Labor induction, also known as inducing labor, is the jumpstarting of uterine contractions before natural labor occurs, with the goal of a healthy vaginal delivery.
Healthcare providers, doctors, and midwives might suggest inducing labor for a number of reasons — both medical and nonmedical (elected).
Here’s what you need to know in order to prepare for labor induction.
A healthcare provider, doctor, or midwife will evaluate your health and the health of your baby at all prenatal appointments. This includes examining your baby’s gestational age, size, weight and position in your uterus.
At later appointments, this may include checking your cervix and considering the overall picture to determine whether or not you or baby are at risk and labor induction is needed.
A labor induction may be suggested if there’s cause for concern regarding the health of you or your baby. Or perhaps you live a far distance from your hospital, and it would be prudent to control the timing of your labor and delivery.
Other reasons include:
- Predicted due date has come and gone.
- Gestational diabetes.
- Chorioamnionitis (an infection in the uterus).
- Baby is growing too slowly.
- Oligohydramnios (low or leaking amniotic fluid).
- Placental obstruction or abruption.
- Broken water, but no contractions.
- History of speedy, short deliveries.
Women with certain medical conditions should not be recommended for induction, so it’s important to ask questions (see below) and discuss all of the options, benefits, and potential risks of a labor inducing procedure with your healthcare provider.
There are many methods of labor induction, and what works for one woman or one delivery, may not work for another.
In addition to natural inducing methods (both proven and unproven), such as sexual intercourse, castor oil, hot baths, breast and nipple stimulation, acupuncture, herbal supplements, and eggplant casseroles, there are many medical/surgical techniques too.
A doctor or midwife can use medicines and other means to assist in opening the cervix and stimulate contractions. Some methods include:
- Amniotomy, or “breaking the water,” where your healthcare provider pokes a small hole in your amniotic sac. This will also make your uterine contractions stronger.
- Pitocin, also called oxytocin, which is a hormone that speeds up labor. Pitocin is delivered through an IV in your arm.
- Cervical ripening, performed by taking medicine orally or by inserting a medicine (prostaglandin analogs) into the vagina to stretch, soften, and expand the cervix.
- Insertion of catheter or balloon by your healthcare provider, which then expands, such as a Foley bulb induction.
- Stripping membranes, where your healthcare provider uses a gloved finger to separate the thin tissue of amniotic sac from the uterine wall.
From time to time, a doctor will use more than one method to induce labor and delivery.
Every labor progresses at its own pace. If your cervix is soft and ripe, a gentle push may be all you need to jumpstart those contractions. If your cervix needs more time, it may take days before delivery occurs.
An induced labor can last anywhere from a few hours to a few days. Sometimes, labor induction doesn’t work at all, or the method used has to be repeated. It all depends on how ripe the cervix is at time of induction and how well your body responds to the method chosen for induction.
Contractions can start within 30 minutes of taking oxytocin, and most women will begin labor within hours after their water breaks.
All healthcare providers should allow you 24 hours or more of the early phase of labor before considering the induction a bust and moving forward with other interventions.
If you and your baby are healthy and doing well after a failed induction, you might be sent home and asked to reschedule the induction for a later date. (Yes, that can actually happen.)
As with everything in life, labor induction comes with some risks.
- You may experience stronger, more painful and
- You may have increased risk of postpartum depression, according to one
- You may have a failed induction and need a cesarean delivery (this comes with its own list of concerns, including a longer recovery time).
A first-time mother whose cervix is not ready for labor has an increased chance of the induction leading to a cesarean delivery, according to the American College of Obstetricians and Gynecologists. This is why asking questions (see below) — especially about the condition of your cervix — is so important.
Throughout the induction process, your healthcare provider, doctor, or midwife will monitor you and your baby to determine whether or not an assisted vaginal delivery or cesarean delivery is necessary.
Other potential risks of induction include:
- Infection. Certain methods of induction, such as rupturing membranes, pose an increased risk for infection in both mom and baby.
- Uterine rupture. This is especially true for women who have had a previous cesarean delivery or another uterine surgery.
- Complications with fetal heart rate. Too many contractions can lead to changes in the baby’s heart rate.
- Fetal death.
It’s important to discuss the potential risks for you and your baby during induction in detail with a healthcare provider, doctor, or midwife before agreeing to any procedure.
Before you agree to be induced, consider finding out the following from your healthcare provider:
- What’s the reason for the induction?
- What are the signs that make you a good candidate for induction?
- What types of induction is your healthcare provider considering?
- What’s your due date? (Confirm that the induction date is indeed set for after the 39th week of pregnancy.)
- What’s the condition of your cervix?
- What is the baby’s position?
- How many times has your doctor or midwife performed this procedure?
- Will you be able to move around?
- What are the risks and benefits of each induction procedure being considered?
- Will it require constant or occasional monitoring?
- Will it hurt? What are your options for pain relief?
- What is the doctor or midwife’s plan if the chosen method for induction fails?
- At what point might you be sent home, with another induction rescheduled?
- Will your doctor or midwife be available during the entire procedure?
- If the procedure takes a very long time, will you be able to use the restroom?
- Do you have a prior medical condition or consideration that will affect this induction?
You’ll also want to know where the labor induction will take place, typically a hospital or birthing center. However, a home delivery with natural induction methods may sometimes be an option.
Set realistic expectations
Maybe an induction isn’t what you had in mind. Well… try to keep an open mind! Induced labor is very different than a naturally occurring labor, but that doesn’t mean you have to throw your entire birth plan out the window.
Take a moment to consider how you think and feel about your labor and delivery plan. The mental and emotional aspects of labor and delivery are complicated enough, and getting induced has its own benefits and risks.
This may be happening, but it’s not always fast.Don’t let the waiting time get to you. Load an electronic device with movies, on-demand shows, and books and add them to your hospital bag.
Pack a journal and plan on taking a few minutes to jot down your in-the-moment labor and delivery thoughts. Make a playlist of music for when you need calming and for the You Can Do This Oomph and Push.
Don’t forget to pack chargers for all electronic devices, a pair of headphones, and comfortable, loose clothing.
Eat something light and then try to go poo
Most practitioners say no food once contractions begin. Don’t stop at your favorite fast food place on the way to the hospital. You don’t want the runs during this business.
Before heading to the hospital, eat a light meal at home… and then give the ol’ porcelain bowl a good visit. You’ll feel much better.
Give your partner permission to scoot
If the induction lasts longer than 12 to 24 hours, consider allowing your partner some fresh air. A bored induction partner can turn into an annoying labor and delivery companion, so allow your partner to pack their own hospital bag.
Tell them to pack some snacks (nothing smelly!) and a good pillow. Once at the hospital, communicate your feelings as best as possible, and then tell them to go find you some ice cream for after.
Accept that it may take longer than you’d like, and may be more challenging than you imagine. It will be okay! Talk with friends and family members who have had induced labors and at some point, and try to stop googling. It’s normal to feel excited and nervous.
Just remember: You have options and choices.