Medical Induction of Labor - Reston Hospital Center | Reston, VA
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Medical Induction of Labor

Definition

In some cases, the doctor needs to help labor begin by using:
  • Medicine
  • Other procedures
Inducing labor is done instead of waiting for your body to go into labor on its own. In the US, nearly one in five labors is induced.

Reasons for Procedure

The most common reason to have an induction is that the pregnancy has gone two or more weeks past the due date. In this situation, the baby may:
  • Get too large for a vaginal delivery
  • Not receive enough oxygen through the placenta (the organ that links the mother and the baby)
Other reasons for induction include:
  • Water breaks and contractions do not begin
  • High blood pressure or diabetes in the mother
  • Infection in the uterus
  • The baby is not growing properly
  • Low amniotic fluid level

Possible Complications

The same complications that may occur when labor begins on its own may also occur during induced delivery. Risks associated with the medications used for labor induction include the following:
  • Stalled labor—If the medicine does not trigger labor, you may need a cesarean section (C-section).
  • Strong contractions—The medicine that causes contractions could make them too strong. Although rare, this can lead to fetal distress and uterine rupture. In the event that your contractions are too strong, your doctor will lower the dose or stop the medicine.
Be sure to discuss these risks with your doctor before the procedure.

What to Expect

Prior to Procedure

The same instructions used when labor begins on its own also apply to induced labor. But, there are some differences. Do not eat too much before arriving at the hospital. It is okay to have clear fluids. The medicines can create very strong contractions and could upset your stomach. Contractions slow the digestive process, so your stomach will remain full. This can cause a problem if you need general anesthesia .

Description of the Procedure

Cervical Ripening
To deliver your baby vaginally, the cervix will need to “ripen.” This means it needs to soften, thin, and open to prepare for delivery. If your cervix is not doing this already, your doctor may aid this process by giving you medicine. Medicine may be a:
  • Gel that is applied to the cervix
  • Suppository put in the vagina
  • Pill taken by mouth
The cervical ripening process can last up to a few days.
There are also procedures that your doctor may try to aid cervical ripening, such as:
  • Strip the membranes (separate your cervix from the tissues around the baby’s head)
  • Expand a small balloon-tipped catheter in the cervix
  • Place small cylinders that contain a type of sponge-like seaweed into the cervix
Changes in the Cervix During Pregnancy
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Contractions
If contractions have not started when your cervix is ripe, your doctor will give you a drug that causes contractions. The drug is a man-made version of a hormone called oxytocin. This hormone is produced by your body during active labor. The drug will be adjusted during labor to strengthen or weaken the contractions. After contractions begin, the labor and birth process will be the same as when labor begins on its own.

Anesthesia

The same pain medicines are available for an induced labor as for a spontaneous delivery, including:
  • Pain medicine given into your vein
  • Epidural block
  • Spinal block
  • Local anesthesia

Immediately After Procedure

If everything goes well, you will vaginally deliver a healthy baby after the induction.

How Long Will It Take?

It can be hours to several days (very rarely) from the time you are induced until the delivery. If your cervix is not ripe when you are scheduled for the induction, labor and delivery could take 2-3 days. It could take longer for first-time mothers and for pre-term babies.

How Much Will It Hurt?

Labor causes severe pain. Talk to your doctor about ways to manage the pain.

Average Hospital Stay

The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if you have any problems.

Postoperative Care

The care after an induced labor is the same as for a spontaneous birth.

Call Your Doctor

When you go home after having a vaginal delivery, call your doctor if any of the following occurs:
  • An unexplained fever of 100.4°F (38°C) or above in the first two weeks
  • Soaking more than one sanitary napkin an hour or if the bleeding level increases
  • Wounds that become red, swollen, or drain pus
  • New pain, swelling, or tenderness in your legs
  • Hot-to-the-touch, significantly reddened, sore breasts
  • Any cracking or bleeding from the nipple or areola (the dark-colored area of the breast)
  • Foul-smelling vaginal discharge
  • Painful urination or a sudden urge to urinate, inability to control urination
  • Increasing pain in the vaginal area
  • Cough or chest pain, nausea, or vomiting
  • Depression, hallucinations, suicidal thoughts, or any thoughts of harming your baby
In case of an emergency, call for medical help right away.

RESOURCES

American Congress of Obstetricians and Gynecologists http://www.acog.org/For%5FPatients

Women's Health.gov http://www.womenshealth.gov/

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Women's Health Matters http://www.womenshealthmatters.ca/

References

Harman JH, Kim A. Current trends in cervical ripening and labor induction. Am Fam Physician . 1999;60:477-484.

Induction of Labor. The American Congress of Obstetricians and Gynecologists, Practice Bulletin No. 107 . August 2009.

Facts about labor induction. Am Fam Physician . 1999 Aug 1;60(2):484. Available at: http://www.aafp.org/afp/990800ap/990800a.html . Accessed December 17, 2012.

Longer hospital stays for childbirth. National Center for Health Statistics website. Available at http://www.cdc.gov/nchs/data/hestat/hospbirth/hospbirth.htm . Updated November 18, 2009. Accessed December 17, 2012.

Morey SS. ACOG develops guidelines for induction of labor. Am Fam Physician . 2000 Jul 15;62(2):445. Available at: http://www.aafp.org/afp/20000715/practice.html . Accessed December 17, 2012.

Revision Information

  • Reviewer: Andrea Chisholm
  • Review Date: 11/2012 -
  • Update Date: 11/26/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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