Inducing labor

Inducing labor (also called labor induction) is when your health care provider gives you medicines or uses other methods to start your labor. Your provider may recommend inducing labor if you have medical problems that could harm you or your baby, or if your pregnancy lasts longer than 42 weeks. For some women, inducing labor is the best way to keep mom and baby healthy.

More inductions are being scheduled a little early for non-medical reasons. This can cause problems for you and your baby.

If your pregnancy is healthy, it’s best to let labor begin on its own. If your health care provider talks to you about inducing labor, ask if you can wait until at least 39 weeks to be induced. This gives your baby’s lungs and brain all the time they need to fully grow and develop before he’s born. If there are problems with your pregnancy or your baby’s health, you may need to have your baby earlier.

What is labor?
You’re in labor when you have short, regular contractions of the uterus (womb). Contractions happen when the muscles of your uterus get tight and then relax. They help push your baby out of the uterus and help your cervix to dilate (open up). The cervix is the opening to the uterus that sits at the top of the vagina (birth canal). Your baby comes through the cervix into the vagina during birth.

Why is labor induced?
Your provider may need to induce labor to help keep you and your baby safe. Here are some medical reasons for inducing labor:

• Your pregnancy lasts longer than 42 weeks. After 42 weeks, the placenta usually stops working well enough to keep your baby healthy. The placenta grows in your uterus and supplies your baby with food and oxygen through the umbilical cord.
• Your placenta is separating from your uterus.
• You have an infection in your uterus.
• You have high blood pressure caused by pregnancy.
• Your water breaks (amniotic sac that holds your baby breaks), but contractions don’t begin.
• You have health problems, such as diabetes, that may harm you or your baby.
• Your baby has a growth problem.
• You have Rh disease.

Labor should be induced only for medical reasons to protect the health of you and your baby. If your pregnancy is healthy, it’s best to let labor begin on its own without inducing labor.

How is labor induced?
Your health care provider uses one or more of these methods to induce labor:

• Separating the amniotic sac from the wall of the uterus (also called stripping the membranes). The amniotic sac is the bag inside the uterus that holds your growing baby. It’s filled with amniotic fluid. Your health care provider gently puts a gloved finger through your cervix and separates the sac from your uterus. When this is done, you may feel some cramping or have some spotting. You can have this procedure done in your provider’s office.
• Ripening the cervix. Your provider gives you medicine that helps soften and thin your cervix. The medicine comes as a pill you take by mouth, or in a gel or suppository that your provider places in the vagina up against the cervix. A suppository is a kind of pill that that melts once it’s in place. You get this medicine at the hospital.
• Giving you medicines to start contractions. Providers often use a medicine called Pitocin to induce labor. Pitocin is the man-made form of oxytocin, a hormone your body makes to help start contractions. At the hospital, your provider gives you Pitcon through an IV (a needle into a vein). Pitocin may make you have really strong contractions. Ask your provider about pain medicine you may want to have during labor. Pitocin also may upset your stomach. Before you go to the hospital, follow your provider’s instructions about what to eat. She may tell you to eat only light foods, like soup or Jell-O®.
• Breaking your water (also called rupturing the membranes). Your health care provider uses a small hook that looks like a knitting needle to break the amniotic sac that holds your baby. This shouldn’t be painful, but you may feel a warm gush of fluid.

How long after inducing labor do you have your baby?
Inducing labor can take a few hours or as long as 2 or 3 days. It depends on how your body responds to your treatment. Inducing labor may take longer if you’re pregnant for the first time or if your baby is less than 37 weeks.

What are the risks of inducing labor?
Risks include:

• Your due date may not be exactly right, so your baby may be born too early. Sometimes it’s hard to know just when you got pregnant. If you schedule an induction and your due date is off by a week or 2, your baby may be . If your pregnancy is healthy, wait for labor to begin on its own. If you need to schedule an induction for medical reasons, ask your provider if you can wait until at least 39 weeks. This gives your baby’s lungs and brain the time they need to fully grow and develop before birth.
• Pitocin can make labor contractions very strong and lower your baby's heart rate. Health care providers carefully monitor your baby's heart rate when inducing labor. They may change or lower the amount of Pitocin you’re getting. Using less Pitocin can make your contractions weaker and help keep your baby’s heart rate safe.
• You and your baby are at higher risk of infection if labor doesn’t begin a short time after your membranes rupture. The amniotic sac normally protects your baby and your uterus from infection. But once it breaks, germs like bacteria can get in more easily and infect you and your baby.
• There may be problems with the umbilical cord. For example, if the amniotic sac is broken, the cord may slip into the vagina before your baby does. This is more likely to happen if the baby is breech (when your baby’s bottom or feet are facing down right before birth), or if the baby’s head is still high in the uterus. Or the cord may get squeezed. If it’s squeezed, the baby doesn’t get enough food and oxygen. These problems can be serious for your baby.
• Sometimes induction doesn't work, and you need to have a cesarean birth (c-section). C-section is surgery in which your baby is born through a cut that your provider makes in your belly and uterus.
• You may have a uterine rupture. A uterine rupture is a tear in the uterus. It can cause serious bleeding. If you’ve had a c-section in a prior pregnancy, you’re at higher risk of uterine rupture because ac-section leaves a scar in the uterus. Uterine rupture is a rare complication of labor induction.

What questions can you ask your provider about inducing labor?
If your provider recommends inducing labor before 39 weeks:

• Is there a problem with my health or the health of my baby that may make me need to have my baby early?
• Can I wait to have my baby closer to 39 weeks?

About inducing labor:

• Why do you need to induce my labor?
• How will you induce my labor?
• Does inducing labor increase the chance that I'll need to have a c-section?
• What are my options for pain medicine?

Last reviewed January 2012

See also: C-section: Medical reasons, Why at least 39 weeks is best for your baby