“I asked to be triggered, I couldn’t take it anymore! “On May 1, it was pregnant “up to the eyes” that Laure went to the maternity ward to ask for an artificial triggering of her delivery. Request to which the medical team has granted. Can all mothers benefit from this protocol? What are the indications for the onset of childbirth? How is it going? 20 minutes explains everything to you.
For medical reasons or convenience
“The artificial induction of labor consists of causing contractions of the uterus to start labor, that is to say the process which leads to childbirth”, indicates the High Authority of Health (HAS). But pressing Mother Nature is not possible in all cases. “In the first place, there is the question of the indication: is there a particular pathology in the mother or the unborn child which requires an artificial induction of labour? “, explains Dr. Philippe David, obstetrician-gynecologist.
The triggering can thus “be programmed from 37 weeks of amenorrhea for medical indications: in the event of twin pregnancy, arterial hypertension and risk of preeclampsia, unbalanced gestational diabetes or even intrauterine growth retardation ” , explains Dr. Aude Du Passage, obstetrician-gynecologist at Saint-Cloud hospital (Hauts-de-Seine).
A triggering of convenience is also possible “from 39 weeks, two weeks before the term, but never before, adds the gynecologist. It can thus be considered when the mother has several children and wants to schedule her delivery to facilitate her organization or when the pregnancy has reached its term, i.e. 41 weeks. Some maternities will systematically induce labor on the day of the term, while others can wait up to 5 days, of course monitoring their condition and that of the unborn child. This is the case with Laure: “My due date was May 1st. When I got up in the morning and still felt no sign of impending delivery, I went to the maternity ward to check that everything was fine and ask to be delivered, jokes the 39-year-old young woman. And from a logistical point of view, it was also more practical to have my son looked after by my mother, who was not working on this public holiday”.
Triggering “as close as possible to physiology”
But to comply with this request, “the conditions must be met allowing a triggering as close as possible to physiology, underlines Dr. David. In this case, the triggering is like the little “starter shot” that launches the operations, and initiates work in line with what it would have been even without the triggering, neither more nor less painful”. In practice, “we examine the patient, we see if her cervix is favourable, sufficiently mature, in which case we can administer oxytocin directly intravenously and break her water bag, which will trigger the work, and give him an epidural,” explains Dr. Du Passage.
On the other hand, if the cervix is still closed, “it must first be prepared by applying a prostaglandin-based gel vaginally, which is a little longer, she specifies. Then we place the oxytocin infusion to harmonize the work, and the epidural. And in any case, we first place the baby under monitoring to make sure that everything is fine, otherwise, it is the cesarean which is preferred”. The practice of induction leads, “from the start of labor, the need for continuous fetal monitoring, and generally high intensity contractions which can be more painful than the start of spontaneous labor”, abounds the HAS.
After getting the green light for her induction, Laure quickly received her oxytocin infusion and her epidural. “I had the first contractions after half an hour and my cervix dilated quickly, and I hardly had any pain during the delivery, which was faster and easier than for my first pregnancy”, says the mother of little Ella, born about four hours after the onset of the onset.
And she’s not the only one. If between 2010 and 2016, approximately 22% of deliveries were induced, between 2016 and 2021, the frequency of labor induction increased, rising to 25.8%, reports Public Health France in the framework of the last national perinatal survey published in 2021.