What is Labor Induction

Labor induction is when steps are taken to cause a pregnant woman to begin the labor process. Most women go into labor on their own between 37 weeks and 42 weeks of pregnancy.

When this does not happen or when there is a medical need for labor to begin, steps may be taken to induce labor. Labor induction causes a pregnant woman’s uterus to contract. It also causes the cervix to soften (ripen), open (dilate), and thin out (efface).

Usually, labor is not induced before 39 weeks of pregnancy unless there is a medical reason to do so. Your health care provider will determine if labor induction is needed.

Before inducing labor, your health care provider will consider a number of factors, including:

• Your medical condition and your baby’s.
• How many weeks along you are in your pregnancy.
• How mature your baby’s lungs are.
• The condition of your cervix.
• The position of your baby.
• The size of your birth canal.

What are some reasons for labor induction?

Labor may be induced if:

• Your health or your baby’s health is at risk.
• Your pregnancy is overdue by 1 week or more.
• Your water breaks but labor does not start on its own.
• There is a low amount of amniotic fluid around your baby.

You may also choose (elect) to have labor induced at a certain time. Generally, elective labor induction is done no earlier than 39 weeks of pregnancy.

What methods are used for labor induction?

Methods used for labor induction include:

• Prostaglandin medicine. This medicine starts contractions and causes the cervix to dilate and ripen. It can be taken by mouth (orally) or by being inserted into the vagina (suppository).
• Inserting a small, thin tube (catheter) with a balloon into the vagina and then expanding the balloon with water to dilate the cervix.
• Stripping the membranes. In this method, your health care provider gently separates amniotic sac tissue from the cervix. This causes the cervix to stretch, which in turn causes the release of a hormone called progesterone. The hormone causes the uterus to contract. This procedure is often done during an office visit, after which you will be sent home to wait for contractions to begin.
• Breaking the water. In this method, your health care provider uses a small instrument to make a small hole in the amniotic sac. This eventually causes the amniotic sac to break. Contractions should begin after a few hours.
• Medicine to trigger or strengthen contractions. This medicine is given through an IV that is inserted into a vein in your arm.

Except for membrane stripping, which can be done in a clinic, labor induction is done in the hospital so that you and your baby can be carefully monitored.

How long does it take for labor to be induced?

The length of time it takes to induce labor depends on how ready your body is for labor. Some inductions can take up to 2–3 days, while others may take less than a day. Induction may take longer if:

• You are induced early in your pregnancy.
• It is your first pregnancy.
• Your cervix is not ready.

What are some risks associated with labor induction?

Some risks associated with labor induction include:

• Changes in fetal heart rate, such as being too high, too low, or irregular (erratic).
• Failed induction.
• Infection in the mother or the baby.
• Increased risk of having a cesarean delivery.
• Fetal death.
• Breaking off (abruption) of the placenta from the uterus (rare).
• Rupture of the uterus (very rare).

When induction is needed for medical reasons, the benefits of induction generally outweigh the risks.

What are some reasons for not inducing labor?

Labor induction should not be done if:

• Your baby does not tolerate contractions.
• You have had previous surgeries on your uterus, such as a myomectomy, removal of fibroids, or a vertical scar from a previous cesarean delivery.
• Your placenta lies very low in your uterus and blocks the opening of the cervix (placenta previa).
• Your baby is not in a head-down position.
• The umbilical cord drops down into the birth canal in front of the baby.
• There are unusual circumstances, such as the baby being very early (premature).
• You have had more than 2 previous cesarean deliveries.

Summary

• Labor induction is when steps are taken to cause a pregnant woman to begin the labor process.
• Labor induction causes a pregnant woman’s uterus to contract. It also causes the cervix to ripen, dilate, and efface.
• Labor is not induced before 39 weeks of pregnancy unless there is a medical reason to do so.
• When induction is needed for medical reasons, the benefits of induction generally outweigh the risks.