Inducing Labor: When and How

If your body does not move into labor on its own your doctor may use medical techniques or medication to get contractions to start. They can use some of the same methods used to augment or speed labor if it is not progressing the way it should for some reason. According to a report produced by the U.S. Centers for Disease Control and Prevention, in 2006 over 1 in 5 births in the U.S. alone were induced, a rate which has doubled since 1990. In this article you will learn the risks of inducing labor and how to induce labor in a safe way.

When Do You Need to Induce Labor?

There are a variety of reasons why your health care practitioner might recommend that you induce labor. Most of these are rooted in concerns for your health or the health of your child.

  • Your water has broken but you are not having contractions
  • You are near 2 weeks beyond your due date without labor starting
  • There is an infection in your uterus
  • There is not an adequate supply of amniotic fluid around the baby
  • The baby has ceased to grow at the predicted rate
  • The placenta has started to deteriorate
  • There is a medical condition present such as diabetes or high blood pressure which puts you at risk
  • The placenta has peeled away from the inner wall of the uterus partially or completely before delivery

The longer pregnancy continues, the larger your baby may be, which could cause complications during vaginal delivery. In some cases, the aging placenta could pose a risk to your child’s health and their ability to continue to thrive in the womb. A baby that is overdue also has a higher risk of inhaling fecal waste which could cause a lung infection or trouble breathing when they are born.

Is It Ok to Wait for Labor to Begin Natually?

In most cases if you are two weeks or less after your due date your doctor will use the “wait and see” approach. Nature will prepare the cervix for delivery in a way that is the most comfortable and efficient for your body. However, your health or the baby’s health could be at risk if you do not go into labor after 2 weeks following your due date. At this point it may be best to induce.

When Is Inducing Labor Dangerous?

If it would be unsafe for you to deliver vaginally then you should not have labor induced. This could occur in a variety of situations including:

  • You have placenta previa where the placenta is lying in an unnaturally low position in your uterus
  • Tests indicate that your body could not tolerate contractions or your baby needs to be delivered immediately
  • Your baby is in a transverse position or breech
  • You have had a “classical” uterine incision during a previous C-section or other surgery on your uterus
  • You have had multiple C-sections previously
  • You have had a genital herpes infection
  • You are having triplets or more babies
  • You are having twins but the first baby is a breech

What Are the Risks of Inducing Labor?

There are risks associated with inducing labor which include:

  • Bleeding after delivery. Inducing labor increases the risk that the muscles in your uterus will not contract properly which could lead to serious bleeding.
  • Uterine rupture. This is a rare but serious condition where the uterus tears along the seam from a previous C-section or surgery. If this occurs an emergency C-section will be necessary
  • Umbilical cord problems. If labor is induced it increases the risk of the umbilical cord slipping through the vagina before delivery occurs. This can cause compression on the cord which could limit your baby’s ability to get oxygen.
  • Infection. Inducing labor puts additional risk of infection on mother and baby.
  • Premature birth. Inducing labor too early in your pregnancy could cause a premature birth which increases the baby’s risk of complications.
  • Low heart rate. If medications such as prostaglandin or oxytocin is used to induce labor it can provoke excessive contractions which can lower the baby’s heart rate and their oxygen supply.
  • Need for C-section. Inducing labor will increase your risk of needing a C-section. This is particularly true for those that have never given birth and your cervix has not yet started to soften or dilate.

Inducing Labor at the Hospital

If you have passed your due date, your midwife or doctor may recommend you visit the hospital to have labor induced. Women that are experiencing high risk pregnancies may be induced very close to their due dates. Low risk pregnancies will often be induced at 42 weeks at the very latest. Below are common procedures used to induce labor at the hospital:

Procedures

Description

Strip the membranes

Your doctor will use a gloved hand to reach through the vagina and cervix and move their finger back and forth to separate the membrane which connects the amniotic sac to the uterine wall. When this is stripped your body will naturally release prostaglandins that can help to prepare the cervix and start contractions.

Break your water--Amniotomy

The doctor will start a vaginal exam and use a small plastic hook to break the membrane of the amniotic sac. If the cervix is prepared for labor this can bring about labor in just a few hours.

Give prostaglandin hormones to ripen the cervix

A vaginal insert or gel holding prostaglandin will be placed into the vagina. You can also be given this hormone orally. This is an overnight treatment given in the hospital that will ripen the cervix for delivery.

Give oxytocin to stimulate contractions

If other methods have not brought about labor, oxytocin can be given via an IV starting in small doses and gradually increasing until labor progresses as needed. After this drug is given the uterus and fetus will need to be monitored to ensure that labor has not stalled and that mother and baby are healthy.

Watch a video for explanations on procedures taken by doctors to induce labor:

Notes on Inducing Labor at Home

Nipple stimulation or a breast massage can help to release oxytocin in the body which could stimulate contractions. However, this technique is only effective if your cervix has started to ripen. There is also not much research regarding whether or not this technique is safe or effective.

Other techniques such as having sex or consuming spicy foods also lack scientific evidence to determine if they are safe or effective to use. Do not attempt to start labor at home without approval from your doctor for the techniques you have been using. If you do are given permission by the doctor, watch the following video to learn what you can do to induce labor. Click here to learn more ways to induce labor. 

How to induce labor naturally: