Sometimes your body goes into labour, but the process is longer than you might expect. If things slow down, you may be offered augmentation of labour to try and keep things moving. Like all intervention in pregnancy and birth, there are benefits and risks to augmentation, and the obstetric team and/or your midwife should discuss these with you thoroughly so you can make an informed decision about your birth.
There are two main ways to augment labour – by breaking your waters (called artificial rupture of membranes, or ARM) and IV synthetic oxytocin (sometimes referred to as ‘synto’ in Aotearoa).
ARM involves a midwife or doctor offering you a vaginal examination and then gently inserting a plastic hook (a little like a long crochet hook) alongside their fingers. They use this hook to grab the bag of waters and tear it open. Once the hook has opened your waters, they may use their fingers to open the bag a little more. This process should not hurt, although if you find vaginal examinations painful then there will be the pain of the examination. This process should not harm your baby, but they may experience a small scratch on their head from the plastic hook.
IV synthetic oxytocin is given through an IV line in your arm. For this, you will have to have an IV cannula placed. Once this is in place, a small amount of synthetic oxytocin is mixed into a bag of IV saline. This is started at a very low dose, and the dose is changed every 20min or so until your contractions are coming 3-4 times in 10 minutes and lasting a minute each time.