Augmentation of Labor

Augmentation of labor is a way to speed up labor when it’s slow or stalled. Healthcare providers use medications and other methods to help move the process along. “Augmenting” means “adding.”

These treatments trigger uterine contractions, making them stronger and closer together. You may need labor augmentation if:

• The amniotic sac has ruptured, but labor hasn’t started.
• You have weak or irregular contractions.
• Your contractions have stopped.

A prolonged labor and delivery can lead to complications for you and the fetus. That’s why your care team may suggest methods to get the birthing process back on track. Also, labor augmentation can aid vaginal childbirth, helping you avoid a C-section.

Your care team will help you understand what’s happening and why they recommend these aids. Don’t hesitate to ask questions. Together, you’ll decide the next steps.

What happens during labor augmentation?

Healthcare providers use similar methods to augment labor as they do to induce (start) labor. The methods help open, soften and thin your cervix.

Labor augmentation options include:

• Amniotomy: Your provider ruptures the sac of amniotic fluid that surrounds the fetus (breaks the water), which can allow the fetus to put more direct pressure on your cervix. This causes your cervix to open wider. You may also have more frequent and stronger contractions.
• Medications: A medication called misoprostol may soften your cervix. It’s a small pill that a provider places in your vaginal canal. Another medication is a manufactured form of oxytocin (a hormone). You receive it through an IV line. It helps open your cervix and strengthen contractions.
• Balloon catheter (Foley bulb): Your provider inserts a catheter with a tiny balloon into your cervix. They inflate the balloon, which widens your cervix over time. After your cervix expands enough, the balloon and catheter fall out. A balloon catheter can stay in your cervix anywhere from two to 12 hours. When it comes out, most people are 4 centimeters dilated.

How fast will it work?

Labor augmentation works at a different pace for each person. Some people respond very quickly to it. For others, it takes a bit longer.

Your care team will check on your health and the fetus’s well-being. Let them know how you’re feeling. They’ll keep you updated on the progress and if they have any concerns.

What are the risks?

In general, labor augmentation techniques are safe, and the benefits outweigh the risks. In rare cases, labor augmentation can lead to certain complications, including:

• Uterine tachysystole: IV oxytocin can lead to strong, excessive contractions that may trigger fetal distress. It also increases your risk of uterine rupture, especially if you’ve had a C-section in the past.
• Chorioamnionitis: An amniotomy and/or a balloon catheter may lead to this bacterial infection.

Your care team will closely monitor your health and fetal health during labor augmentation. They’ll act quickly to treat any complications that arise.

There are some reasons why your care team won’t augment labor. It’s not safe to use these methods if:

• The fetus is in a complex position that isn’t headfirst, like breech or transverse.
• You have Asherman’s syndrome (intrauterine scar tissue).

What is the difference between augmentation of labor and induction?

Labor induction starts the labor process. A healthcare provider uses artificial means to open your cervix and start contractions.

Providers use augmentation of labor only when your labor stalls after it has already started.