Different Ways Labor Is Induced (2023)

What is induction? We talk about inducing labor as a wayto artificially start the process of labor. This usually happens when there is a medical need for the baby to be born sooner or for the mother to not be pregnant.

When labor needs to start, there are multiple ways to approach it. Many people are surprised to find that there are many different types of induction. No single method will work for every pregnancy.

Breaking the Bag of Water

Using an item called an amnihook, your practitioner will make a tiny tear in the bag of water. This will cause the water to begin leaking out. Since the bag does not have nerves, this should be no more painful than your average vaginal exam. The thought is that once the bag is ruptured contractions will usually begin.

Benefits: No chemicals may be needed, you maintain more mobility than if you were required to have an IV.

Disadvantages: Contractions may not start and then this leads you to other interventions such as the use of Pitocin.It may additionally create an infection of the sac, the cushion for the baby is now removed, and rarely, but possibly, the prolapse of a cord, necessitating an immediate cesarean.

Breaking the amniotic sack also requires that you have a babywithin a certain amount of time, depending on the circumstances and your practitioner's beliefs. It is better to use amniotomy with other methods of induction.

Artificially Breaking Water to Start Labor

Pitocin

This is an artificial version of the body's hormone oxytocin. It is given by way of an IV lineand is used to cause contractions. The amount of Pitocin used will depend on how your body accepts it. Generally, the amount is increased every 10-30 minutes until a good contraction pattern is achieved. Sometimes this is done in combination with breaking the bag of water.

Benefits: A bit easier to control than say breaking the water, because the drug can be stopped by closing off the IV line. This does not commit you to have the baby. It can be turned off or stopped to allow mom to rest or even go home.

Disadvantages: Can cause fetal distress. May not cause contractions. May cause too many contractions or contractions that last too long. Because of the potential risks, the FDA came out and declared that this drug was not to be used for inductions for convenience or scheduling reasons.

Pitocin for Labor

Prostaglandin Gels/Suppositories

These are used more frequently when the cervix is not favorable, meaning that it is dilated less than 3 centimeters, hard, posterior, not effaced, barely effaced, or any combination of the above. By using Bishop's Score your practitioner will decide if this is the best place to start. This can be used alone, or more often will be done 12 or more hours prior to the use of Pitocin.

Frequently it will be given more than once over the course of an evening/night. A suppository or tampon-like substance will be placed in or near your cervix during a vaginal exam.

Benefits: The more favorable your cervix, the less likely the induction is to "fail." Sometimes this is all that is needed, other times Pitocin is also used. It can be done as an outpatient procedure. It does not commit you to having the baby.

Disadvantages:Takes longer to get into active labor, can be nerve-wracking if your institution's policy is that you have to stay at the hospital during the waiting period. Sometimes mom becomes nauseated or has headaches. This cannot be quite as controlled as Pitocin but tends to be milder. Some forms of the prostaglandins now have strings attached making them removable if dangerous contractions occur.

(Video) Techniques for induction of labour

Misoprostol (Cytotec)

This is a pill that can either be ingested orally or placed near the cervix. It is used more often when the cervix is not very favorable.

Benefits: No tethering of the IV line. It can be used alone. The more favorable your cervix, the less likely the induction is to "fail." Not as messy as the suppositories potentially can be. Does not commit you to having the baby.

Disadvantages: May require the use of Pitocin or other means in addition. It can cause a very rapid labor. The recent thought is that this is not a valid option for mothers who are attempting VBAC; discuss this with your practitioner.

Home Induction

Therearea number of ways to induce labor at home. They vary from nipple stimulation and intercourse to ingesting herbs and substances likecastor oil.

Many women will swear by one or all of these, however, not all women will go in to labor with any method of induction.

  • Walking
  • Sexual intercourse
  • Orgasm with or without a partner
  • Nipple stimulation
  • Certain foods (i.e. spicy foods, oily salads)
  • Bumpy car rides
  • Strenuous activity
  • Visualization
  • Castor oil
  • Certain herbs andhomeopathics(black and blue cohosh, Caulophyllum, etc.)

Benefits:Typically less intervention and less likely to lead to a cesarean. Generally if your body and baby are not ready these will not work but it varies by method. These are easier to do and less worrisome for most moms.

Disadvantages:There can be serious consequences, particularly if you are not a term and your baby is not ready to be born. Many of the old wives' tales, like castor oil, do not generally work and can have potential complications including things likemeconium staining, fetal distress, etc. Always check with your practitioner before using any of these methods.

10 Labor Positions for a Faster, More Comfortable Birth

Factors Affecting Labor Induction

Many times inductions are done for the reason of being past yourdue date. There has been some research recently that shows that due dates actually need to be longer than 40 weeks. Often there are unnecessary inductions.

Sometimes they are done because a woman is attempting vaginal birth after cesarean (VBAC) or has suspected large baby. Many studies have shown that these are not necessarily good reasons for induction, particularly if the cervix is not ripe.

Some women are fearful of induction for a variety of reasons, including the increased chances of a c-section, the increased need forpain medications, or the fear of the reason for induction, particularly if there is a question about the baby's health.

Will an induction be more painful than natural labor? Not necessarily, that really depends more on your reasons for induction, the type of induction, and whether or not your mobility is limited. Many women are able to be induced and still follow through with their plans for an unmedicated birth, though they can expect certain changes in their birth plans.

Using a Foley Bulb Catheter for Induction of Labor

(Video) Induction of Labour at St George's Hospital

A Word From Verywell

If induction is suggested, gather facts and information, and ask questions. Why is it being suggested? How would it be attempted? What happens if it doesn't work? What happens if you do nothing?

There isn't a consensus on the use of induction, though it has its time and place, as any intervention does for medical reasons, though even the experts can't agree on all of the times an induction would be the best choice.

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Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. American College of Obstetricians and Gynecologists. Labor Induction. 2017.

  2. Sayed ahmed WA, Hamdy MA. Optimal management of umbilical cord prolapse. Int J Womens Health. 2018;10:459-465.doi:10.2147/IJWH.S130879

    (Video) How To Induce Labor Naturally | Natural Ways To Induce Labor

  3. Prescriber’s Digital Reference. oxytocin - Drug Summary.

  4. Bakker JJ, Van der Goes BY, Pel M, Mol BW, Van der Post JA. Morning versus evening induction of labour for improving outcomes. Cochrane Database Syst Rev. 2013;(2):CD007707.doi:10.1002/14651858.CD007707.pub2

  5. Smith LK. Outpatient induction of labour with prostaglandins: safety, effectiveness and women’s views. British Journal of Midwifery. 2017;25(12). doi:10.12968/bjom.2017.25.12.774

  6. Macones GA, editor. Management of Labor and Delivery. 2nd edition. Sussex, UK: John Wiley & Sons, Ltd; 2015.

  7. Parveen S, Khateeb ZA, Mufti SM, et al. Comparison of sublingual, vaginal, and oral misoprostol in cervical ripening for first trimester abortion. Indian J Pharmacol. 2011;43(2):172-5.doi:10.4103/0253-7613.77356

  8. Armstrong C. ACOG Updates Recommendations on Vaginal Birth After Previous Cesarean Delivery. Am Fam Physician. 2011;83(2):215-217.

  9. Bovbjerg ML, Evenson KR, Bradley C, Thorp JM. What started your labor? Responses from mothers in the third pregnancy, infection, and nutrition study. J Perinat Educ. 2014;23(3):155-64.doi:10.1891/1058-1243.23.3.155

  10. Duryea E. UT Southwestern Medical Center. The truth about “natural” ways to induce labor. 2017.

  11. Middleton P, Shepherd E, Crowther CA. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2018;5:CD004945.doi:10.1002/14651858.CD004945.pub4

  12. Santiago-Munoz P. UT Southwestern Medical Center. Who is a good candidate for VBAC? 2016.

Additional Reading

Different Ways Labor Is Induced (1)

(Video) 10 Tips on How to INDUCE LABOR ON YOUR OWN | NATURAL Ways to INDUCE Labor | Birth Doula | Lamaze

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.

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(Video) HOW WILL YOU BE INDUCED? WHAT TO EXPECT w/ INDUCED HOSPITAL BIRTH | Cervidil, Misoprostol, Pitocin

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FAQs

What is the most popular method of inducing labor? ›

Prostaglandins gel is often the preferred method of inducing labour since it is the closest to natural labour.

What are the types of induced? ›

Types of Inductions:

There are two types of Induction process: (1) Mutual Induction and (2) Self Induction. (1) Mutual Induction: If suppose the current in the primary coil changes continuously, then the induced magnetic field of the primary coil produces a changing current in the secondary coil.

Which method of induction is least painful? ›

Membrane sweep

This separation releases hormones (prostaglandins), which may start your labour. Having a membrane sweep does not hurt, but expect some discomfort or slight bleeding afterwards. If labour does not start after a membrane sweep, you'll be offered induction of labour.

What is the number one way to induce labor? ›

Inducing labor usually starts with taking prostaglandins as pills or applying them inside the vagina near the cervix. Sometimes this is enough to start contractions. If that's not enough to induce labor, the next step is Pitocin, a man-made form of the hormone oxytocin. It stimulates uterine contractions.

Is gel or balloon better for induction? ›

Conclusion: Similar to findings in randomised controlled trials and meta-analyses of IOL methods, we observed more unassisted vaginal births, less blood loss, decreased fetal acidaemia, and a greater likelihood of vaginal delivery within 24 h, with use of balloon catheter as compared to PGE2 vaginal gel.

How long is average labor when induced? ›

Typically, a normally progressing labor for a first time parent from the very first sign of labor through birth of a baby can take between 24 to 36 hours. Typically, we expect an induction to last close to 36 hours.

How can I make my cervix open faster? ›

Getting up and moving around may help speed dilation by increasing blood flow. Walking around the room, doing simple movements in bed or chair, or even changing positions may encourage dilation. This is because the weight of the baby applies pressure to the cervix.

Is there an alternative to Pitocin? ›

If labor has slowed, there are other effective alternatives to Pitocin, including: Waiting. Moving around; try walking, sitting up, standing, getting into a shower. Changing positions, like sitting on a birth ball or in a rocking chair.

How do hospitals induce labor? ›

In the hospital, a health care provider might inject a version of oxytocin (Pitocin) — a hormone that causes the uterus to contract — into a vein. Oxytocin is more effective at speeding up labor that has already begun than it is as at cervical ripening. The provider monitors contractions and the baby's heart rate.

How many inductions end in C section? ›

Women and their doctors chose the induction method: In general, it is done either by rupturing the amniotic sac or with hormonal medications that trigger labor. In the end, the C-section rate was less than 19 percent in the induction group, versus just over 22 percent in the standard-care group, the findings showed.

Why is being induced more painful? ›

As oxytocin levels increase, more endorphins are released. When labour is induced, the artificial oxytocin used to stimulate contractions does not cross the blood-brain barrier. Your body doesn't receive signals to release the endorphins and you experience more intense pain.

How long after Pitocin does baby come? ›

Response time varies – some women start having mild contractions within a few hours of Pitocin being started. A quick response is more likely if you have had a baby before. Many women need 6-12 hours or more of Pitocin to enter active labor (when the cervix dilates at least a centimeter an hour).

Can a cervix ripen overnight? ›

It is not uncommon for the cervical ripening to take up to 24-36 hours!! It is also not uncommon to use different techniques to ripen the cervix. You may feel contractions during this process. If the contractions become painful, you will be able to request medication to relieve your discomfort.

How can I get my water to break? ›

There are no proven safe ways for a woman to break her water at home. It can be dangerous if the water breaks before natural labor begins or before the baby is fully developed. During the natural process of labor, the water breaks when the baby's head puts pressure on the amniotic sac, causing it to rupture.

How can I open my cervix naturally? ›

Are there natural ways to ripen the cervix?
  1. Acupuncture.
  2. Breast stimulation.
  3. Castor oil.
  4. Enemas (injection of water or liquid into the rectum to clear the colon).
  5. Herbal supplements.
  6. Hot baths.
  7. Sexual intercourse.
  8. Transcutaneous electrical nerve stimulation (TENS).
18 Nov 2021

How long does it take to dilate from 1 to 10? ›

When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.

Why are inductions done at night? ›

In human and animal studies spontaneous onset of labour is proven to have a circadian rhythm with a preference for start of labour in the evening. Moreover, when spontaneous labour starts in the evening, the total duration of labour and delivery shortens and fewer obstetric interventions are needed.

How painful is balloon induction? ›

Yes, a Foley bulb insertion can hurt. Some women describe it as a sharp pain, and others say it's very uncomfortable. But the procedure only takes a couple of minutes, and the pain usually goes away after the catheter is in place. You can ask your doctor for pain medication to make insertion less unpleasant.

What are the disadvantages of induced Labour? ›

Labor induction increases the risk that the uterine muscles won't properly contract after giving birth (uterine atony). This can lead to serious bleeding after delivery. Occasionally blood products are needed for serious bleeding.

What happens if you don't dilate after being induced? ›

Usually your cervix will open up naturally on its own once you're ready to go into labor. However if your cervix shows no signs of dilating and effacing (softening, opening, thinning) to allow your baby to leave the uterus and enter the birth canal, your practitioner will need to get the ripening rolling.

What to expect when you get induced? ›

Pitocin is a synthetic form of the naturally occurring hormone oxytocin and should induce contractions. Contractions typically start about 30 minutes after you've been given the medication, and they're usually stronger, more regular, and more frequent than natural labor contractions.

What positions help you dilate? ›

Squats open the pelvis and can encourage baby to put added pressure on the cervix, which helps with dilation. It's important to have good support when in a squatted position during labor, and to keep your feet as parallel as possible instead of in a "V" shape.

How can I tell if Im dilating? ›

Check for dilation.

Try to insert the tips of your fingers into your cervix. If one fingertip fits through your cervix, you're considered one centimeter dilated. If two fit, you're two centimeters dilated. If there's additional space in the opening, try to estimate how many fingertips would fit to determine dilation.

How can I soften my cervix and dilate? ›

Nonpharmacologic Cervical Ripening
  1. HERBAL SUPPLEMENTS.
  2. CASTOR OIL, HOT BATHS, AND ENEMAS.
  3. SEXUAL INTERCOURSE.
  4. BREAST STIMULATION.
  5. ACUPUNCTURE/TRANSCUTANEOUS NERVE STIMULATION.
  6. MECHANICAL MODALITIES.
  7. SURGICAL METHODS.
  8. Stripping of the Membranes.
15 May 2003

How dilated do you have to be to start Pitocin? ›

The cervix should be 2-3 cm dilated, and mostly thinned out, to use pitocin for induction. If the cervix is not ready, not dilated or thinned enough, we can use a different medicine to start the induction.

Should you avoid Pitocin? ›

Pitocin, like any medication, can have side effects and can cause problems when used incorrectly. It does increase the amount of cramping pain after delivery. When given at too high a dose in labor it can cause the contractions to be too close together and can sometimes result in the baby's heart rate dropping.

What do they give you before Pitocin? ›

Cervidil comes in the form of a thin, gel-like package and is inserted vaginally. The drug is then gradually released over a 12-hour period, usually the night before doctors plan to give Pitocin.

When do they break your water during induction? ›

If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn't broken on its own when you arrive at the hospital, and you're five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.

What to do the night before getting induced? ›

If you're wondering what to do the day before an induction or scheduled cesarean, I want to share a few ideas with you all too!
  • Pamper Yourself. Take a long, Epsom salt bath to relax. ...
  • Take Pictures. ...
  • Double Check Your Hospital Bag. ...
  • Cuddle Up Together. ...
  • Go to Bed Early.
15 Mar 2018

Can you be induced the same day? ›

While you might think your baby's birthday will be on the same day as your induction, that might not be the case. For some mamas-to-be, induction progresses slowly and you may not give birth within 24 hours of the start of your induction.

What does induction feel like? ›

It can also be a little uncomfortable to have your water broken. You may feel a tug followed by a warm trickle or gush of fluid. With prostaglandin, you might have some strong cramping as well. With oxytocin, contractions are usually more frequent and regular than in a labor that starts naturally.

What causes induction to fail? ›

Several factors are considered as predictors of induction failure such as Bishop's score < 6, nulliparity, gestational age < 41 weeks, maternal age > 30 years, pregnancy complicated by preeclampsia, premature rupture of membranes (PROM), isolated oligohydramnios, gestational diabetes, and hypertension [3–5].

What are the risks of induction? ›

Increased Risk of Complications

Inducing labor involves intervening in the body's natural processes by breaking the amniotic sac, using medication, or both. However it's done, it can lead to fetal distress (such as abnormal heart rate). 1 In addition, when labor is induced using medication, labor may take longer.

How do you mentally prepare for an induction? ›

How to prepare
  1. Ask questions. Before you agree to be induced, consider finding out the following from your healthcare provider: ...
  2. Set realistic expectations. Maybe an induction isn't what you had in mind. ...
  3. Pack entertainment. ...
  4. Eat something light and then try to go poo. ...
  5. Give your partner permission to scoot.
27 Feb 2020

How can you survive an induction without an epidural? ›

Below are common coping mechanisms for births without medical pain relief.
  1. Relaxation. ...
  2. Hot water bottles on the back (not the uterus) right where you feel the contractions.
  3. The shower. ...
  4. Massage, or direct pressure, where you feel contractions. ...
  5. Positioning. ...
  6. Visual imagery.

Do I take my hospital bag when being induced? ›

When you come to the maternity unit you should bring your hospital bag. This is because, once the induction process has started, you will need to stay in hospital until your baby is born.

Can Pitocin cause autism? ›

Researchers analysed this against the amount of synthetic oxytocin administered to their mothers during labour. The overall finding was that there was no relationship between exposure to synthetic oxytocin in labour and autistic behaviours.

What are the side effects of Pitocin on baby? ›

Pitocin may cause serious or life-threatening side effects in the newborn baby, including:
  • slow heartbeats or other abnormal heart rate;
  • jaundice (a yellow appearance of the baby's skin);
  • a seizure;
  • eye problems; or.
  • problems with breathing, muscle tone, and other signs of health.

Why am I not dilating with Pitocin? ›

No induction will start with Pitocin unless your cervix is favorable. What does that mean? Essentially, a “favorable” cervix is one that's already gearing up for labor. If your body is nowhere near ready to have a baby, your cervix will be “closed, thick, and high,” meaning it won't be dilated or effaced at all.

Which mode of induction is faster? ›

Key clinical point: The combination of misoprostol and cervical Foley significantly sped time to vaginal delivery, compared with either method alone. Major finding: The combination was 92% faster than only misoprostol and 82% faster than only Foley for vaginal deliveries.

Which is better Cervidil or pitocin? ›

Pitocin is used once the cervix is already ripened, meaning the cervix is softened and ready to start dilating. On the other hand, Cervidil is used when the cervix has NOT ripened. Cervidil helps soften the cervix and prepares it for labor, but it is not used to stimulate contractions.

How successful is a balloon induction? ›

The success rate of a Foley bulb induction is about 70%. Many factors affect how successful it will be, such as the condition of your cervix or if you've given birth before.

Can I be induced without Pitocin? ›

Unless a Pitocin induction is medically necessary, it's often better to let labor happen on its own. But if you end up inducing, don't worry — communicate with your doctor to make sure you know what's going on and how they can help you deliver safely and happily.

How many inductions end in C section? ›

Women and their doctors chose the induction method: In general, it is done either by rupturing the amniotic sac or with hormonal medications that trigger labor. In the end, the C-section rate was less than 19 percent in the induction group, versus just over 22 percent in the standard-care group, the findings showed.

How can I make my cervix open faster? ›

Getting up and moving around may help speed dilation by increasing blood flow. Walking around the room, doing simple movements in bed or chair, or even changing positions may encourage dilation. This is because the weight of the baby applies pressure to the cervix.

How long after Pitocin does baby come? ›

Response time varies – some women start having mild contractions within a few hours of Pitocin being started. A quick response is more likely if you have had a baby before. Many women need 6-12 hours or more of Pitocin to enter active labor (when the cervix dilates at least a centimeter an hour).

How long does it take to dilate from 1 to 10? ›

When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.

How dilated do you have to be to start Pitocin? ›

The cervix should be 2-3 cm dilated, and mostly thinned out, to use pitocin for induction. If the cervix is not ready, not dilated or thinned enough, we can use a different medicine to start the induction.

Is the Foley bulb painful? ›

Yes, a Foley bulb insertion can hurt. Some women describe it as a sharp pain, and others say it's very uncomfortable. But the procedure only takes a couple of minutes, and the pain usually goes away after the catheter is in place. You can ask your doctor for pain medication to make insertion less unpleasant.

Can you pee with Foley bulb? ›

You should be able to have normal urination and bowel movements. You may continue with activity as tolerated, unless you have been instructed otherwise by your physician.

How painful is a cook balloon? ›

Having a Foley bulb inserted can be pretty uncomfortable and even quite painful for some women, but the pain shouldn't last long (though everyone is different). Once the balloon is in, it usually just feels like a super tampon.

Is cervical ripening painful? ›

It is not uncommon for the cervical ripening to take up to 24-36 hours!! It is also not uncommon to use different techniques to ripen the cervix. You may feel contractions during this process. If the contractions become painful, you will be able to request medication to relieve your discomfort.

Why is induced Labour more painful? ›

As oxytocin levels increase, more endorphins are released. When labour is induced, the artificial oxytocin used to stimulate contractions does not cross the blood-brain barrier. Your body doesn't receive signals to release the endorphins and you experience more intense pain.

When do they break your water during induction? ›

If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn't broken on its own when you arrive at the hospital, and you're five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.

How can you survive an induction without an epidural? ›

Below are common coping mechanisms for births without medical pain relief.
  1. Relaxation. ...
  2. Hot water bottles on the back (not the uterus) right where you feel the contractions.
  3. The shower. ...
  4. Massage, or direct pressure, where you feel contractions. ...
  5. Positioning. ...
  6. Visual imagery.

Videos

1. INDUCING LABOR NATURALLY (AT HOME) 39 WEEKS
(Araceli Chan DIY)
2. Induced Labor | Beaumont Labor and Birth
(Beaumont Health)
3. HOW TO INDUCE LABOR NATURALLY | ACTIVATING LABOR | 10 TIPS TO INDUCE LABOR | WAYS TO INDUCE LABOR
(The Maternity Mentor)
4. Inducing Labor and What to Expect
(St. Louis Children's Hospital)
5. Exercises to INDUCE LABOR at HOME fast | Get baby in position & engaged!
(Fearless Momma Birth)
6. INDUCING LABOR? Do NOT Do These 5 Things! | The Induction Series Pt 5
(Bridget Teyler)
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