What Is an Induction in Pregnancy?

An induction in pregnancy is the initiation of labor by medical means in a woman close to giving birth, with the goal of a vaginal delivery. Labor inductions are performed to reduce potential health risks of a continued pregnancy to the mother or child. Some women may elect to induce pregnancy for other, less medically urgent reasons.

Like all such procedures, labor induction carries risks as well as benefits. Labor induction can be an effective means of protecting health during the final stages of pregnancy but is not appropriate in every situation. If you’re pregnant or planning a pregnancy, the Baptist Health OB-GYN team is ready to serve you.

Why Might a Doctor Induce You?

There are numerous reasons for inducing labor. Most involve health concerns for you or your child as you approach the end of your pregnancy:

• Chronic health problems such as hypertension or diabetes
• Medical issues with the major organs, including the heart, lungs, or kidneys
• Loss of amniotic fluid
• Problems with the placenta, including separation from the uterine wall (called a placental abruption)
• Uterine infection
• A condition known as PROM – the prelabor rupture of membranes
• A pregnancy lasting longer than 41 or 42 weeks
• Indicators of poor health in the fetus

Some inductions are elective. Induction may be requested by otherwise healthy individuals with a history of short labor times, excessive physical discomfort, or reduced hospital access.

Labor induction isn’t always appropriate, even when health issues for the mother or child are present. These situations usually involve a potential obstacle to vaginal delivery:

• A possible breech birth
• A prolapsed umbilical cord, which can entangle an infant during birth
• Placental attachment to the cervical opening, known as placenta previa
• A genital herpes infection

The alternative delivery method is a cesarean or C-section.

When Does Labor Induction Happen?

The timing of labor induction varies by pregnancy, depending on the health of both mother and child. Physicians rarely induce labor prior to the 39th week of pregnancy. If evidence arises earlier of a serious medical issue, especially with the fetus, your provider may choose to induce labor before the 39th week.

What Happens When You Get Induced?

One of the earliest indicators of labor are changes in the cervix, a muscular canal that connects a woman’s uterus to her vagina. The cervix must “ripen” beforehand, meaning soften and open up, to enable movement of the infant down the birthing canal.

Your physician’s first act will be to determine the condition of the cervix. Its readiness for delivery will dictate the next steps in the induction process.

What Are the Methods of Induction?

There are several potential steps for inducing labor, depending in part on the condition of the cervix. If the cervix has not yet ripened, your physician may:

• Strip the membranes: Your physician inserts a gloved finger between the amniotic sac and the uterine wall. This separates fetal membranes from the uterine wall and also releases natural chemicals called prostaglandins that accelerate changes in the cervix.
• Provide a prostaglandin: Prostaglandins can also be introduced in pill or suppository form. Chemical changes to the cervix hasten the onset of labor and contractions.
• Insert a balloon catheter: This technique involves inserting a balloon at the top of the cervix and filling it with a saline solution. The pressure it exerts aids the ripening process by gently widening the cervical opening.

There are two additional steps that your physician can take once the cervix has ripened. He or she may:

• Perform an amniotomy: Your physician uses a surgical instrument ending in a small hook to break the amniotic sac in which the fetus has developed. (This is commonly called “breaking your water.”) This can only occur when the cervix has widened enough to allow the passage of the instrument.
• Order intravenous oxytocin: Oxytocin is a hormone that causes labor contractions. A synthetic version can be introduced to the woman’s body by means of an intravenous (IV) drip.

How Long Can Induced Labor Take?

There is no set time for the duration of induced labor. Different persons respond differently to the various methods used to initiate the birthing process. In general, active labor begins within 24 hours of induction but can vary by individual. First-time mothers may find that labor takes longer for them than for women who have given birth before.

Induction vs. Natural Birth

The period of induced labor tends to be shorter and more intense than that of natural labor, in which contractions arise more gradually. Many women with induced labor opt for pain medications to lessen their discomfort during the birthing process.

What Are the Benefits and Risks of Induction?

Labor induction offers both benefits and risks. These are described below.

Advantages of Inducing Labor

The primary benefit of induced labor is a successful delivery without medical complications occurring in either mother or child because of preexisting health concerns. A second benefit is a vaginal delivery rather than a C-section, which is harder on the mother and requires a longer recovery period.

Risks of Inducing Labor

Induced labor involves a number of risks. These include:

• Inability to deliver: Not every induced labor is successful. A failed vaginal delivery is typically followed by a C-section.
• Strength of contractions: Artificially induced contractions tend to be stronger than natural ones and occur in a more compressed time period. This makes delivery more difficult and can lead to medical complications in both mother and infant.
• Uterine atony: The muscles of the uterus sometimes remain distended following delivery, a condition known as atony. Internal bleeding can result.
• Possible infections: Induction can sometimes injure the membranes of the reproductive system, making them more prone to infection.
• Premature birth: Premature births occur when the induction process works, but the baby is younger and less developed than was estimated beforehand. Premature infants often require intensive care in a hospital setting.
• Fetal death: In rare cases, induced labor can lead to a loss of the infant.
• Other risks include those associated with any surgical procedure, such as adverse reactions to anesthesia.

Additional FAQs About Inducing Labor

Below are additional areas of concern for persons with questions about induced labor.

How to Prepare for Induction

If you decide with your partner and physician to induce labor, these are steps that you can take to prepare yourself beforehand:

• Ask questions to be fully informed: You need to know the potential benefits and risks of inducing labor prior to undergoing the procedure. Your provider can answer all your medical questions.
• Pack for a hospital stay: Don’t assume that inducing labor will have you home with your child in record time. Bring items to make your hospital stay more pleasant. Your partner, too, should be ready to support you through the entire process.
• Accept the process: Labor and delivery, whether natural or induced, don’t happen on a set schedule. Every mother’s experience is different. You must be willing to live with possible frustration and delays, with the ultimate goal of delivering a healthy baby.

Can You Eat Before Being Inducted?

It’s best not to eat immediately prior to having labor induced. Your gastrointestinal system should be clear of matter during this process. Your physician will let you know when to eat a final meal before the procedure.

Is Induction Painful?

Inducing labor sometimes results in pain. Stripping the membranes can bring temporary discomfort, as can an amniotomy (the procedure for breaking water). Using prostaglandins or oxytocin to initiate labor can intensify contractions and lead to cramping.

What Are Natural Ways to Induce Labor?

There are no proven safe methods for inducing labor at home. The various recommended methods—bathing in hot water, taking herbal supplements, or having sexual intercourse—are without scientific basis. Work with your provider to plan your delivery in an appropriate setting. He or she can advise you regarding the proper circumstances for inducing labor.

Contact your provider today.