We have already covered cesarean birth, and today is time to talk about induced birth in Helsinki and Espoo hospitals. Many birthing people and partners face a potential induction with fear and anxiety, so let’s try to put all my doula knowledge to work on release those feelings and ease your journey. Let’s go!
Why would they induce you in Finland?
I work mostly in the Helsinki metropolitan area as birth doula, but this part of the post is generally shared along Finland. Coming from Spain, and of course, comparing both countries, I must say Finland is in general a country where inductions are not done “just because”.
However, it is true that recently I’ve been with some families that got induction dates just because due date was approaching. The general rule until really recently was to offer families an induction at week 41+5. But, as mentioned, these times are getting a bit more stretched, with inductions happening at 41+2 or 41+3.
If this is your case and you are reading this post, ask yourself: is there a medical reason to induce my birth?
If the answer is no, or you did not get clear information about it from your medical team, then ask them again or call to reschedule your induction. They will accept your wishes here in Finland without any problems.
And, of course, apart from that, we have some other reasons for induced birth in Finland. The most common ones will be preeclampsia or suspicion of it, and an uncontrolled gestational diabetes at the end of the pregnancy.
The process to get to an induced birth in Helsinki
Before the birth day even arrives your neuvola sends a referral for a consultation in the hospital. It happens around week 41. You can also have a 41 week visit in neuvola, and then get the referral to hospital in that one.
This visit is simple: ultrasound, monitors to control heart beat and if some contractions are happening already or even blood tests can be taken during that appointment.
Also usually, and against science-based information we have, a cervical exam is offered on that appointment: remember you can politely say no.
I always instruct my clients to use this appointment to ask all their questions about the induction process and proposal.
After that first appointment in the hospital, you can go home. Hospital will propose a new date to, either come back for a new check up, or come back for an induction.
Then, when do inductions usually happen in Finland?
If no medical reason to induce earlier, inductions happen in Helsinki birth units, Espoo birth units (and in Finland, in general) around week 42. Most commonly you get an invitation to hospital on 41+3 to 41+5. And of course, you can always ask for more days and more time.
The Induced Birth Protocol in Helsinki
Let’s imagine you are now on day birth, what is going to happen if you have a birth induction in Helsinki or Espoo hospitals?
First thing to know, similar to what happened in the cases of cesarean births, you get an appointment with an approximate hour. It doesn’t mean that you will get your induction started at that time, so prepare to be waiting.
Depending on how busy the birth unit is, you can get a room for your first tests and controls, or even get those done in the waiting room. Last client I had a week ago for an induced birth got the blood tests done in front of everyone in the waiting room. It can feel odd, but no worries – we have tools to keep you in your relaxed birth bubble. For example, that’s a great time to listen to your music or meditations.
The healthcare team needs to evaluate the status of cervix with a cervical exam. They will then establish a Bishop score – but no worries, you don’t need to learn a lot about it. The most important thing to keep in mind is that the higher the score, the better the chances the induction will progress and be successful.
What happens after cervix exam in an induced birth?
The main thing to keep in mind is that, depending on how the cervix is, the induction will start one way or another:
- For less favourable cervix, they will start with hormonal pills. The dosage is given every 2 hours, and usually you stay in the hospital until contractions starts. After around 12 hours of doses given, if nothing happened, they will move to the next step.
- If cervix is a bit dilated, they can install a “balloon”. The balloon is similar to what the famous Hamilton procedure does. It’s, essentially, a mechanical opening of the membranes. But, it’s done in a very slow way. If your induction starts with this, there are big chances that you are sent home for the next 12 hours.
- If you arrive to hospital with cervix already opened and active labor contractions two options are possible. First one is being sent home if the contractions are still not strong enough to stay in hospital or if dilation is still smaller than 4cm. This will be the best if you are hoping to have a vaginal birth (less risk of interventions will come if the process keeps progressing by itself). But sometimes due to medical reasons you can also be invited to stay in the hospital. In this case, being able to create your own birth room and bubble is specially important. Many times I go to check on my clients and we prepare the birth room with lights, affirmations, aromatherapy, music… and after a few hours I leave home until the birth is in a real active phase.
In most of the induced births I’ve attended in Finland, birth augmentation has been commonly offered. The medical team do it with synthetic oxytocin and it’s one of the most problematic interventions, as it produces extremely strong and frequent contractions.
If you have a doula with you, it’s most probably that you will avoid this intervention and gain time doing other alternatives, like natural oxytocin, movement for better progressing of baby in pelvis,
When does the doula come to an induced birth in Helsinki?
Well that of course depends on you, the birthing person!
I usually recommend clients with good health (both physical and mental) to go with their birth partner to the first part of the process. I will join them in the hospital when the “action” starts to kick in.
Despite that, we are in constant contact and I help them navigate decisions if needed. But most usually, my clients have learn with my prenatal sessions on how to request information from the healthcare providers (with BRAIN approach), and we have discussed in details the options and interventions commonly offered in induced birth in Finland.
So, in general, you will need your doula the most when active birth phase starts. I work as a doula in Helsinki and in Espoo, and I’m usually just half an hour away from main hospitals (or your home, if you are considering a home birth).
But, for real… how does an induction take?
That’s the holy grail question. I know you want an answer but… I can’t give you an accurate one.
I’ve supported families which induction started end of the day, the night was quiet… and when active phase started, birth was over in less than 3 hours. And, on the other hand, I’ve supported families which induction started and went over 2 to 3 days.
Sometimes you will read or hear that inductions are extremely hard, painful… I don’t like to send a negative message around them, but the truth is that in general is a process that takes time. And that is the main thing you need to be mentally ready for.
Can I reject an induction?
Of course!
You, as the pregnant person, have the right to:
- Ask your medical team all the questions, remember your BRAIN (benefits-risks-alternatives-intuition-not doing)
- Get a change of medical team if you are not happy with the ones that are assigned to you, or the information they are providing.
- Reject an induction, if there is no medical reason behind it.
Can I still move around, eat, or use the shower or birth pool if I’m being induced?
Of course, and even more: it will be encouraged.
All births take some time. Your body and your baby need that process.
Think of an induced birth as a regular birth BUT with some helpers that kickstart the process (or help it keep going and progressing well).
But it’s true that I’ve observed somethings are a bit different when induced birth happens in Helsinki or Espoo hospitals. The medical team would probably insist a bit more on putting an IV on the birthing person. Why? Well, because there is slightly more options that you will need an oxytocin drip, or, if water breaks for a long time, the medical team can consider you need some antibiotics.
Will the medical team offer epidural at induced births in Helsinki?
I will maybe reword this question into “can I request an epidural?” but the answer is the same: yes, you can. And in general, we observe more epidural use at induced births when:
- cervix is not prone to induced birth, and therefore the actions to get it ready start too soon, advance too fast and intensity escalates
- the body doesn’t get time enough. Remember that even if you are getting an induction you need your time.
- there is no birth intentions and birth plan created, nor discussed with the medical team
- and, there is no doula in the picture (sorry, but we even have studies about this! We help you cope during inductions
What if my induced birth doesn’t work?
The medical team will follow up on the birth progress, keeping mum and baby safe at all times. When an induction doesn’t work, we usually see a two-case-scenario:
- Birth does not start, no matter which actions are taken.
- after birth starts, the progress stops at some point despite any action taken
In these cases, and of course, if there’s any issues with mother or baby well being, a cesarean birth will be discussed and proposed.
I hope this very long reading has helped you to navigate your options when having a birth induction in Helsinki, Espoo and of course in Finland in general.
Do you need more information? Contact me