All About How to Induce Labor

As your due date approaches, you may be curious about the process of labor induction, especially if you're eager to be done with pregnancy. You may even have discussed the pros and cons of inducing labor with your healthcare provider, or asked about natural ways to induce labor at home. Read on for answers to some frequently asked questions on this topic, and speak to your doctor for advice regarding your particular situation.

What Is Inducing Labor?

This is when a doctor gives you labor-inducing medication or uses another technique to try to bring on your labor or speed up your contractions.

When Does Labor Need to Be Induced?

Labor might need to be induced for medical reasons; for example, if continuing the pregnancy would be harmful for you or your baby. Some other reasons can include:

• Post-term pregnancy. If it’s two weeks past your due date, an induction might be recommended to avoid the pregnancy lasting longer than 42 weeks.

• Premature rupture of membranes. This means that your water has broken, but labor hasn't begun naturally yet.

• Infection of the uterus, placenta, or amniotic fluid.

• Fetal growth restriction. The baby has stopped growing at the expected rate.

• There's not enough amniotic fluid surrounding the baby.

• You’ve developed diabetes during pregnancy.

• A high blood pressure disorder such as preeclampsia, chronic high blood pressure, or gestational hypertension.

• Detached placenta.When the placenta detaches from the inner wall of the uterus before delivery.

When considering when to induce labor, your doctor will look at these factors:

• Your health

• Your baby's health

• How far along you are in your pregnancy

• Your baby's weight and size

• Your baby's position in the uterus

• How soft and thin your cervix is

Are There Reasons Why Induction Might Not Be Recommended?

Yes. In some cases, your doctor might recommend a cesarean birth, or c-section, instead of inducing labor. These cases can include:

• A previous cesarean section. If you've had a c-section with a classical incision or major uterine surgery previously, induction could be risky. In some situations, though, the doctor may simply avoid certain types of medications to help prevent a rupture of the uterus.

• Placenta previa If the placenta is blocking the cervix.

• The baby is not positioned head down. If the baby is lying buttocks first (breech) or sideways (transverse lie).

• If you have an active genital herpes infection. In this case, a c-section may be recommended to avoid transmitting the infection to the baby.

• Umbilical cord prolapse. If the umbilical cord slips into the vagina before delivery.

What Is an Elective Induction?

An elective induction is when there is no medical reason for inducing labor, but the doctor schedules the induction in advance either for convenience or to ensure the baby is delivered safely. For example, an elective induction may be scheduled if the mom-to-be lives far from the hospital or if she has a history of fast deliveries. Before scheduling an elective induction, the doctor will first confirm the pregnancy is at least 39 weeks along.

Is Inducing Labor Safe?

Vaginal birth that begins naturally, when the cervix is ready for delivery, is generally the best and most efficient way to start the birth process. However, sometimes nature needs a little help. If this is true for you, your doctor will weigh the pros and cons of inducing labor and discuss those with you, and go over any relevant risks of inducing labor.

Medical inductions are conducted in the hospital where you and your baby can be safely monitored. Possible risks include:

• Excessive contractions causing changes to the fetal heart rate>

• Umbilical cord problems

• Increased need for a cesarean section

• Uterine rupture

• Bleeding after delivery

• Infection

What Are the Best Ways to Medically Induce Labor?

When labor is induced, the uterus is stimulated to contract so that a vaginal birth is initiated. How doctors induce labor can vary, but here are a few of the methods:

• Ripening the cervix. Doctors might use either medications or devices to help soften or thin out the cervix in a process called “ripening the cervix.” This helps encourage contractions to start.

• Stripping the membranes to induce labor. To encourage the natural production of prostaglandins (which help ripen the cervix, bringing on contractions), doctors might brush a finger over the membranes that connect the amniotic sac to the wall of the uterus.

• Administering oxytocin. A common labor-inducing drug is a synthetic version of the hormone oxytocin. It is administered intravenously to help induce labor, and can also be used to speed up contractions.

What Happens After Labor Is Induced?

After inducing labor, it can be a matter of hours or days before your baby is born. It depends on how ripe your cervix is, which induction method is used, and how your body reacts.

Sometimes the induction may not work, and so your doctor may try the same method again, try another labor-inducing technique, or suggest a cesarean section if your labor doesn’t start naturally.

To help things go smoothly, consider discussing comfort measures and pain relief during labor before labor is induced.

Is There a Safe Way to Naturally Induce Labor at Home?

You may have heard about various natural tricks and home remedies that may induce labor. One example is taking castor oil, which is a laxative. Consult your doctor or midwife if you're considering using castor oil to help induce labor and keep in mind that the side effects can include uncomfortable intestinal cramps and diarrhea. It's important to remember that although there are lots of old wives’ tales about how to induce labor at home, these methods are not backed by science, and some (such as herbal supplements) can even cause harm. Ask your doctor or midwife whether it’s OK to speed things up, and how to safely give nature a helping hand.