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Labor induction: what you need to know and what to expect

Sometimes a baby needs extra encouragement to make its grand entrance. If you have gone past your due date and you and your baby are ready, one option to start the delivery process is to induce labor.

Going past your due date can be frustrating – and sometimes scary – for some parents, but labor induction is a great solution.

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What does induced labor mean?

Induced labor means that your care team will use medication, or other methods, to start the labor and delivery process for you, rather than your body starting it naturally. The induced labor process usually happens 1-2 weeks after your due date. Unless medically necessary, inductions are not done before the 39th week of pregnancy.  

In the United States, induced births make up 23.4% of all births, according to the American Academy of Family Physicians.

IS IT BETTER TO ALLOW LABOR TO BEGIN NATURALLY?

As you get further along in the pregnancy timeline, your care team will discuss with you the best options to begin labor for you and your baby. Labor induction may be necessary, but you may also be able to choose one of many delivery methods.

However, it is typically best to allow labor to begin on its own, though there are multiple medical reasons why you may need induction. There is also data to support elective induction of labor (not medically-indicated, but instead performed by request of the pregnant person) after 39 weeks of pregnancy without significantly increased risks to pregnant people or babies.

WHAT IS A BISHOP SCORE?

A Bishop score is a system your provider uses to see how ready the cervix is for the labor process. The calculation or scoring system will inform them if you will go into labor soon and, if induction is necessary, the best medications or methods to use. The scoring system will evaluate your cervix and the baby’s position to help determine their decision.

How does labor induction work?

This most often happens through the use of induced-labor medication. Patients may need cervical ripening with medications called prostaglandins or through mechanical ripening with a small balloon catheter inserted through the cervix. Your care team may also help induce labor with Pitocin, a hormone to help progress labor. Pitocin is a synthetic version of the natural hormone oxytocin that your brain releases in spontaneous labor.

On your scheduled induction day, you’ll be admitted to the birth center. Your care team will review the methods they think are best when you come to the hospital for induction. If needed, you will receive Pitocin through an IV. Your contractions will begin soon and you will be in active labor. 

HOW LONG DOES INDUCED LABOR TAKE?

With the use of induce-labor medicine, active labor can start quickly, but it truly depends on each person and how their body responds to the medication. For some people, labor starts quickly, and for some, it can take hours to days to begin active labor. We typically advise people to expect at least 24 hours for their induction.

WHAT IS FAILED INDUCTION OF LABOR?

A failed induction of labor may happen if the labor induction process does not turn into active labor within 24 hours or more. If this does happen, a Cesarean birth (C-section) may be necessary. While it may sound scary, C-sections are a very common and safe way to deliver. 

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Reasons to induce labor

Many people wonder what the reasons are to be induced. There are a few reasons why you may need one from where you are in your pregnancy, typically if you’re beyond your due date, or if you have any medical issues, like bleeding, preeclampsia, or gestational diabetes.

BABY IS OVERDUE

One of the main reasons behind scheduling an induction date would be if you are 1-2 weeks beyond your due date, meaning you are 41-42 weeks into your pregnancy. Doctors want to induce you at that point to help you have a safe delivery and decrease the fetal risks of post-term pregnancy.

GESTATIONAL DIABETES

Gestational diabetes is something you might develop during your pregnancy. This means that you may not have diabetes when you’re not pregnant, but when you are, your body isn’t responding appropriately to insulin. If you do have gestational diabetes, your care team may recommend an elective induction, meaning you would schedule your induction whenever your care team thinks is best (does not have to be after your 40 weeks). This is because having gestational diabetes may put you at a higher risk of pregnancy complications.

PREECLAMPSIA

Preeclampsia is when you develop high blood pressure (and other symptoms like swelling, headaches, etc.) during your pregnancy. With this pregnancy complication, early delivery, or early induced labor may be recommended to keep you and your baby safe.

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Learn about the signs and stages of labor to know when to get in touch with your physician.

BLEEDING

During pregnancy, some people may bleed. But, as you near your due date and the bleeding is heavy, it can be a sign you may need to be induced. Heavy bleeding could be a sign your body is trying to start the labor and delivery process earlier than planned.

HEART DISEASE

Having heart disease does qualify you for having a “complicated” pregnancy. This is because you have something going on in your body that may make your labor and delivery more complicated than normal. It’s important to discuss your heart disease with your provider before birth.

INFECTION

Infections can happen during pregnancy. One infection that may lead to induction is chorioamnionitis. This is when the amniotic sac is broken and then the placenta and amniotic fluid get infected. Chorioamnionitis can cause complications for you and your baby.

Delivery is always recommended when there is an infection inside the uterus, along with giving antibiotics to the pregnant person.

LABOR FAILED TO START AFTER AMNIOTIC SAC IS BROKEN

When an amniotic sac is broken, many people call that your “water breaking.” So, when your water breaks and you start to prepare for giving birth but labor doesn’t begin, beginning the process of inducing labor may be needed.

BABY IS AT RISK

If you are over your due date by 1-2 weeks, this could put your baby at risk which then may bring up the conversation of an induction. Other reasons could be your baby stopped growing, they don’t have enough amniotic fluid, they’re in distress, and more.

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Risks of inducing labor

Delivering a baby can be risky no matter the type of delivery you have, whether it’s a natural birth, C-section, home birth, induction, and so on. While inducing labor is typically safe, there are risks for this option as well. Many of the risks of induction are also risks of spontaneous labor. Below are some possible risks with induction:

  • Failed induction: A failed induction of labor may happen if the labor induction process does not turn into active labor within 24 hours or more. If this happens, you may need a C-section.
  • Bleeding after delivery: After an induction birth, if your uterus does not contract properly and strongly enough, it can cause bleeding.
  • Infection: Some methods of induction have increased risks of infections for mom and baby than other types of births.
  • Low fetal heart rate: Sometimes when you receive induction medications, it can cause your uterus to be overstimulated and contract too often. When this happens, it can cause a low fetal heart rate.
  • Uterine rupture: Sometimes after someone has had a previous C-section birth, they may be at a higher risk of uterine rupture during induction on their next baby.

Labor induction methods

There are different types of induction. It will depend on your care team and preferences for the method of induction. There are medical labor-inducing methods, like cervical ripening and amniotomy, and there are natural labor induction methods like breast and nipple stimulation and exercise.

MEDICAL LABOR INDUCTION METHOD

There are a variety of different medical methods to induce labor. Depending on your health care provider and your pregnancy, this may impact which method is chosen to induce you. Some providers may even use a combination of the below methods:

  • Amniotomy: This is when your care team breaks your water for you instead of it happening naturally. They do this by going in and rupturing your amniotic sac.
  • Cervical ripening: Your care team can “ripen your cervix” by giving you medicine to make it soft and thin in order to prepare for labor and delivery. This may also help begin dilation.
  • Foley bulb induction: This method is when your provider inserts a Foley bulb into your uterus, putting pressure on it, making the cervix hopefully start to dilate and contract.
  • Stripping membranes: This method is done by your health care provider with their fingers. Your provider performs a cervical examination and separates the lower amniotic sac from the wall of the uterus. When this happens, your body will release a substance called prostaglandin which will help prepare your cervix for delivery.
  • Medical injection: Oxytocin is a natural hormone in your body that helps deliver your baby. During induction, your care team will use the medication form of oxytocin to induce labor, this is called Pitocin. They will give you this through an IV to help further along with delivery.
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NATURAL LABOR INDUCTION METHOD

While you are waiting for your baby to make their grand entrance, you will undoubtedly hear an excess of tips on how to get labor started.

Here’s the truth about some common myths and a couple of options that actually work.

  • Breast and nipple stimulation: This is one activity that is proven to cause contractions and can get labor started. Please be sure to discuss this with your doctor before doing it at home. Breast and nipple stimulation can cause a lot of contractions in a row, which can be alarming if you aren’t expecting it and could potentially cause problems for your baby. But don’t worry, nipple stimulation during sex is not enough to cause significant contractions.
  • Spicy food: A very popular myth is that spicy food will put women into labor, but don’t expect spicy food to deliver more than possible heartburn! If you are worried about going to labor early, rest assured that you can safely eat spicy food.
  • Pineapple and cinnamon: Pineapples contain bromelain, an enzyme that is thought to soften the cervix and start contractions. However, eating pineapples has not been proven to start labor. Similarly, boiling cinnamon sticks into tea is not a proven labor starter, but it may have a calming effect and help with relaxation. 
  • Castor oil: Should you say bottoms up to castor oil? Similar to spicy food, there is no proof that castor oil helps start labor. Our advice is to spare yourself the unpleasant experience of drinking castor oil — which can cause diarrhea and dehydration — as there is not a medically sound reason to drink it.
  • Movement and exercise: Unless advised against it by your doctor, movement, and exercise are good for you and should be a regular part of your day, but don’t expect it to induce labor.
  • Sex: Engaging in sex is fine as long as your doctor hasn’t advised against it. But sex will not cause your water to break nor directly cause you to go into labor. However, semen contains high levels of prostaglandins, which can ripen or soften the cervix.
  • Acupuncture: There’s a lack of proof of whether acupuncture does indeed help start labor. Acupuncture can reduce stress, anxiety, and fatigue and relieve muscle and joint pain, which can make you more comfortable and relaxed during the end of your pregnancy.
  • Full moons: We have to admit that it does seem like we see increased medical activity around full moons. The moon does pull the ocean tides, but there is no evidence of full moons having any pull in labor.

Does labor induction change your birth plan?

Depending on your pregnancy, your birth plan may not have included an induction. Not many people plan to go beyond their due date so, the idea of an induction may not have crossed your mind when creating your plan. But as mentioned above, inductions can happen for a variety of reasons – beyond going past your due date by 1-2 weeks.

If you are likely to be induced based on your pregnancy or complications, it could still be beneficial to make a birth plan that includes how you want to go about induction, whether you want medication, or if you prefer the less-invasive medical methods for induction, etc.

Delivered peace of mind through labor induction at The Mother Baby Center

We hope this article helps you further understand what labor induction is, how it works, and when it is needed. At The Mother Baby Center, we are here to do everything possible to bring your personal birth journey to life. Our goal is healthy babies and healthy parents, and caregivers. We will offer expert guidance and support, with available resources to help new parents heal and enjoy their new family members.

Tour one (or all three) of our locations and find a provider who will help bring your preferred birth journey to life at The Mother Baby Center.

Frequently asked questions about labor induction

Because labor induction is less common than giving birth naturally on or around your due date, many people have questions. Here are the answers to some frequently asked questions about labor induction. We do still recommend talking to your doctor and care provider about your labor and delivery as each person’s pregnancy and delivery will be different.

HOW LONG DOES LABOR INDUCTION TAKE?

There is no straight answer to this question. It could take anywhere from 2-3 hours to 2-3 days to induce labor.

It may be different if you’ve had a baby before. It will just depend on how your body reacts to the induction method used. Labor induction is different for everyone.

HOW LONG DOES INDUCTION TAKE FOR FIRST-TIME MOMS?

Because you are a first-time mom, labor induction could be slower – between 24-36 hours – than people who have given birth before. However, this also will differ patient-by-patient; it is not a full-proof answer.

CAN I ASK TO BE INDUCED AT 39 WEEKS?

You can ask for an elective induction at 39 weeks but the answer from your health care provider will depend on your and your baby’s safety. It is extremely important that both you and your provider agree on this decision.

CAN I BE INDUCED EARLY BY REQUEST?

Asking for an elective early induction can be done. However, like the answer above, your provider will decide what is best for you and help you weigh the pros and cons of doing so. They will help provide you with an expert opinion and suggestions for how to best move forward. We do not typically perform inductions in less than 39 weeks unless there is a medical indication to do so.

IS INDUCED LABOR MORE PAINFUL THAN NATURAL LABOR?

Sometimes induced labor can be more painful than natural labor because of the method of inducing you. In order to induce someone, your care team will need to use a medical method to do so which may cause some additional pain beyond labor. Pitocin works on your uterus in the same way oxytocin from your brain causes contractions.

DOES LABOR INDUCTION HURT?

As mentioned above, labor induction may be a little painful depending on the method of induction your health care provider chooses to use. You can discuss options but ultimately, they will choose the method that is best for you and your baby’s safety.

WHY DO DOCTORS PUSH INDUCTION?

Many people may feel their doctors and care teams may be “pushing” for inductions, but in reality, they are really trying to look out and make sure you and your baby stay safe and healthy. Sometimes, induction is the best way to do that.