Ways to Augment Labor

In many cases labor progresses just fine on its own but sometimes there is a reason to augment, or enhance, labor. Augmentation of labor is different than induction of labor. Augmentation would happen after spontatneous labor is already underway.

There are a few reasons why a provider may want to augment labor. One main reason for augmentation, according to WHO, is to “treat delayed labor when poor uterine contractions are assessed to be the underlying cause”. A different scenario could be If the water has been broken for a long time, labor contractions are underway, and the baby and mother are showing signs of infection (usually fever). Typically the provider would want to augment labor to speed up the labor process. Augmentation can also be requested by the person in labor, often if the labor has already been very long.

The good news is that there are many different ways to try to augment labor. We will list several ways in this post ranging from more holistic to more conventional. Please discuss any of these options with your care provider before utilizing any of them.

Getting some nourishment

Sometimes labor stalls if the body needs more energy. The most recent research and evidence says that laboring people should eat and drink throughout labor. Boosting the energy level of the body can sometimes get labor moving along again. If at all possible, encourage a mix of eating carbs and protein. If the provider recommends clear liquids we recommend warm broth or a honey stick. Alternatively, an IV of Lactated Ringer’s solution can provide some fluids and electrolytes to the body.

Let the love flow

Oxytocin is often called “the love hormone”. This is the hormone that gets released into our bodies when we are feeling safe and loved. Oxytocin is also the hormone responsible for causing contractions. There are some easy ways to get the oxytocin flowing again. Ask everyone but the partner to leave the space of the birthing person. Have the partner give the laboring person a backrub or shoulder rub. Discuss any concerns or fears. Help the laboring person release any fears. Offer reassurances of safety. Ask the parents-to-be to descrtibe a favorite memory they have together. Turn off the lights, leave the room, and encourage them to cuddle and kiss.

Acupressure

Acupressure can be a helpful tool to enhance labor. Certain pressure points in the body can help trigger contractions when those pressure points are activated. Many of these trigger points are located in the hands and feet. A support person can grab some lotion and give the laboring person an indepth hand and foot rub.

Chiropractic adjustment

At times labor may stall for several hours as baby tries to move into the best position for descending into the pelvis. Occasionally chiropractic care may help by adjusting the person in labor so that their body is in better alignment, particularly in the hips. Some chiropracters will even come to the place of birth to adjust someone in labor. Someone who is trained in working with pregnant women is key.

Oils and herbal tinctures

Disclaimer: please consult an aromatherapist or herbalist for guidance in using this option.

There are certain herbal tinctures that can enhance labor by causing stronger uterine contractions. Typically these are given to the person in labor via mouth and drops of the tincure are placed on or under the tongue.

Certain essential oils are also thought to cause stronger uterine contractions. Usually these are potent and just the smell of the oil near the birthing person can have the intended effect.

Changing positions

We are fond of saying “change brings change”. Changing positions in labor every 30 minutes or so can help move labor forward. Particulary helpful positions are ones that utilize gravity and help baby better engage in the pelvis. One position that does both is laboring on the toilet. Emptying the bladder may also help contractions become more productive. If the person in labor has an epidural, utilize the peanut ball to encouragement movement within the bed. This can also be combined with moving the bed itself into different positions.

Nipple stimulation

Nipple stimulation can help release oxytocin (see above) into the body. This is one method of augmentation that is evidence-based. This stimulation can be done manually by the birthing person or by their partner. Focus on one breast at a time for the duration of about 5 minutes. Stop stimulation during any contractions that occur. After those 5 minutes take a break for several minutes before moving to the other breast. Stop nipple stimulation completely once contractions are coming regularly every few minutes. Another option to manual stimulation is to use a breast pump. Follow the same guidlelines as above for manual stimulation. Because this augmentation method can be very effective, your provider may want to do some fetal and uterine monitoring to make sure the uterus doesn’t become overstimulated and to make sure that the baby is coping well with the increased frequency of contractions.

AROM (Amniotic Rupture of Memranes)

Some providers will offer to do an amniotomy (break water) to see if that encourages labor to progress. Somtimes the release of the amniotic fluid will case a hormone dump that might cause more frequent and much stronger contractions. Another reason AROM may work is because the baby’s head can better engage on the cervix and encourage dilation.

Pitocin

Pitocin is a synthetic hormone that is very similar to the oxytocin produced by the body. PItocin can cause contractions that are more frequent and strong. The birthing person would be connecting to and IV drip that would continuously run fluids and Pitocin into the body. Continuous fetal monitoring is indicated with the use of Pitocin. Typically providers will start with the lowest dose and gradually increase the amount every 15-30 minutes to get contractions into a more frequent pattern. This may cause cervical change and to move the labor forward.

There are many augmenation methods that folks can use to enhance labor. Some of the above suggestions can be paired together but guidance from a care provider is hghly encouraged for any of the above methods. Even if labor is not moving forward, the person in labor can ask for more time to labor before doing any of the interventions listed in this post. The general rule of thumb is that it is OK to not change anything as long as the baby and the mother are doing well. If there is a reason to augment labor, however, definitely consider some of the methods in this post. Happy laboring!