How to Induce Labor

Ways to induce labor

Verywell / Madelyn Goodnight

As your pregnancy nears its end, you may want to get labor going as soon as possible for a variety of reasons. You may have a baby who's measuring large or certain medical issues that lead your doctor to think it's safer for you to give birth right away. Or, you may pass the 40-week mark and are anxious for your baby to arrive (and the pelvic pain, interrupted sleep, and indigestion to end).

Induction is the formal term for the process of stimulating uterine contractions before you naturally go into labor. Some 22% of pregnant women in the United States have their labor induced, according to the American College of Obstetricians and Gynecologists (ACOG).

To induce labor, doctors commonly use techniques like membrane sweeping or medications, but some people try to get things moving through alternative methods, from acupuncture to sex. Learn all about these common labor induction approaches and why it's important to keep in constant communication with a healthcare provider as you consider ways to speed up labor.

Medically Induced Labor  

Many doctors will recommend induction if your pregnancy goes beyond 41 or 42 weeks since your placenta becomes less efficient at nourishing your baby by that time. Some doctors suggest inducing at 39 weeks since research shows that babies born then have the healthiest outcomes. Before that, induction is only recommended when your health or your baby's health is at risk due to infection, a medical condition like preeclampsia, low amniotic fluid levels, or other problems.

There are many ways that a medical professional can induce labor. All of these methods should be performed only by a doctor or, in some cases, a midwife or doula. Don't try them yourself.

A recent study found that people who had elective labor induction at 39 weeks were not more likely to have a Cesarean section than those who went into labor after their due dates. “This supports the safety of elective induction at 39 weeks,” says Juan C. Sanchez, MD, an obstetrician at the Family Health Centers at NYU Langone. . “However, many in the medical community still prefer to allow patients to wait for spontaneous labor contractions rather than schedule elective induction of labor.”

Membrane Sweep

Membrane sweeping or stripping is when a doctor, midwife, or doula gently separates the amniotic membrane from your cervix to stimulate the release of prostaglandins, hormones that are essential for "ripening" (softening) the cervix in preparation for delivery.

“Membrane sweeping is done in the office setting after 38 weeks,” says Meleen Chuang, MD, medical director of women’s health at the Family Health Centers at NYU Langone. "There could be light bleeding from the cervix, and sometimes your water may break."

This procedure is sometimes offered at term once your cervix has begun to dilate, adds Jada Shapiro, birth doula and founder of boober, which offers classes for expectant parents and new families. “For most people, this will cause the onset of labor within a few days."

Amniotomy

Most people go into labor within hours after their water breaks (when the fluid-filled amniotic sac bursts). By artificially rupturing this sac, your doctor can jump-start contractions that have not begun yet or have stalled.

To do an amniotomy, your doctor will use a special device to create a hole in the sac with a special device. Sometimes, medications are used along with this procedure to move labor along.

Balloon Catheter

A balloon catheter, otherwise known as a Foley Bulb, is another option to discuss with your medical team if your birth is being induced. In this procedure, a catheter is placed and inflated with sterile water above the cervix, inside the uterus. The balloon mechanically dilates the cervix.

Balloon catheter induction does not require the use of medications, says Dr. Chuang. However, it can be used in conjunction with medications such as Cytotec (misoprostol), which is a small tablet placed by a doctor into the vagina or taken orally that will release prostaglandins to help soften the cervix and cause contractions.

When used in conjunction with medication, the balloon has been shown to increase the chance of delivery within 24 hours.  However, the procedure can be uncomfortable, and those with ruptured membranes cannot take advantage of this option. In addition, patients with previous C-section scars should not use the misoprostol pill because of the risk of uterine rupture.

Pitocin / Oxytocin IV Infusion

Administrated at a hospital under close medical supervision, pitocin and oxytocin infusions can be used to increase the rate and strength of contractions, says Dr. Chuang.

“While the medication dose is continually adjusted to achieve an adequate contraction pattern, fetal heart rate changes are continually monitored to ensure the well-being of both mother and baby,” says Dr. Sanchez. “If contractions are not well tolerated by the baby, this will limit the ability to administer oxytocin.”

Alternative Therapies to Induce Labor

Aside from medical techniques, many people turn to alternative methods to induce labor. While some of these induction techniques have a long tradition of use in several cultures and tend to not be performed in a hospital setting, it's important to consult with a doctor or a trained midwife or doula about trying them.

Chiropractic and Massage Methods

“There are many ways to induce labor outside of the conventional, clinical methods,” says Shapiro. Chiropractors and specially trained massage therapists attempt to help align the pelvis and stimulate labor initiation through certain bodywork techniques.

The Webster Technique is a gentle adjustment that chiropractors use to help "make space" in the pelvis. Some research indicates this technique can be helpful if a baby is in a breech position. Prenatal massage therapists may stimulate specific acupressure points to bring on labor.

Acupuncture

Acupuncture uses very fine needles that are inserted into specific points in the body to stimulate blood flow or relieve certain symptoms. While acupuncture appears safe in pregnancy, data supporting its use to induce labor is limited. “Limited observational [studies] have shown a change in cervical maturation with acupuncture,” says Dr. Sanchez. “However, the length of labor does not appear to be shortened.”

Many acupuncturists stress they do not induce labor, but rather, prime a person's body to be physically, mentally, and emotionally prepared for it. “We help prepare the expectant parent for labor and support the smooth labor process, which is an important distinction,” says Daryl Thuroff, DACM, who holds a doctorate in Acupuncture and Chinese Medicine and is Bodywork Program Manager at Yinova in New York City.

Acupuncture-based preparation for labor usually starts around 36 weeks by a licensed professional. Along with acupuncture, practitioners often use moxibustion, where moxa (mugwort leaves) are burned over particular parts of the body (often in an attempt to turn a breech baby). They might also use Chinese herbal medicine for placenta previa and massage to help manage anxiety and pain that comes from contractions, says Dr. Thuroff.

At-Home Methods to Induce Labor

You’ve surely heard of a friend or family member who's gone into labor because they ate some exotic food or had sex every day in their third trimester. “There are many natural and anecdotal practices one can try at home to encourage labor,” says Dr. Thuroff.

Keep in mind that while some common at-home methods may seem to speed things up for some people, they may not work for all, and a few have unpleasant side effects, says Dr. Thuroff.

Eating Spicy Foods

There's little research to show spicy foods bring on labor, but some people swear by it. Anecdotal evidence suggests belly upset could be the trigger. "Spicy foods, for those not used to them, can increase digestive upset and a release of prostaglandins which may help stimulate labor," says Shapiro.

Eating spicy foods is not usually problematic during pregnancy, but it's always best to run any dietary changes by your doctor. “There is no harm if there is no known GI disease," says Dr. Chuang. "But it's not recommended [if you have] irritable bowel syndrome, Crohn's disease, ulcerative colitis, or peptic ulcer disease."

Castor Oil

Castor oil is taken orally and is a known laxative that can cause uterine irritation and contractions. “The increased bowel movements may help stimulate labor onset," Dr. Chuang explains.

The science is not definitive, but some research suggests that castor oil can help induce labor within 24 hours if a woman is 40 weeks pregnant. But don't try downing castor oil without speaking with your doctor first. “There are not any identified downsides or harmful effects on mother or baby but it may cause dehydration, diarrhea, or cramping in the stomach,” says Dr. Chuang.

If you are looking to increase bowel movements in an attempt to speed up the start of labor or just dealing with pregnancy constipation, high-fiber fruits like pineapple, papaya, or prunes are a tastier bet.

Nipple Stimulation 

There's some evidence that this age-old midwifery technique may safely stimulate labor on or after your due date.Nipple stimulation can be done a few minutes at a time while you monitor for contractions and fetal movement,” says Dr. Chuang.

If your doctor green lights it, you can try some sensual play to help move things along. “Massaging and stimulating your nipples and having orgasms create the hormone oxytocin, also known as the love hormone,” says Shapiro. “Oxytocin initiates labor, creates uterine contractions, helps move your milk during lactation, and is the hormone which promotes bonding."

Sexual Intercourse

“Semen is a prostaglandin and the thought is the stimulation from sex and semen may help promote the release of more prostaglandin,” says Dr. Chuang.

Sex is mostly regarded as safe throughout pregnancy, though there are concerns if you have certain conditions, including placenta previa or a breech pregnancy. Discuss your individual risk factors with your doctor before having penetrative sex late in pregnancy.

Long Walks

One easy way to help get things going with no side effects? Take a walk! "Walking every day after 37 weeks can help allow for the descent of baby and increase contractions," says Dr. Chuang.

A gentle, regular exercise routine during pregnancy like walking is a great way to stay healthy and keep your spirits up during pregnancy. As you round your due date, any sort of light physical activity may help things along. "Women who are more active are more likely to go into spontaneous labor," says Dr. Chuang.

A Word From Verywell

It's natural to want to speed up the start of labor as you get more and more uncomfortable towards the end of your pregnancy. In some cases, like when you have a medical condition that puts you or your baby at risk for problems before or during childbirth, your doctor might even recommend it. Be sure to talk to your obstetrician, midwife, or another medical provider about all of your options for labor induction, both medical and natural. The most important thing is that your baby arrives in a time and manner that's safest and healthiest for them and you.

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9 Sources
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