Many pregnant women cringe at the suggestion of being induced into labor. The process of labor induction can be made much less intimidating by understanding what to expect.
Will I need an induction?
Induction is recommended for women with certain medical conditions, such as diabetes or hypertension, because it is safer to schedule delivery before the risk of complications increases.
In a healthy pregnancy without complications, induction is only recommended if you reach 41 weeks.
Women with normal healthy pregnancies can usually wait until they go into spontaneous labor.
How long does an induction take?
It depends on how far dilated you are and whether you’ve had a vaginal delivery before. If you are already several centimeters dilated or are contracting frequently, it is easier to get into labor and it will take less time, potentially less than 24 hours.
If your cervix is not dilated, it can take 24-48 hours for the cervix to thin out and start to dilate.
While it can take a long time to dilate the first few centimeters, once you make it to “active labor” at 5-6 centimeters, things progress much faster.
How will my labor get started?
Misoprostol is a medication that mimics one of the body’s natural hormones that causes contractions and softens the cervix so it can dilate. A Foley balloon can also be placed inside the cervix to put pressure on the cervix and help it dilate. Pitocin, a synthetic hormone similar to the natural oxytocin made in the brain, can also be given intravenously to stimulate contractions, usually once you are several centimeters dilated. The Foley balloon can be used at the same time as the misoprostol, or in combination with Pitocin.
What happens after I start dilating and contracting?
Some women continue to contract regularly on their own without any medications, while others need Pitocin to keep contractions strong and frequent enough to continue to dilate the cervix. Your water may break on its own at any point during labor, or your provider may offer to rupture the bag of water, as it often helps labor progress faster. Once you are contracting well every 2-3 minutes and your water is broken, we just wait until you reach 10 centimeters and can push!
Are there natural ways to start my labor at home?
Most home remedies to induce labor are not supported by evidence, but are also unlikely to be harmful.
There is some evidence that nipple stimulation, which produces oxytocin, can increase your chances of going into labor naturally. Intercourse produces oxytocin as well, but there is less evidence to support it as a method to induce labor. Exercise, acupuncture and acupressure, red raspberry leaf tea, evening primrose oil, and castor oil have also been used, but without proof of success. If you are thinking about using any of these methods, talk to your doctor or midwife first to do it as safely as possible!
About Katherine Bishop, MD
Dr. Katherine Bishop is an OB/GYN physician with clinical interests in low- and high-risk obstetrics, contraception management, minimally-invasive surgery, managing cervical dysplasia and menopause. She earned her medical degree from the Washington University School of Medicine in St. Louis, MO, and completed a residency in obstetrics and gynecology from Duke University Medical Center in Durham, NC.