Intermountain Health used labor and delivery data to improve the outcomes and experience for pregnant moms and their newborn babies
At the end of their pregnancy, many moms might wonder if, when, and how, it is safe or necessary to induce labor or take steps to help labor start if it’s not starting on its own.
Labor lives up to its name. By its very nature, labor is typically painful, difficult, and a long process, especially for first-time moms. The length of a mom’s labor can really vary and so can her length of stay in the hospital.
“First time moms can spend about 24-36 hours in the hospital just for labor and delivery. Moms who’ve had a baby before often spend 11-12 hours in the hospital for labor and delivery,” said Sean Esplin, MD, an OB-GYN, a maternal fetal medicine specialist, and the senior medical director for women’s health at Intermountain Health.
During those last couple of weeks of pregnancy, moms can be quite uncomfortable as their baby gets bigger, and it can be difficult not knowing when their baby will be born, so that leads to a lot of questions about inducing labor.
“In an effort to help enhance patient experience for moms during labor and delivery and improve the outcomes for pregnant moms and their newborn babies, we’ve been looking at the data in medical studies about labor induction and the experience of our patients,” said Dr. Esplin.
“It turns out somewhere between 30-40 percent of our pregnant patients have a labor induction – either because they have a medical complication and it would help reduce risk to mom or baby – or because women are choosing that option late in pregnancy,” he added.
According to OB-GYN providers, for labor to start naturally, the cervix or the narrow opening of uterus needs to begin opening wider or dilate and it also becomes soft. Your body starts this process by naturally releasing hormones in your body, ripening the cervix for delivery.
According to Dr. Esplin, the best approach for inducing labor is one that mimics the natural process that happens in our bodies.
For labor to start naturally, the cervix or the narrow opening of uterus needs to begin opening wider or dilate, and it also becomes soft. Your body starts this process by naturally releasing hormones in your body, ripening the cervix for delivery.
“We can induce labor by softening the cervix to make it ready to dilate either through mechanical dilation or by using medication or both,” said Dr. Esplin.
Mechanical dilation is done by placing a small dilating balloon in the cervix which puts pressure on the cervix to dilate it. Medication can also be placed into the vagina near the cervix to help it dilate.
The national data shows the best time for a labor induction is around 39 weeks unless there’s a serious medical reason to induce labor earlier. And if a mom’s pregnancy is low-risk, they can opt for the mechanical dilation procedure and then spend the labor preparation time at home before coming to the hospital for delivery.
“We’re learning how we can make labor shorter and more effective and increase the odds for regular, vaginal delivery. And as OB providers, we help explain the benefits and risks of inducing labor so moms can make an informed decision, about whether to be induced,” he added.
According to Dr. Esplin, most moms will spend an evening and overnight at home and return to the hospital after about 12 hours. This means moms spend less time in the hospital and more time in the comfort of their own home.
Some women can sleep through this cervical ripening phase. Some won’t sleep as well as they’d like. Changing positions, taking some acetaminophen and using a heating pad can help.
“This can cut 8-12 hours off of their labor time in the hospital. It also reduces the rate of Cesarean births, lowers the risk of preeclampsia, and perhaps lowers the chance of your baby being admitted to a newborn intensive care unit,” said Dr. Esplin.
The responses from low-risk patients who have opted to have their labor induced mechanically or through medication have been very positive. Comments include…
“If given the option, most women would opt for a shorter and more effective labor. That’s why it can be a win-win for everybody: moms, partners, labor and delivery nurses, and their midwives and OB-GYNs,” he added.
This is just one of the ways Intermountain is looking for ways to partner with patients to find better ways to care for them and to help lower costs.
For more information visit the pregnancy and baby page at intermountainhealth.org
About Intermountain Health
Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, approximately 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a nonprofit health plan called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For up-to-date information and announcements, please see the Intermountain Health newsroom at https://news.intermountainhealth.org/. For more information, see intermountainhealth.org/ or call 801-442-2000.
Qiana Redner
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