Inducing labor

What is inducing labor?

Inducing labor (also called labor induction) is when your health care provider gives you medicine or uses other methods, like breaking your water (amniotic sac), to make your labor start. The amniotic sac (also called bag of waters) is the sac inside the uterus (womb) that holds your growing baby. The sac is filled with amniotic fluid. Contractions are when the muscles of your uterus get tight and then relax. Contractions help push your baby out of your uterus.

Your provider may recommend inducing labor if your health or your baby’s health is at risk or if you’re 2 weeks or more past your due date. For some women, inducing labor is the best way to keep mom and baby healthy.

If there are medical reasons to schedule induction, talk to your provider about waiting until at least 39 weeks of pregnancy. This gives your baby the time she needs to grow and develop before birth. Inducing labor should be for medical reasons only.

How is labor induced?

Your health care provider uses one or more of these treatments to induce labor:

• Separating the amniotic sac from the wall of the uterus (also called stripping or sweeping the membranes). Your provider gently puts a gloved finger through your cervix and separates the amniotic sac from your uterus. The cervix is the opening to the uterus that sits at the top of the vagina. You can have this procedure done in your provider’s office. You may have some cramping or spotting.
• Ripening the cervix. Your provider gives you medicine called prostaglandins to help soften and thin your cervix so it will open during labor. You may get the medicine by mouth or it may be put in your vagina. You get the medicine at a hospital. Your provider also may use a medicine called laminaria in your vagina. It absorbs moisture and expands to help open the cervix. Or your provider may use an instrument called a Foley bulb. This is a thin tube with a balloon at the end. Your provider inserts it in the vagina to widen the cervix.
• Giving you medicines to start contractions. Providers often use a medicine called oxytocin to induce labor. This medicine is the man-made form of a hormone that helps start contractions. At the hospital, your provider gives you oxytocin through an IV (a needle into a vein). It may make you have really strong contractions. Ask your provider about pain medicine you may want to have during labor.
• Breaking your water (also called rupturing the membranes or amniotomy). Your provider uses a small hook that looks like a knitting needle to break the amniotic sac that holds your baby. This shouldn’t be painful, but you may feel a warm gush of fluid.

Inducing labor can take a few hours or a few days. It depends on how your body responds to your treatment.

What are the risks of inducing labor?

Risks include:

• Your due date may not be exactly right. Sometimes it’s hard to know exactly when you got pregnant. If you schedule an induction and your due date is off, your baby may be born too early. If your pregnancy is healthy, wait for labor to begin on its own. If you need to schedule an induction for medical reasons, ask your provider if you can wait until at least 39 weeks.
• Oxytocin and medicines that ripen the cervix can make labor contractions too close together. This can lower your baby’s heart rate. Your provider carefully monitors your baby’s heart rate when inducing labor. If your baby’s heart rate changes, your provider may stop or reduce the amount of medicine you’re getting.
• You and your baby are at higher risk of infection. The amniotic sac normally protects your baby and your uterus from infection. If labor takes a while to start after your membranes rupture, infections are more likely. 
• There may be problems with the umbilical cord. If the amniotic sac is broken, the cord may slip into the vagina before your baby does. This is called umbilical cord prolapse. It’s more likely to happen if your baby is breech. This is when your baby’s bottom or feet are facing down before birth instead of being head-down. Umbilical cord prolapse can cause the umbilical cord to get squeezed during birth. If this happens, your baby doesn’t get enough oxygen, which can be life-threatening.
• Induction may not work so you may need a c-section (also called cesarean birth). C-section is surgery in which your baby is born through a cut that your provider makes in your belly and uterus.
• You may have a uterine rupture. This is when the uterus tears during labor. It happens rarely, but it can cause serious bleeding. If you’ve had a c-section in a prior pregnancy, you’re at higher risk of uterine rupture because a c-section leaves a scar in the uterus.
• You may be at higher risk of serious bleeding after birth (called postpartum hemorrhage). Inducing labor increases the chances that your uterine muscles don’t contract the right way after you give birth, which can lead to bleeding.

Last reviewed: September, 2018

See also: 39 weeks infographic