Labor induction is a procedure used to start labor and delivery in pregnant women. There are a few reasons why labor induction is considered. It is intended to be done when health risks are associated with continuing the pregnancy, such as preeclampsia or gestational diabetes.
Labor induction has become increasingly popular over the last few decades, but it’s essential for you to understand what’s involved before making any decisions about whether or not you want to pursue getting induced.
Many mamas are coming to me filled with questions and concerns about labor induction and want tips. So I am gonna break down the different methods of labor induction and their pros and cons so you can make an informed decision about your own experience.
If you've considered going for induced labor instead of waiting for labor to start on its own, here are some top-secret tips I've gathered as a veteran labor nurse that I want to share with you!
Why I am here and who I am:
Hey mama, I am Trish— AKA Labor Nurse Mama. I am a labor and delivery nurse with over 15 years of high-risk OB experience. And I am also a mama to 7 kids and have given birth to 6! My professional and personal experiences allowed me to labor thousands of mamas and delivered many, many babies.
I am the online birth class educator for Calm Labor Confident Birth and The VBAC Lab birth classes. and the mama expert inside our Calm Mama Society Mama Membership Community! I am passionate about your birth and motherhood journey! You can find me over on IG teaching over 230k mamas daily.
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Spontaneous Labor Vs. Induced Labor
Before we dive deep into the whole topic, let's define what labor induction actually is, so we're all on the same page. Labor induction, also known as inducing labor, happens when your doctor or midwife uses medication or other medical techniques to start labor. There are also ways you can induce your labor. But for this post, we will chat about medical labor induction.
In medical terms, it refers to two parts: thinning out the cervix (effacement) and making the uterus start to contract.
On the flip side, Spontaneous or natural labor typically starts any time between 37 and 42 weeks of pregnancy. For a first-time mom, the average is 40 weeks and five days.
As your little one's head descends into the pelvis, it puts pressure on your cervix; this tells the pituitary gland to release Oxytocin, which causes the contractions to increase. The pressure of the head and the hormones cause the cervix to soften and start to open.
Now, if you're getting induced, the stuff I mentioned above is started artificially. It may involve different techniques such as:
- mechanically or using medicine to soften your cervix
- breaking your water
- using medicine to begin your contractions
- or a combination of these
Why your doctor may induce labor
Generally speaking, your healthcare provider might recommend labor induction for different reasons, if you follow me or know me well, then you know I am not a fan of many of those reasons.
There are legit reasons for you to be induced. But for someone else's curiosity or convenience, I say heck to no.
Here are some of the common reasons why your provider may want to induce labor (remember, it is your choice!) I will give you tips for navigating situations when your provider wants to induce your labor, but you are not in agreement.
- Your due date has come and gone. You've gone through one or two weeks past the due date without signs of labor starting (post-term pregnancy). In fact, the 2013 Listening to Mothers III survey shows that out of everyone who was induced, 44% said that they were induced because their baby was full-term and it was close to the due date. (I am not a fan of this reason)
- If tests suggest your baby is not doing well inside of you and would benefit from being born.
- You live too far from the hospital if you live far from where the hospital/delivering or they fear you might not make it to the center in time. (again not a fan, especially for a FTM, who has plenty of driving time)
- You have a medical condition. If you have a medical condition (including heart, lung, or kidney disease and obesity) that puts you or your baby at risk, induction may be recommended.
- You're not progressing in labor: If you're in labor but not progressing as quickly as your doctor would like (not a fan) to augment your labor. (movement is key)
- Your water has broken: If your water has broken but labor hasn't started on its own, induction may be recommended. (see my recommendations)
- When there's not enough amniotic fluid surrounding the baby (oligohydramnios).
- You have an infection in the uterus (chorioamnionitis).
- Your baby's confirmed estimated weight is less than the 10th percentile for gestational age (fetal growth restriction). (not always a fan if baby is doing fine)
- When diabetes develops during pregnancy (gestational diabetes), or have been diagnosed with diabetes prior to your pregnancy. (only a fan if your diabetes is not controlled)
- You develop high blood pressure during pregnancy, protein in your urine, swelling legs, headaches, and blurred vision (preeclampsia), or have been diagnosed with high blood pressure prior to your pregnancy
- You develop high blood pressure before 20 weeks of pregnancy (chronic high blood pressure).
- You develop high blood pressure after 20 weeks of pregnancy (gestational hypertension).
Tip #1 For Labor Induction -You have a choice
Back in the old days, doctors routinely induced labor. When I first became a labor nurse, providers induced labor willy-nilly. There was nothing to govern it. We had so many NICU admissions. It was awful. Then some rules were set into motion that restricted them to a couple of rules so that they had to answer to someone when they induce a mama. Basically, it had to be medically necessary if it were before 39 weeks. After 39 weeks, it could be elective. Meaning no real reason just someone wants it—you or them.
According to BMC Pregnancy and Childbirth, one in six (1 out of 6%) women who planned to have a vaginal birth reported feeling pressure from their provider to have an induction, with more women who had an induction reporting pressure (27%) than those who did not (7%).
KNOWLEDGE IS POWER, and YOU HAVE THE POWER TO CHOOSE.
And as much as possible, I don't want you to be part of this statistic.
If you're considering whether or not you'd want to be induced, the best advice I can give you is to listen to your body and make an educated decision.
Don't be afraid to speak up and ask your doctor questions.
Open communication is key! Here are some questions that can help you communicate with your healthcare provider:
- Why would I need an induction?
- What happens if I don't want to get induced?
- What procedures are involved in my case?
- How will you induce my labor?
- How will labor induction impact me and my baby?
- Will labor induction increase the chances of me having to go for a c-section?
- What measures will your team be doing to take care of me and my baby?
- What options do I have for pain medicine?
- Do I have a health problem that makes inducing labor necessary before 39 weeks?
- Will you support me going past my due date if the baby and I are healthy?
Can I request an elective induction?
Elective labor induction means opting for induced labor just for convenience when there's no medical need.
A common example is if you live far away from the birth center (or hospital) or if you have a history of rapid deliveries. In this case, your healthcare provider will need to confirm that the baby's gestational age is at least 39 weeks or older before induction to reduce the risk of health problems for the baby.
How labor induction is done
There are several different ways that labor can be induced:
- Membrane sweep: (not really labor inducing but hey) This method includes stripping or sweeping the membranes. Using a glove, your healthcare provider inserts a finger into the vagina, through the cervix. They move the finger back and forth to gently separate the amniotic sac (which keeps your baby protected and holds the amniotic fluid) from the wall of your uterus. Doing so releases hormones that can aid in starting labor.
- Prostaglandin to soften the cervix: This hormone is usually given overnight in the hospital to help ripen the cervix. It is either inserted in the vagina in the form of a gel or vaginal insert; or taken orally in the form of a tablet. Prostaglandin may be used alone or in conjunction with oxytocin to induce labor.
- Mechanical Methods: Another way your provider may start the process is by mechanical labor inducing methods, such as the foley bulb, the Cook's catheter or Dilapan S. All of these mechanically start the dilation and softening process. Both the foley bulb and the cook's catheter are inserted into the cervix (you have to be a little open for this to work) and then your provider inflates the caheter balloon which puts pressure on the cervix opening it. Once you hit about 4 cm it will fall out.
- Pitocin to stimulate contractions: A synthetic form of the hormone oxytocin, pitocin can be used to help start or strengthen contractions. This drug is given continuously through an IV, starting with a small dosage which increases depending on your labor's progress. Once it is administered, the fetus and uterus need to be monitored closely.
What will it feel like?
Labor induction can be an uncomfortable process, and some women may experience strong and painful contractions.
During an induction, your doctor will want to artificially rupture your membranes, or “break your water.”
I encourage my students and members to refuse this one. The bag of water serves as a protection and cushion for baby during labor. I recommend asking them to wait until active labor to do this if at all.
The pain from contractions can vary, depending on your pain tolerance and body. Some mamas say it feels similar to menstrual cramps while others say they feel intense pressure in their lower back or abdomen.
How long does it take to deliver a baby after being induced?
After being induced, it usually takes between 18-24 hours for a woman to give birth. The length of time varies depending on your induction process. for instance, if your cervix is soft and you do not need prostaglandins then you may go quicker. Some mamas may go into labor more quickly (especially if it is not your first), while others may take longer. In general, though, the majority of women will have their delivery within this time frame.
What are the risks and precautions of getting induced?
Inducing labor can be faulty if your body isn't ready. I personally say if you and baby are healthy, then wait on your wonderful body and it's perfect timing.
Here are some scenarios for you to know about.
- Failed induction: If your body is still not ready for labor, inducing labor might not be as successful as you'd hoped it would be. What's worse is even after long dreadful hours (or even days!) of trying, you might end up having a c-section instead… which normally happens more likely if your cervix hasn't ripened yet.
- Infection: In terms of breaking your water, once the doctor proceeds with rupturing the amniotic sac and labor still doesn't start, they will proceed to a different labor induction method. That's because there's a risk of infection to both you and the baby if the membranes are ruptured for too long right before the delivery happens.
- Uterine rupture: When medication (prostaglandin or oxytocin) is used, the risk of abnormal contractions rises. This leads to the healthcare provider removing the vaginal insert or lowering the oxytocin dose. On rare occasions, there might be the risk of tearing in the uterus (uterine rupture). Other complications that are related to oxytocin are low blood pressure and low blood sodium. And when you have either of the two, it could cause seizures.
- Low fetal heart rate: Medication used could cause excessive or abnormal contractions, which can lessen the baby's heart rate and lower their oxygen supply.
- Bleeding after delivery. When you're induced, there's a risk that the uterine muscles won't properly contract after giving birth (uterine atony) which then leads to serious bleeding after delivery.
- Pre-term delivery. You might give birth to a late pre-term baby (born after 34 weeks, before 37 weeks) mainly because your expected due date (EDD) may be wrong. In this case, pre-term babies are generally healthy but may have temporary problems with feeding, breathing, maintaining body temperature, or jaundice. They are also more likely to have developmental or school problems compared to full-term babies.
It's totally normal to feel scared reading about these risks and precautions, but I want you to ground yourself and understand that we're learning about them, not for a scare, but for you to be prepared and know your options.
Top Tips for Getting Labor Induced from Labor Nurse Mama!
1. Start with the basics.
Make sure your cervical exam is favorable for induction (dilated, effaced, soft) and you are at least 39 weeks gestation.
2. Don't do it, if you don't want to
You need to be educated to know when an induction is necessary. If you and baby are healhty and there are no legit reasons, push to wait.
3. Be patient.
Patience is definitely a virtue at this stage. Let nature take its course. While there are many methods that can be used to help bring on labor, it's best to be patient and wait for things to naturally progress. Sometimes it can take a few days for everything to get moving, but in the end, it will all be worth it!
4. Explore different positions to help open up the cervix. Think about gravity!
If you are in your induction there are a few things you can do to help things along. One of the most important is to try different positions to help open up the cervix if needed. Gravity can be your friend here, so think about how you can use it to your advantage. Take long walks, climb stairs, bounce on birth ball and more…..all while hooked to the monitor.
Walking around and moving around, in general, always helps get things moving along.
5. DRINK. YOUR. WATER.
I can't emphasize this enough! H2O does wonders for your body, especially when getting induced. Drinking water helps keep the body hydrated. This in turn helps keep the muscles in the uterus relaxed in between contractions.
Additionally, dehydration can cause spikes in the hormone oxytocin, which can make labor a beast.
5. Have lots of sex!
Okay, maybe not a lot, but having sex is a great way to get prepared for your labor indcution. When semen is released, it helps your body produce a hormone called prostaglandin which helps soften the cervix and… you've guessed it, help to induce labor.
6. Nipple stimulation
Nipple stimulation is another method of getting your body prepped for your labor induction. This involves using your fingers or a breast pump to massage and stimulate the nipples. This can help increase the production of oxytocin in the body.
6. Old wives' tale style
Castor oil is a herbal remedy that can be taken orally to induce labor. It works by stimulating the intestines which can in turn stimulate the uterus to contract. I don't recommend it on its own and only if you are healthy and past 40 weeks. Read my fave recipe here.
Or, try acupressure. It's an ancient Chinese practice that involves applying pressure to specific points on the body.
At the end of the day, it's all about what makes you feel safe. Your body, your choice. That's the motto. Don't be shy to go all out when asking your healthcare provider about the options you have, the risks, and what would happen if you decide to go with whatever it is that you're 100% sure with.
I hope this blog has helped you learn everything you need to know about getting induced and guide you with your decision. I'm so excited about your birth story!