Understanding Labor at 37 Weeks
A pregnancy is considered “early term” when it reaches 37 weeks, extending through 38 weeks and 6 days. This differs from “full term,” which begins at 39 weeks. At 37 weeks, most of a baby’s organ systems are developed, but the lungs may still be maturing.
Induction of labor can be medically indicated due to health concerns for the birthing parent or baby, or it can be elective, chosen without a direct medical necessity. Medical professionals generally do not recommend elective induction at 37 weeks due to potential risks, preferring to allow natural labor to begin when the body and baby are ready.
Common Natural Approaches to Induction
Many pregnant individuals explore natural methods to encourage labor. Walking or other forms of exercise are often suggested, with the idea that gravity and movement can help the baby descend and engage in the pelvis, potentially stimulating contractions. However, scientific evidence directly linking walking to labor induction is limited.
Sexual intercourse is another commonly discussed method, theorized to work through the prostaglandins present in semen, which can help soften the cervix. Nipple stimulation, either manual or with a breast pump, aims to release oxytocin, a hormone that stimulates uterine contractions. While oxytocin plays a role in labor, studies on nipple stimulation’s effectiveness in initiating labor are mixed, and some research indicates it may increase contractions without a sustained increase in circulating oxytocin.
Certain foods and herbs, such as dates, pineapple, spicy foods, evening primrose oil, and castor oil, are anecdotally believed to induce labor. Dates are thought to prepare the cervix, while pineapple contains bromelain, an enzyme that some believe can soften the cervix and trigger contractions. However, studies suggest that for pineapple, any effect on uterine contractions is primarily seen when extracts are applied directly to tissue, not when consumed. Spicy foods are thought to stimulate intestinal activity, which could indirectly lead to uterine contractions, but scientific support for this is lacking. Evening primrose oil contains gamma-linolenic acid, a precursor to prostaglandins, but clinical trials have not shown it to be effective for labor induction.
Castor oil, a strong laxative, is believed to stimulate uterine contractions through its effect on the intestines. While some studies suggest it may help induce labor, particularly in individuals who have given birth before, it can cause unpleasant side effects such as nausea, vomiting, diarrhea, and dehydration. Acupuncture and acupressure are also explored, with the theory of stimulating specific points to encourage labor. Limited observational studies suggest acupuncture may improve cervical readiness, but more evidence is needed to confirm its effectiveness in reducing the need for medical induction.
Medical Procedures for Labor Induction
Healthcare providers use medical procedures to induce labor when necessary. One common approach is cervical ripening, which prepares the cervix for labor by softening and effacing it. This can involve medications like prostaglandins, such as dinoprostone or misoprostol, administered vaginally or orally. Mechanical methods, such as a Foley catheter or balloon catheter, can also be used to physically dilate the cervix and encourage the release of natural prostaglandins.
Another procedure is amniotomy, or the artificial rupture of membranes, often referred to as “breaking the water.” This involves using a specialized tool to puncture the amniotic sac, releasing fluid and potentially stimulating contractions. Amniotomy can also allow for internal monitoring of the baby’s heart rate.
Synthetic oxytocin, commonly known as Pitocin, is administered intravenously to stimulate uterine contractions. This medication mimics the natural hormone oxytocin, causing the uterus to contract and progress labor. These medical induction methods are performed under close supervision, with continuous monitoring of both the birthing parent and the baby.
Essential Safety Considerations
Labor induction, especially when not medically indicated or performed without professional oversight, carries potential risks. One concern is uterine hyperstimulation, where contractions become too frequent or too strong, potentially reducing oxygen supply to the baby and causing fetal heart rate abnormalities. This condition can result from medications used in induction, particularly oxytocin.
Induction may increase the risk of a Cesarean section if the induction fails or complications arise. Other risks include infection for both the birthing parent and baby, especially after amniotomy. Umbilical cord prolapse, though rare, is a serious risk that can occur if the cord slips through the cervix after the membranes rupture. Uterine rupture, a rare but severe complication, involves a tear in the uterine wall, which is more likely in individuals with a previous Cesarean section or uterine surgery, particularly with prostaglandin use.
It is crucial to consult with a doctor, midwife, or other qualified healthcare provider before considering any form of labor induction, whether natural or medical. Certain conditions, such as placenta previa, active genital herpes, or specific prior uterine surgeries, can make induction unsafe. Trusting medical advice and allowing labor to begin naturally is generally recommended unless there is a clear medical reason for intervention.