Sometimes an induction is necessary, and other times clients may choose it. It’s important to provide information about inductions in your prenatal appointments, even if your client is strongly against having one, because there are circumstances that can present and require this kind of intervention. It is wise to make sure your client is prepared ahead of time for what to expect.
Traditionally, if one of our clients was going in for an induction, we would join them at the hospital and stay with them to get them settled and ease any concerns. Then we would go home and check in with them the next day, possibly go to see them, and then join them again once active labor began. Since covid, this has changed. Many hospitals now require doulas to remain with their clients and if we leave, we are then considered a visitor and not allowed back in until regular visiting hours. This can be difficult during a long labor, but it especially presents a challenge in the case of induction.
During the prenatal meeting, this information should be reiterated to the client. (It is clearly explained in our birth doula contract template, which is available for purchase here. Remind them that in the case of an induction, you will provide phone/text support as needed from the beginning of the induction until active labor begins. Active labor is now considered to be around the point of six cm dilation. Some clients may request your support earlier in labor but this is pretty standard. Then you proceed with support as usual.
What to Expect
Induction of labor can be long! Days even. While other times your client’s body is ready for labor and the induction goes quickly. You just never know, just like spontaneous labor. If you are at home, waiting for labor to kickstart, it is essential to maintain communication with your client and/or their partner. The hardest part of not being there is having your mind think of all the “what ifs.” Let your client know that you would like to continue to communicate throughout the early parts of the induction every few hours, even if it’s just to share some positive birth affirmations.
Be ready at a moments notice for any unexpected circumstances to arise that would necessitate you to hightail it to the hospital. While we never wish anything bad will happen, there are times a smooth going induction turns emergent.
Reasons for Induction
As doulas, we are familiar with many of the medical indications for induction and how the Bishop’s score should be used as a guideline for induction. By explaining the Bishop’s score guidelines in prenatal meetings with our clients, we can help give them vital information that can make the difference in their birth experience. For a review on the details of the Bishop’s score check out this article.
Whether your client chooses or needs an induction, having given them the pros and cons ahead of time will help them feel more in control and less afraid – which are some of the most important things we can do as doulas. As doulas, we can help open a conversation between the client and their care provider about the reason an induction is necessary, options on which induction method to choose, and how to preserve what the client can still achieve with her birth plan. This makes for a more empowering birth experience for your client.