Patient education: Labor induction (The Basics)

What happens during labor? — When a person is pregnant, labor is the process that leads to the birth of the baby. During labor, you will have contractions, which is when the uterus tightens. Your cervix will soften, thin out, and open up, or "dilate." As you get closer to giving birth, your baby will move down from your uterus into your vagina (figure 1).

Most of the time, labor starts on its own between 37 and 42 weeks of pregnancy.

What is labor induction? — This means using medicines to help start labor. It is also called "inducing labor."

Your doctor or midwife might recommend induction if:

●You are more than 41 weeks pregnant, and labor has not started on its own.

●Your water has broken, and labor has not started on its own.

●You have certain health conditions, like high blood pressure, diabetes, or an infection.

●There is a problem with the placenta.

●Your baby is not growing as expected.

●There is a problem with the amniotic fluid. (This is the liquid that surrounds the baby in the uterus.)

●You are pregnant with twins.

Doctors only induce labor before 39 weeks of pregnancy if there is a medical reason. Usually, this means a situation where waiting to give birth could be dangerous for you or your baby.

Some people choose to be induced at, or after, 39 weeks. This might be an option if you are certain about your due date.

How do I prepare for labor induction? — Before your induction, your doctor or midwife will do an exam. They will also:

●Confirm exactly how many weeks pregnant you are

●Check your baby's position

●Estimate how much your baby weighs

●Check your cervix

●Check your baby's heart rate

What happens during labor induction? — When it is time for your induction:

●If your cervix has not started to soften or dilate, the doctor or midwife can use medicine or a device to help with this. This process is called "cervical ripening." It might be done with:

•A balloon catheter – This is a thin tube that goes into the vagina and through the cervix. It has a small balloon on the end. The balloon inflates to help slowly open the cervix.

•Medicine – This can be given by mouth or into the vagina. The medicine slowly softens and dilates the cervix. It might also cause contractions.

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●If your water has not broken, the doctor or midwife might break your water. To do this, they will insert a finger or a special tool through your cervix and break the amniotic sac.

●Sometimes, cervical ripening or breaking the water is enough to get labor started. But most people also get a medicine called oxytocin (brand name: Pitocin). This is given through the IV.

●You should start having contractions. It can take a while for contractions to start, sometimes 12 hours or longer. Your doctor or midwife will monitor your contractions to see how frequent they are. They will also monitor how much your cervix dilates over time.

●The staff will monitor your baby's heart rate during labor induction.

What happens after labor induction? — If the induction works, your labor should continue until you give birth. Your doctor or midwife will talk to you about your options for pain relief, if you choose this.

Sometimes, labor induction does not work. In this case, you will probably need to have a cesarean birth (c-section).

What are the risks of labor induction? — Your doctor or midwife will talk to you about all of the possible risks, and answer your questions.

Possible risks of labor induction with oxytocin include:

●Contractions happening too frequently

●Changes in your baby's heart rate

●A tear in the uterus

●Longer labor than if labor began on its own

There is also always a chance that the induction will not work and you will need to have a cesarean birth.

What else should I know? — Labor induction is not always an option. This depends on many different things, including your health, your baby's health, your past births, and your baby's position. Your doctor or midwife can talk to you about your situation. They will help you make the decision that is best for you and your baby.

You might have heard about "natural" ways to induce labor. But there is not good evidence that these things work. Experts do not recommend things like drinking castor oil, getting acupuncture, or having sex as a way to try to start labor.

More on this topic

Patient education: How to tell when labor starts (The Basics)
Patient education: Labor and childbirth (The Basics)
Patient education: Managing pain during labor and childbirth (The Basics)
Patient education: Fetal monitoring during labor (The Basics)
Patient education: Cesarean birth (The Basics)
Patient education: Vaginal birth after a cesarean (The Basics)

Patient education: C-section (cesarean delivery) (Beyond the Basics)