labor. Recent thought is that this is not a valid option for mothers who are attempting VBAC, discuss this with your practitioner.