There are several reasons women choose to induce labor, but most often it’s out of medical necessity. If you have questions talk to your doctor, and remember that the end goal is a safe birth and a healthy baby.
Inducing labor — also known as an induction of labor (IOL) — is done for a variety of reasons, but the goal is to start the labor process for whatever reason, including complications with pregnancy such as low fluid around the baby, restricted growth, gestational diabetes, and being post-dates (or past your due date). There are a lot of reasons why you can be induced, but unless you have a medical reason, it is usually best for you and your baby to wait until your doctor thinks it is necessary. Sometimes, this can be as late as one t0 two weeks after your due date.
Initiating Induction of Labor
An IOL is started based on a handful of factors, including how ready your body is for labor. This means that if your cervix is long, thick and closed, otherwise not ready yet for labor, expect the process to be slow, as it is difficult to jump start your labor. The doctor will start with one of three options – first, you are usually admitted to the hospital, then a pill or gel is placed near the cervix.
You will need to wait up to six to 12 hours to see how you respond to the medicine, and may even start feeling contractions quickly, as everyone responds differently to medication. Sometimes, if you are stable, you may even receive the gel then be sent home and admitted the next morning (this is common with post-dates IOLs).
The nurse or doctor will recheck you and then decide the next best step. Sometimes this is administered vaginally, other times this is starting IV pitocin, which is a man-made version of the hormone your body normally makes for contractions. Also, it is common to have your water broken at 3-4 cm of dilation, as this helps jump start your labor.
Another option for starting labor is a balloon placed inside your cervix that causes pressure to start the dilation process.
If you come to the hospital already dilated and your cervix is soft and thinning out, the doctor will likely start pitocin first, and consider breaking your water earlier. Pitocin will need to be increased until you feel strong or “adequate” contractions. They are deemed adequate once your cervix makes consistent change.
The Cons of Inducing Labor
It’s important to know that having an induction of labor can increase your risk of Cesarean section, simply because you are trying to force your body into labor when it isn’t necessarily ready. That is one reason why you should be patient with your IOL, as it can take up to 48 hours if needed. Also, IOLs tend to hurt more than natural labor, simply because we are forcing your body to have contractions, which may be more painful than what your body would normally do.
There are some times you cannot have an induction, most notably if you have had a C-section before. Also, your doctor may not be able to do an induction if your baby isn’t strong enough for labor or if you are too sick and need to have the baby quickly (such as severe preeclampsia or having an abruption).
The most important thing to remember is to deliver a healthy baby. Talk to your doctor about an induction of labor near the end of your pregnancy if you have any questions.
Tamsen Carson, PA
Tamsen Carson is an OB/GYN physician assistant with Renown Health. She provides essential prenatal, pregnancy and post-pregnancy care to women, including delivering babies. Tamsen completed her OB/GYN Physician Assistant residency at Arrowhead Regional Medical Center in Colton, CA and has been a part of the Renown Health team for more than five years.