In some of our other blog articles, we have already shared information about cervical ripening (CR)—such as what exactly it is or why it is so important—and we have even explained what to expect during labour and how you can prepare for the hospital.
However, some mums may have the option of experiencing cervical ripening in the comfort of their own home. That is referred to as outpatient or at home-based cervical ripening and it has been found to improve mothers’ satisfaction as well as to reduce the time needed to stay at the hospital.
Safety concerns?
Outpatient cervical ripening—as opposed to inpatient, which takes place in the hospital—may be a new concept for some women. It is completely natural to find yourself wondering whether it is safe.
Healthcare is always seeking ways to improve. Researchers around the world investigate ways to advance, to be more efficient, all while maintaining the highest safety and aiming to keep the patients happy with their overall experiences.
Outpatient cervical ripening represents one of these opportunities. Multiple studies have evaluated the safety and benefits of outpatient induction of labour. According to the results, the process is highly valuable for both moms and their babies. Therefore, it has been to be a suitable option for many induced women.
As more studies are still being published, outpatient induction has been gaining momentum worldwide.
Who may experience outpatient cervical ripening?
As recently released NICE clinical guideline says, clinicians may consider outpatient induction in women who wish to return home, and who have no co-existing medical conditions or obstetric complications.
Some women may not have the option of outpatient cervical ripening due to potential risks for themselves or the baby. Some of the reasons for this could be:
- previous caesarean delivery,
- history of uterine surgery,
- the baby being in any other position than with its head down,
- abnormal placenta location,
- too large or too small baby/fetus
- vaginal bleeding,
- suspicion of infection.
None of these apply to you and you feel like you may be suitable for this approach? Firstly, it is important to discuss this matter with your practitioner and ask if your delivery hospital offers outpatient .
If you are not sure how to ask, you can always check our guide.
And what´s next?
If your practitioner decided that outpatient ripening is an option for you, you might find yourself struggling to understand what is about to happen next. Mechanical cervical ripening, such as one with DILAPAN-S, is a suitable and recommended option for outpatient ripening due to its and gentle mode of action.
During your appointment with your OB or at hospital, your practitioner will insert DILAPAN-S dilators and after brief monitoring, they will send you home for the next 12-24 hours with time for return specified.
You will also be instructed to return before your scheduled time if you experience one of the following symptoms:
- water breaking,
- excessive bleeding (although some spotting is normal and to be expected),
- significant pain,
- active contractions,
- concerns about decreased fetal movement.
If everything is going well, you can enjoy some of your favourite activities. So go for a stroll, enjoy your favourite movie, hop in the shower, or take a nap. One of our providers even shared, that when she once visited a local restaurant in her leisure time, she saw her own patient, to whom she had inserted Dilapan-S dilators earlier that day. The patient seemed perfectly fine, enjoying a meal with her family, as the dilators were gently doing their job and preparing her cervix for labour.
Return to hospital
After some rest and relaxation at home, you will go to the hospital. Once you arrive, your practitioner will monitor you and the baby and eventually remove the dilators. They will then examine your cervix to update your Bishop score.
After this initial evaluation, you and your practitioner can determine the best next step for your induction, which may include having , breaking your water or starting you on oxytocin. Either way, you are getting closer and closer to meeting your baby face to face.
Woman sharing personal experiences
As discussed before, there has been extensive research about the options of outpatient ripening. It has confirmed that many women prefer this choice and were overall very pleased with their DILAPAN-S experience. If you would like to read more opinions and reviews, explore the expectant mothers page on our website.
Mums reported they were able to walk, eat, and shower more comfortably during the process and also agreed that this was a great idea and a beneficial experience. In addition to them being more satisfied with , the research has also shown that women, who had had an outpatient induction, required less pain killers compared to those who remained in the hospital for the entire process.
Conclusion
If you require cervical ripening, make sure you have a thorough discussion with your practitioner, so that you understand your options. Don’t be afraid to ask questions, your practitioner is there for you. And as long as you are low risk and your hospital offers this option, you too can leave the hospital and enjoy moments before your baby arrives in comfort and privacy of your home.
