Preparing for the Best Labor Induction

Woman in labor

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An induction of labor is when the start of labor is provoked before it begins on its own. Your provider may suggest that you are induced because of a pregnancy complication like high blood pressure or diabetes. But an induction of labor can also be elective, meaning there is no medical indication for delivery.

Induction of labor can be a positive experience. Having an understanding of what a labor induction entails will help you prepare for the big day. Understanding the process and having realistic expectations are key to helping you prepare.

Know Your Cervix

Once you and your provider have determined that your labor will be induced, you’ll need to know a bit about your cervix. Your doctor or midwife will do a vaginal exam and calculate a Bishop Score that estimates how likely an induction is to bring on labor. It’s easier to get a cervix to open and labor to begin when the cervix is ready or ripe for birth. The cervix is evaluated on:

  • Consistency (firmness)
  • Dilation (openness)
  • Effacement (thickness)
  • Position (which way is it angled)
  • Station (how low the baby's head is in the pelvis)

Each of the points above is given a score of zero, one, two, or three based on an examination. The higher the number, the more likely it is that the cervix will open easily and labor will begin. If this number is low, you may need to have treatments to prepare or ripen the cervix. This helps the cervix be more favorable to other methods of induction.

Ask About Options

There is more than one way to do an induction of labor. Not every option is right for every woman. Factors affecting the choice of induction method include:

  • Conditions inside the uterus (amniotic fluid volume, baby’s position, etc.)
  • Maternal conditions (pre-existing complications, vaginal birth after cesarean [VBAC] status, number of babies previously born, etc.)
  • Maternal preference
  • Practitioner preference
  • The reason for induction

If your cervix needs ripening as part of your induction process, your provider will discuss the most appropriate option. This likely will either be the use of a prostaglandin medication (placed in the vagina or taken by mouth) or mechanical dilation of your cervix with a balloon catheter.

To get contractions going, your provider will most likely recommend using a medication called Pitocin. It is a synthetic version of the hormone oxytocin, which is responsible for natural labor contractions. Pitocin is given continuously through an IV until your baby is born.

In some cases, when it is appropriate, your provider may recommend nipple stimulation to help your body release its own oxytocin. Performing an amniotomy, or breaking the bag of water, may also be an option in certain situations.

Talk about your birth preferences with your practitioner to help figure out the best way to respect those preferences while undergoing an induction of labor.

Know Your Due Date

Often, the closer you are to your due date, the easier it is to get labor going. This is because your body and your baby are closer to being ready for spontaneous labor. Sometimes a woman will show up for induction of labor and already be in the early stages of labor. In this case, any interventions are actually called an augmentation of labor (a speeding up or shortening the duration) of a labor that has already begun.

When considering an induction of labor, your provider will pay very close attention to your due date. If your due date is not well known, or you have not reached 39 weeks gestation, the benefit of early delivery for you and/or your baby will be carefully balanced with the risks of early delivery for your baby.

If you are considering an elective induction of labor (an induction that has no medical indication), your provider will more than likely recommend you wait until you are at least 39 weeks.

Keep Your Balance

While you may be excited to finally meet your baby, you may also be concerned about an induction of labor. Be sure to discuss your concerns with your provider. You may find it helpful to talk about possible scenarios and options for you and your baby. Induction is not an exact science. This means that not every method will work the same way, nor will it necessarily be a fast process.

At the hospital, you may need to adopt a go-with-the-flow attitude. But that doesn’t mean that you have to give everything you had planned for your birth experience. You still have options and choices.

For example, if not using pain relief was important to you, induction does not mean that you have to accept pain relief. Many women are able to keep parts of their birth plans intact, despite induction of labor, with proper planning, practitioner support, and labor support from both family members and doulas.

Questions to Ask Before an Induction

  • How long would we try this before trying something else?
  • What are the likely risks and benefits of each intervention?
  • What happens if this method doesn't work? What's the next step?
  • Will this method require constant fetal monitoring or only brief periods?
  • Will I be able to move around?

Find Support

Many women find induced labors to be very different than spontaneous labor. The mental and emotional factor is a large part of this toll. Support from your family and doula, as well as the medical staff, will be vital to how you think and feel about your birth.

While some inductions of labor happen very quickly, others take much longer. It may mean that you start induction on one day and do not have your baby for a day or two, depending on the condition of your cervix, the methods tried, and how you and your baby handle labor. In fact, sometimes, you're bored at the beginning of induction. Having a team of supporters will help make this time bearable.

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  1. De Vaan MD, ten Eikelder ML, Jozwiak M, et al. Mechanical methods for induction of labour. Cochrane Database Syst Rev. 2019;10:CD001233. doi:10.1002/14651858.CD001233.pub3