Induced Labor

What is labor induction?

Labor induction (inducing labor) is when a pregnancy care provider starts labor instead of letting labor start on its own. Providers induce labor to speed up the process of childbirth in situations where your health or the fetus’s health is at risk, or when you’re past your due date. They can also induce you if your labor stalls or isn’t progressing.

What are some ways to induce labor?

Your provider will examine you and check your cervix before deciding how to proceed with inducing labor. They’ll weigh the benefits of induction against the risks of induction. Throughout a labor induction, your provider monitors the fetus to make sure it’s tolerating labor well.

There are several ways pregnancy care providers induce labor. A few of them are:

• They give you medication to soften, thin (efface) and open (dilate) your cervix to prepare it for childbirth.
• They rupture the amniotic sac or “break your water.”
• They give you medication that causes contractions. This typically happens when labor stops progressing on its own.
• They use a cervical ripening balloon.

What are some reasons for inducing labor?

The main reason healthcare providers induce labor is to protect your health and the fetus’s health. Your healthcare provider may recommend labor induction if:

• You’re two or more weeks past your due date. Once you reach 41 weeks of pregnancy, the placenta may not work as well. This means the fetus may not get the oxygen or nutrients it needs.
• Your amniotic sac breaks (your water breaks), but you’re not having contractions. This is called premature rupture of membranes (PROM).
• You have a health condition like gestational diabetes, high blood pressure or preeclampsia.
• The fetus stops growing.
• You have oligohydramnios (not enough amniotic fluid).
• The placenta separates from your uterine wall (placental abruption).
• You have an infection in your uterus (chorioamnionitis).
• You have a history of rapid delivery (precipitous labor).
• You’re in labor, but it’s not advancing. This may mean you’re slightly dilated (open) and effaced (thin), but need extra help to progress further.

Who may need labor induction?

Inducing labor may help lower your risk of complications from certain medical conditions. Your healthcare provider may also recommend labor induction if you have a past history of stillbirth or other complications during childbirth.

In what week does labor induction happen?

The timing of labor induction varies depending on the health of your pregnancy. Pregnancy care providers weigh the risks and benefits of inducing labor. Ideally, they wait until 39 weeks of pregnancy to induce labor. However, if the fetus’s health is at risk, inducing labor before 39 weeks may be the safest option.

What can I expect if I’m induced?

It depends on the induction method your provider uses. It also depends on how soft (or ripe) your cervix is. Ripening refers to how open (dilated) and thin (effaced) your cervix is. Before inducing labor, your provider will examine your cervix to see how “ripe” it is.

If your cervix is hard and closed, the first step in inducing labor is to ripen your cervix. If your cervix is already starting to ripen, it could change how your provider approaches induction.

How do you induce labor?

Healthcare providers may recommend one or more of several methods for inducing labor. It depends on how soft your cervix is and if you’re dilated or effaced.

If your cervix isn’t effaced or dilated, your provider may use one of the following methods to ripen your cervix first:

• Stripping the membranes: Your provider passes a gloved finger over the membranes connecting the amniotic sac to your uterus. This action releases certain natural chemicals, called prostaglandins. These chemicals soften your cervix and help contractions begin. This doesn’t work for everyone, but it’s a good first attempt in starting labor.
• Prostaglandins: Prostaglandins are substances that act like hormones in your body. They help soften and ripen your cervix. Your provider can give you prostaglandins in a pill or as a suppository in your vagina to induce labor. The two most common prostaglandins for labor induction are misoprostol (Cytotec®) and dinoprostone (Cervidil®).
• Balloon catheter: Your provider places a small tube with a balloon at the top into your cervix. Then, they fill the balloon with saline so it expands. This pressure can ripen your cervix and help it widen.

Once your cervix is ripe, your provider may recommend the following methods to increase the intensity of your uterine contractions. Contractions help push your baby down the birth canal.

• Amniotomy: Your healthcare provider inserts a small, plastic hook through your cervix to break your amniotic sac. Your cervix needs to be partially dilated and effaced for this procedure. This isn’t painful.
• Oxytocin (Pitocin®): Oxytocin is the hormone in your body that causes contractions. Your provider may give you man-made (synthetic) oxytocin to start or speed up labor contractions. Oxytocin is given intravenously (through an IV).

How long does a labor induction last?

It depends. Some people respond very quickly to labor induction, while others take several hours to respond. There aren’t any rules on how long you can be in labor or how long it takes until delivery. However, the majority of people progress into “active” labor within 24 hours of an induction. Active labor is when your cervix reaches about 6 centimeters (cm).

What are the advantages of inducing labor?

A labor induction reduces the risk of complications from continuing the pregnancy or letting labor start or progress on its own.

What are the risks of inducing labor?

Inducing labor can have some risks. The risks depend on the method your healthcare provider chooses. However, most providers choose a labor induction because the benefits outweigh the risks.

Some methods, such as receiving too much oxytocin too quickly, may overstimulate your uterus. This overstimulation can cause your uterus to contract too frequently. Too-frequent contractions may lead to complications, including problems with the umbilical cord and the fetus’s heart rate.

Other possible risks of labor induction include:

• Infection.
• Uterine rupture.
• Increased risk of C-section.

There are reasons providers can’t or shouldn’t perform an induction. If this happens, your provider may discuss an assisted vaginal delivery or a C-section delivery.

Is recovering from an induction different from a normal birth?

In most cases, recovering from a labor induction is the same as recovering from labor that began on its own.

What is the fastest way to induce labor?

It depends. Often, it’s a combination of methods that work fastest to induce labor — for example, breaking your water and giving you Pitocin in an IV. Only your pregnancy care provider can decide what will work best for you based on your situation.

Is inducing labor painful?

How painful labor induction is depends on a few factors, including:

• If you’ve had an epidural or other anesthetic to reduce or block your pain.
• What induction method your provider uses.

Having your membranes stripped typically happens late in pregnancy as a first attempt to jumpstart labor. It may feel a little uncomfortable, and you may begin cramping or spotting shortly after.

If your provider breaks your water, you may feel a pulling or popping sensation followed by a flood or trickle of liquid from your vagina. This shouldn’t be painful.

Taking medications for labor induction may cause pain because medications work to intensify uterine contractions. Labor contractions can be quite painful and feel like very strong menstrual cramps.

However, depending on when labor induction occurs, you may have already had an epidural (the most common pain medication for childbirth). In this case, you may not feel anything. Or your provider may suggest an epidural once labor pain becomes too severe.

What are some natural ways to induce labor?

It’s not safe to try to induce labor on your own by taking medications or supplements. Some people say having sex or stimulating your nipples can help you go into labor. But no studies have proven this. If you’re feeling anxious about meeting your baby, it’s best to talk with your provider. They may have ideas about things you can do to help start the labor process.

A note from Cleveland Clinic

A labor induction is sometimes necessary to protect your health and the fetus’s health. This can be because you’re past your due date or because there’s a health complication with your pregnancy. Your pregnancy care provider can induce labor with medications or other techniques such as breaking your water. Getting induced may not be part of your birth plan, but know that your provider is making that recommendation based on what they believe is best. Don’t be afraid to ask questions about what you can expect.