Inducing labor is a common medical intervention used to stimulate uterine contractions before spontaneous labor begins. While it can be a necessary and safe option in many cases—such as when a pregnancy extends beyond term, when there are health concerns for the mother or baby, or when the water breaks without contractions—it also involves important considerations. 

Understanding the reasons for induction, the methods used, and the potential risks and benefits is essential for expectant mothers and their families as they prepare for childbirth. Here, Holly Krone, a nurse in the Riverside Family Birthing Center, discusses the key facts about labor induction to help guide informed decisions during the final stages of pregnancy.

Why Do Women Undergo Induction?

Labor induction involves starting labor artificially through methods like medication or breaking the water to trigger contractions and cervical dilation. It may be recommended for medical reasons such as going past 41 weeks, premature rupture of membranes, high blood pressure, gestational or preexisting diabetes, cholestasis, or concerns about the baby's growth or amniotic fluid levels. In some cases, induction may also be elective, beginning at 39 weeks.

“If there are any medical concerns or indications, your provider will go over recommendations and the safest course of action. If you're considering an elective induction, you can always bring it up with your provider. And, if appropriate, they'll schedule it for you,” explains Krone. “In some cases, patients come to labor and delivery with specific concerns or for additional monitoring. Based on their overall clinical picture, the provider may recommend moving forward with an induction at that time.”

The Induction Process, Start to Finish

When you arrive for a scheduled induction, you'll be changed into a gown and settled in bed, and your baby’s heart rate will be monitored for at least 20 minutes. After reviewing your medical history and preferences, an IV will be started and labs will be drawn. A cervical exam will help determine the best induction method. Once induction begins, continuous monitoring of your baby and contractions is required, but portable monitors allow you to move around to help labor progress.

“The method of induction depends on that cervical exam, which helps us assess several different things,” notes Krone. “We take into consideration dilation or how open the cervix is, effacement or how thin it is, its consistency, whether it's firm, medium or soft, its position, and fetal station or how high or low the baby's head is in the pelvis.”

For example, if the cervix isn’t ready for labor, cervical ripening is the first step. This can involve medications like Cervidil (a vaginal insert used for 12 hours) or Cytotec (a pill taken orally or vaginally every four hours), both designed to soften the cervix—similar to softening cold butter to room temperature. 

Another option is a balloon catheter, which uses gentle pressure to help the cervix dilate over about 12 hours. If the cervix is already dilated and the baby is low enough, the provider may break the water to trigger stronger contractions. Pitocin, a synthetic form of oxytocin, may also be used via IV to stimulate contractions, which typically begin within 30 minutes and increase in intensity over time.

How Long Does the Induction Process Take?

The length of the induction process can vary greatly. Some progress quickly, while others take more time, especially if cervical ripening is needed. Factors like the induction method, how the body responds to medications, and whether it’s a first-time birth all influence the timeline. For first-time moms, labor often takes longer and may span over a couple of days before active labor begins.

“Overall, whether it's spontaneous or induced, induction may take more time because the body hasn't gone through that process before, and the cervix may need additional preparation before contractions become regular and effective,” shares Krone. “But, for those who have given birth before, labor often progresses more quickly, whether induced or spontaneous.”

Pain Management Considerations

It’s important to think about pain management before labor begins, as being informed can help you feel more in control. Two common medication-based options include Stadol, an IV pain reliever that takes the edge off early contractions but may cause drowsiness or dizziness, and an epidural, which offers longer-lasting relief. An epidural involves placing a catheter in the lower back to deliver continuous medication that numbs the lower body, significantly reducing pain while still allowing you to feel pressure.

There are also non-medication techniques that can make a huge difference in managing discomfort, such as breathing exercises, movement and positioning, counterpressure and massage, and guided relaxation. 

“Finding out you're going to be induced can bring a lot of emotions, excitement, nerves, maybe even uncertainty. Patients should have open conversations with their providers about that process, including why it's being recommended and the anticipated method to do so,” urges Krone. “The best way to prepare is to educate yourself about that process so you feel more confident going into it. And, go in with flexibility and patience.”

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