Being induced for labor? Here's what to expect.

Being induced for labor with Pitocin is common, but there are also other induction methods. Here’s what to expect with an induction from a birth nurse. Plus, some natural methods for starting labor.

As an RN in the birth world for over 15 years, let’s dive into all the induction things. If you’re being induced for labor, here’s what to expect.

There are many questions surrounding induction like:

Should I be induced?
What does induction look like?
Do I have to stay in the bed while I’m being induced?

Let’s look at it all, plus natural methods to kickstart labor.

Medical vs Elective Induction

Medical Inductions are inductions done for medical reasons. For instance, they may be needed because of high blood pressure, water breaks but labor doesn’t start, gestational diabetes, baby’s health is at risk, or other medical conditions.

Elective inductions are different. They are usually done because of convenience. Common reasons from a mom’s choice would be, “I’m tired of being pregnant,” “I want my baby born on a certain day,” or “I feel uncomfortable.”

Elective induction encouraged by a doctor is usually because they are scheduling you to deliver at a time when they are in the hospital or on call.

Should I be induced?

The decision, of course, is between you and your doctor, and in the end, up to you. Reasons that I often give, as a birth nurse, to forego an elective induction are the risk of complications that come with Pitocin (looked at in depth below), as well as the likelihood of other interventions during birth.

Induced labour also produces a need for more monitoring, which can confine you to the bed. This will inhibit movement and can slow labor down. Basically, interventions often lead to more interventions.

Medical inductions are often necessary. Something is happening that is putting you or your baby at risk, and your healthcare provider believes delivering your baby is safest. If this is the case, induction is usually a good bet.

If you choose an elective induction, it’s a good idea to wait until your due date to schedule it. This gives you a better chance of vaginal delivery, especially if it’s your first time giving birth. First-time moms often take longer to get into the labor pattern because their bodies haven’t done it before.

Things to consider when scheduling an elective induction:

Due Date (weeks of pregnancy)
Cervical Ripening (Is the cervix effaced/thinned out? If not, an induction may not go well.)
Is it your first baby or first time giving birth? (It often takes first-time moms a bit longer to “get ready” for labor because they have never done it before.)
Cervical Dilation (If zero dilation has occurred, an induction may not go well.)

Being induced for labor? Here’s what to expect.

Induction Methods

Labor induction is the use of an outside method to kickstart labor. Your healthcare provider chooses which method to use, and they may use a combination of several of the ones listed below. The different induction methods are Pitocin, membrane sweeping, a Foley bulb induction, rupture of membranes, or Cytotec. Let’s take a look at each.

Pitocin Induction:

Pitocin is a synthetic form of oxytocin (the natural labor hormone that makes you contract) that your healthcare provider uses as an induction method. It is delivered through an IV and will cause uterine contractions. Pitocin may cause contractions to feel more intense than labor contractions would, depending on the dose.

Healthcare providers also often rupture membranes (break water) when administering Pitocin. Rupturing membranes can cause increased pain with contractions. Though pitocin may not cause more pain on its own than regular contractions, partnering with ruptured membranes can be intense.

Because Pitocin is a drug, there are risk factors that come with it. You will also need to be monitored continually while on Pitocin. Too much Pitocin can cause uterine rupture. Too little won’t make a difference in uterine contractions, so it’s important to get it just right. Continuous monitoring helps your healthcare team do this.

Risks of Pitocin include uterine rupture (rare), eventual cesarean birth, fetal heart rate issues, and increased internal monitoring.

The bottom line is that if a pregnant woman is in good health and baby is healthy, it’s best to wait for spontaneous labor if there is no medical reason to induce. Letting labor happen on its own leads to less interventions and a better chance of vaginal birth.

Let’s look at other methods used for induction of labor.

Membrane Sweeping:

A membrane sweep is when your OB runs a gloved finger along your amniotic sac during a cervical check. This can separate the sac from the wall of the uterus. It may trigger labor-starting hormones and can kick-start labor.

Membrane sweeping can be done in the hospital or in your OB’s office at an appointment. These don’t always start labor, but may. Risk includes accidental rupture of membranes (breaking your water).

Foley Bulb Induction:

A foley bulb is an inflatable balloon device that is inserted into the cervix while the OB does a cervical check. The foley balloon is slowly expanded and manually dilates the cervix. This method helps open the cervix and can give you a good start to labor before other methods are used.

A foley bulb induction is often used the night before an induction to help prepare the cervix for later labor. Usually, around 5 am the next morning, the OB comes around, starts Pitocin, breaks water, and the bulb falls out.

Risks of Foley Bulb use are infection (but no more than regular cervical exams), discomfort, pain, or vaginal bleeding. Most moms feel this as similar to an annual pap smear exam.

Rupture of Membranes:

Your doctor may decide to break your bag of water (release amniotic fluid) in an attempt to kickstart labor or make it move faster. This is when a plastic, small hook is inserted and the amniotic sac breaks. Usually, this procedure is pain-free. The main risks of this method are infection or the baby’s heart rate dropping.

Does breaking the waters make labor faster? It may. It can also cause contractions to feel much more intense. For moms wishing to labor unmedicated, this can cause a problem.

Cytotec:

Cytotec is a synthetic form of prostaglandin. It can soften the cervix and cause contractions. There are two ways it is given, vaginally to dissolve or underneath your tongue. If given vaginally, you will need to stay in the bed for several hours so it doesn’t fall out. Risks of Cytotec include inflammation, nausea, uterine cramps, diarrhea, and pain.

Being induced for labor? Here’s what to expect.

The Induction Process

If you are being induced with a method that works on your cervix, like a Foley bulb or Cytotec, you will more than likely be scheduled to come into the hospital at night. This is like a “pre-induction.” You may be able to sleep some through the night.

These methods work to soften or open the cervix in the hope that your body will be more susceptible to the rest of the labor process. After a night of cervical methods, usually your healthcare provider comes in nice and early (around 5am) and begins other induction steps. The most common are starting Pitocin or breaking your bag of water (or both).

Your labor nurse monitors you and adjusts your Pitocin as needed throughout the day. How long an induction takes depends on the steps your OB is taking for induction. Some do two-day inductions, some one day. Be sure to ask your OB questions, so you know what to expect. The protocol on what you eat during inductions may vary as well. Many OBs don’t care what you eat or drink as long as it isn’t red.

Wondering what to wear in the hospital? Here’s the insider’s guide.

Natural Methods for Labor Induction

Bodies tend to start labor when they are ready to. No one knows exactly what triggers labor to start, but it’s probably a shift in hormones. Babies may even cause this shift when they’re ready to live outside the womb.

At times, labor may be delayed. Usually, this is due to baby’s position. Ideally, a baby will be head down and LOA (left occiput anterior) when labor starts. This position makes the most room for mom and baby. It also helps baby with fetal rotation as they move through the pelvis.

Keep in mind: it is NORMAL to go past your due date. Especially with a first baby. My midwife friends never plan on an early baby with a first mom. Almost always, they are born past the due date.

If you’re ready for labor or past your due date, here are some things to try:

1. Spinning Babies® Three Balances

Taking a Spinning Babies® Birth Preparation Class is a great way to balance your body and make space for your baby. Spinning Babies® is an approach, created by a midwife, to create comfort in pregnancy and ease in labor.

2. See a chiropractor who specializes in the Webster method

Oftentimes, a woman will go into labor within 72 hours of seeing a chiropractor. They are good at getting the nervous system ready and the body in alignment for labor. Be sure to find a chiropractor who works with pregnant women.

3. Eat dates

A recent study suggests that eating six dates a day starting around 36 weeks led to shorter, faster labors and decreased needs for inductions. Why not give it a try?

4. Acupuncture

Believed to stimulate the release of oxytocin and prostaglandins. More studies are needed to make this an evidence-based approach, but many moms and healthcare providers recommend this non-pharmacological approach for starting labor.

5. Sexual Intercourse

Semen helps ripen the cervix because of the prostaglandins it contains, so go for it! You aren’t going to hurt your baby, plus it will be at least six weeks after giving birth before you are cleared to have sex again. Spend some intentional time with your partner.

6. The Miles Circuit

The Miles Circuit is a set of moves and exercises, created by a doula, to kickstart labor or to help your baby get into the right position. When labor is delayed, sometimes it is due to the baby’s positioning. If this is the case, something like the Miles Circuit or Spinning Babies can help.

Trust your own instincts. Oftentimes, you have a “gut feeling” about what method is right for you. I encourage you to go after it. It may be one thing or a combination of several. Wishing you a healthy, happy, and safe birth!