Induction

(Using medication or procedures to start labour)

• Sweeping membranes (provider separates amniotic sac from uterus)
• Mechanical dilator (device inserted in cervix and expanded)
• Cervical ripening agents (medication applied on or near cervix)
• Pitocin (medicine added to IV)

• Too far past due date
• Water breaks without contractions
• Pregnancy has put you or baby at risk

• Increased chance of cesarean birth
• Increased labour discomfort
• Infection (with mechanical dilator and sweeping membranes)

Fetal distress

Augmentation

(Using medication or procedures to speed up labour)

• Pitocin (medicine added to IV)
• Amniotomy (breaking the bag of waters)

• Labour slows down
• Need for stronger, more frequent contractions

• Doesn’t always shorten labour
• Infection (with amniotomy)

Fetal distress

Analgesic

(Narcotic pain medication)

• Nurse injects medication to into your thigh or hip

• Can be given shortly after requested
• Provides fast relief
• Doesn’t numb muscles

• Drowsiness, nausea, and itching
• May slow breathing
• May lower blood pressure

• Slow breathing
• Sleepy and less alert at birth

(Avoid 1-3 hours before birth to reduce those effects)

Epidural

(Regional anesthesia that numbs pain in the lower body)

• Anesthesiologist places a catheter in your lower back that carries medication to you

• Safe, effective pain relief
• Chance to rest
• Does not affect mental state

• Shivering, fever, itching, nausea
• Lowered blood pressure
• Incomplete pain relief
• Other rare risks are listed on consent form

• No significant risks to the baby are known
• Higher doses and longer administration could impact breastfeeding

Second Stage Interventions

(Procedures that help baby through birth canal)

• Episiotomy (an incision in the perineum)
• Vacuum extractor (a suction cup and pump that helps guide the baby out)
• Forceps (an instrument shaped like tongs to help guide the baby out)

• Too tired to push
• Epidural causes ineffective pushing
• Baby needs to be born quickly

• Doesn’t offer substantial benefit (episiotomy)
• Increased pain and infection after birth (episiotomy)
• Tearing of the perineum (forceps and vacuum extractor)

• Temporary marks/ bruising on the baby’s face or head (vacuum/ forceps)
• Temporary nerve problems in baby’s face (forceps)