What Is Labor Induction?
If your doctor or midwife has concerns about your or your baby's health toward the end of your pregnancy, they might suggest speeding up the process. This is called inducing labor, or induction. Instead of waiting for labor to start naturally, your doctor or midwife will use drugs or a procedure to start it sooner.
Induction can be the right choice for some, but it has risks. And it doesn't always work. If it doesn't, you may need a C-section. Most experts say it's best to let labor begin on its own and progress naturally unless there's a clear medical reason to induce.
"The only reason we recommend an induction is because it's our job to keep an eye on you and baby and make sure that everyone comes out of this process safe," says Jessica Vernon, MD, a board-certified OB/GYN and an associate medical director at Oula, a midwifery-based women's health start-up in New York City. "It's always a conversation between you and your provider, and understanding the risks and benefits and alternatives. And if you want a second opinion, you can always talk to another provider."
Why Is Labor Induced?
Usually, your body goes into labor without much prompting. But if you or your baby is at risk, your doctor may want to induce labor.
Induction is common — 1 out of 4 births in the U.S. start with induction. Many times, it's done for medical reasons, but it can be elective (meaning you choose to induce for convenience).
Why does labor sometimes need to be induced?
You're one to two weeks past your due date. Studies show that inducing labor at 39 weeks doesn't raise the risk of having a C-section or birth complications for the baby. After 41 weeks, you and your baby are at greater risk for complications. Being a little "late" isn't a reason to induce. You also don't want to be induced too early. Babies born before 39 weeks are more likely to have health problems, longer hospital stays, and more time in neonatal intensive care.
Your water breaks, but labor doesn't start. Once your water breaks, you and your baby have a higher risk of infection. You might not need induction right away, though. Check with your doctor or midwife. Sometimes, it's still safe to let labor begin on its own. After your water breaks, your doctor will limit the number of vaginal exams performed because of the chances for infection.
A problem puts you or your baby's health at risk.Examples are infection (chorioamnionitis) and too little amniotic fluid (oligohydramnios). If you have conditions such as diabetes, high blood pressure, preeclampsia, or eclampsia, your doctor or midwife might want to induce labor.
Your baby's health is at risk. If your baby isn't growing as it should be or has an abnormal heart rate, your doctor or midwife might want to induce labor.
Some doctors recommend elective inductions for non-medical reasons. Maybe you live far from the hospital and your doctor worries that you won't get there in time. Or maybe your doctor asks you to accommodate their schedule. Experts say you should reconsider, though. As induction poses some risks, experts say you shouldn't be induced unless it's medically necessary.
Your cervix prepares for labor by:
- Ripening, which is also called softening
- Opening, also called dilation
- Thinning, also called effacement
These things may start to happen but then stall. Or your water may break, but contractions don't follow. In these cases, a doctor may choose to induce labor to stimulate the body's progress.
Other conditions that call for inducing labor are:
- Lung disease
- Diabetes
Reasons Not to Induce
Some signs your doctor shouldn't induce you and you shouldn't have a vaginal delivery, are:
- You had a C-section before that involved a classical incision or major surgery.
- Your placenta covers your cervix (placenta previa).
- Your baby is in the wrong position (sideways or feet-first).
- You have a prolapsed umbilical cord (the cord has dropped down in your vagina ahead of the fetus).
- You have an active genital herpes infection.
How to Induce Labor
Medical induction
Stripping (or sweeping) the membranes.Your doctor inserts a gloved finger into your vagina and up into your cervix to separate your water (amniotic) sac, or bag, from your uterus without breaking the sac. Your doctor uses this technique to urge your body to release prostaglandins, hormones that stimulate labor. As the water sac separates from your uterus, your cervix may soften and contractions may begin.
Your membranes can only be swept once your cervix opens enough for your doctor to insert a finger. Membrane sweeping to induce labor works for 1 in 8 women. It's one of the less risky labor-induction techniques.
Hormones. At the hospital, your doctor will give you hormones called prostaglandins to open the cervix and trigger contractions. If you've had a C-section in the past, your doctor won't use this treatment because it raises the risk of uterine rupture.
Mechanical dilation. Another way your doctor or midwife triggers labor is with a balloon catheter. At the hospital, your doctor inserts a thin tube through your vagina into your cervical opening. Then, the doctor uses water to inflate the balloon at the end of the tube, causing your cervix to expand.
Medications. The medicine oxytocin (Pitocin) can start contractions. You get this at the hospital through an IV tube in your arm. Your doctor or midwife starts with a small dose and gradually increases it until your contractions are strong and frequent enough for your baby to be born.
Natural ways to induce labor
Acupuncture. In parts of Asia, it has been used for centuries to induce labor. Some studies suggest it can help women who are 40 weeks or less pregnant, but it may not help bring on labor in women who are postterm, or 41 weeks or more pregnant.
Sex. Another strategy that gets positive reviews from doctors and midwives is inducing labor the same way you started your pregnancy: by having sex.
Although there's no proof sex can start labor, there is a good reason why it might. Sex releases prostaglandins. If you're comfortable with having sex, it won't hurt to try. Make sure your water hasn't broken and your doctor or midwife has given you the green light.
Long walks. Going for a walk is good exercise, but experts don't think it will help bring on labor.
Spicy foods. It's a popular theory, but there's no direct connection between the stomach and the uterus. So, there's no reason to think a particular type of food will bring on contractions.
Castor oil. Some experts recommend taking a small amount of castor oil after the 38th week. But castor oil brings on diarrhea and could cause dehydration.
Cohosh. Some people try starting labor with cohosh, but doctors caution that this herb contains plant-based chemicals that may act like estrogen in the body.
Evening primrose oil. This herb has substances that your body changes into prostaglandins, which soften your cervix and get it ready for labor.
Red raspberry leaf tea. Some people think this herbal tea helps bring on spontaneous labor. The verdict is still out, but the tea is full of iron and calcium, which can be healthy for you and your baby. Studies show it's safe to drink this during pregnancy.
Nipple stimulation. This method releases oxytocin, which can trigger contractions.
Eating dates. Research shows that eating dates may lower your chances of needing to be medically induced, but scientists need to carry out more studies to confirm this.
Eating pineapple. Some think an enzyme in pineapple called bromelain may induce labor, but scientific research doesn't support this.
Natural methods of inducing labor "can help get your cervix favorable and ripened and ready for labor," Vernon explains. "But if your body's not ready, you're just going to have painful cramping and you won't go into labor."
Don't try any of these methods without first talking to your doctor or midwife. Some can cause side effects or pose risks.
How Long Does Labor Induction Take?
You might go into labor and deliver within a few hours after induction. Or it may take one or two days to start labor. If none of these methods start your labor and waiting isn't a good option, you'll most likely need a C-section — especially if your water has broken.
Is It Safe to Induce Labor?
Induction doesn't work for everyone, and every pregnant person reacts differently to induction techniques. Generally, inducing labor is safe, but there are risks, such as:
Longer hospital stay. If you're induced, you may be in the hospital longer during labor and delivery. If you need a C-section after induction, your time in the hospital will be even longer.
Increased need for pain medicine. Inducing labor might cause contractions to come on stronger and more often than they would naturally. You're more likely to need an epidural or another medicine to manage the pain.
Increased risk of infection. Breaking the amniotic sac can lead to infection if you don't deliver within a day or two after induction.
Health problems for your baby. Pregnant people who are induced before the 39th week for medical reasons may deliver a baby who has problems with breathing. These babies have a higher risk of long-term developmental problems.
Complications during delivery. Induction, especially with medications, might not be safe if you've previously had a C-section or other surgery to the uterus. You have a higher risk of uterine rupture. Intense contractions also cause the placenta to detach from the wall of the uterus, called placental abruption. Both of these conditions are serious but rare, even with induction.
If your doctor or midwife recommends induction, ask questions. You want to be absolutely sure that it's the best decision for your and your baby's health.
Possible Risks of Not Inducing Labor
Your health. If you let your pregnancy go past full-term, you're at greater risk of a difficult delivery as your baby continues to grow in utero. You're also at an increased risk for a type of high blood pressure that's associated with pregnancy after your due date.
Your baby's health. Your baby is also at risk as your pregnancy goes on. With each passing week, the placenta becomes less effective at passing nutrients and blood to your baby. A baby that grows larger than your birth canal may make a C-section unavoidable.
Staying pregnant longer can increase the risk of your baby passing their first meconium stool in utero. If your baby breathes meconium in the birth canal, it significantly increases their risk of developing an infection. A baby born after 42 weeks of gestation also has an increased risk of sudden infant death syndrome (SIDS).
Takeaways
- Labor induction accelerates your labor process instead of making you wait for it to happen naturally.
- Your doctor or midwife may suggest labor induction if your or your baby's health is at risk.
- You can take medicine, such as oxytocin (Pitocin), or have a procedure, such as mechanical dilation, to start labor.
- You might hear that having sex, getting acupuncture, or going on long walks can induce labor, but more research is needed to show they work.
Labor Induction FAQs
What are the benefits of waiting for labor to start on its own?
A full-term pregnancy allows your baby's organs, such as their brain, lungs, and liver, to develop. They're also less likely to have health problems and be underweight.
Does walking help induce labor?
While it's good for your physical health, experts don't think walking induces labor.
What is the quickest way to induce labor?
The only guaranteed way to bring on labor is by medically inducing it with drugs or an induction procedure.
Is it painful to induce labor?
Inducing labor is often more painful than when it starts naturally. But even when you're induced, pain relief options are available.
