Labor Induction

What Is Labor Induction?

If your doctor or midwife has concerns about your health 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 women, but it has risks.And it doesn’t always work. If it doesn’t, you may need another induction or 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.

Why Is Labor Induced?

Induction is very common -- 1 out of 4 women in the U.S. starts labor with induction. Many times it's done for medical reasons, but it can be elective.

Why do some women need to have labor induced?

You’re 1-2 weeks past your due date. Studies show that inducing labor at 39 weeks doesn’t raise the risk for 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 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 potential for infection.

A problem puts you or your baby’s health at risk.Examples are infection (chorioamnionitis), too little amniotic fluid (oligohydramnios), and placental abruption. If you have conditions like diabetes, high blood pressure, preeclampsia, or eclampsia, your doctor or midwife might want to induce labor.

If your baby isn’t growing as it should be, or has an abnormalheart 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. Because induction poses some risks, experts say that women shouldn't be induced unless it's medically necessary.

Reasons Not to Induce

You doctor shouldn’t induce if:

You had C-section before that involved a classical incision or major surgery

The placenta is covering the cervix (placenta previa)

Your baby is in the wrong position (sideways or feet-first)

How Is Labor Induced?

There are a few ways a doctor or midwife can induce your labor, including:

Stripping the membranes. In this procedure, your doctor or midwife will use a gloved finger to gently separate the amniotic sac from the wall of the uterus at the cervix. This releases hormones that can trigger contractions. You can get it done in your doctor's or midwife's office. It can be uncomfortable. Afterward, you’ll probably go home to wait for contractions. You might have cramping and spotting.Studies disagree about how well membrane stripping works. Considering that and the discomfort it causes, talk over the pros and cons with your doctor or midwife beforehand.

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 Pitocin (oxytocin) 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.

Some women go into labor and deliver within a few hours after induction. Others take 1 or 2 days to start labor. If none of these methods starts your labor, and staying the course isn’t a good option, you'll most likely need a C-section, especially if your water has broken.

What Are the Risks of Inducing Labor?

Induction doesn’t work for everyone, and every pregnant mom’s body reacts differently to induction technique. Generally, inducing labor is safe, but there are risks:

Longer hospital stay . If you're induced, you may be in the hospital longer during labor and delivery. If you wind up needing 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. Women 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 for women who’ve had a previous C-section or other surgery to the uterus. They 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 health and your baby's health.

Can I Induce Labor Myself?

Tales abound of home remedies that supposedly bring on labor, but there is no scientific evidence to back them up. These methods include:

Having sex

Gently stimulating your nipples

Herbal remedies including blue or black cohosh (some herbs can be dangerous if you don’t use them properly)

Drinking small amounts of castor oil (Recent, well-controlled studies say it’s safe during late pregnancy but castor oil can have unpleasant side effects, like diarrhea.)

Walking

Don’t try any of these methods without first talking to your doctor or midwife. Some can cause side effects or pose risks.

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