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Inducing labor: Your questions answered
Sometimes it's better to deliver sooner rather than later. Here's what you need to know about inducing labor.
By Mayo Clinic staffNature controls most aspects of labor. But sometimes, nature needs a nudge. If your health care provider decides you and your baby would benefit from delivering sooner rather than later, he or she may suggest inducing labor.
And you'll be in good company. In the United States, an estimated one in five labors is induced.
Why would I need an induction?
Your health care provider may recommend inducing labor for various reasons — primarily when there's concern for your health or your baby's health. For example:
- You're one to two weeks beyond your due date, and labor hasn't started naturally.
- Your water has broken, but you're not having contractions.
- There's an infection in your uterus.
- Your baby has stopped growing at the expected pace.
- There's not enough amniotic fluid surrounding the baby.
- Your placenta has begun to deteriorate or separate from the wall of your uterus.
- You have a medical condition that may put you or your baby at risk, such as high blood pressure or diabetes.
Rarely, inducing labor is a matter of practicality. If you live far from the hospital or you have a history of rapid deliveries, a scheduled induction may be best.
There's an important caveat, however. If you've had a prior C-section, you may not be a candidate for labor induction. After a prior C-section, inducing labor increases the risk of uterine rupture. This rare but serious complication — in which the uterus tears open along the scar line from a prior C-section — can cause life-threatening blood loss, infection and brain damage for the baby.
Can I wait for labor to begin naturally?
Up to two weeks after your due date, a wait-and-see approach may be preferable. Nature prepares the cervix for delivery in the most efficient, comfortable way. However, if your health care provider is concerned about your health or your baby's health or your pregnancy continues two weeks past your due date, inducing labor may be the best option.
Why the concern about two weeks? The longer your pregnancy continues, the larger your baby is likely to be — which may complicate a vaginal delivery. In a few cases, aging of the placenta may compromise your baby's ability to thrive in the womb. An overdue baby also is more likely to inhale fecal waste (meconium) during childbirth, which can cause a lung disease.
Remember, there's no right or wrong way to have a baby. If complications make an induction necessary, don't consider it a sign of failure. Though you may not welcome the news, it may simply be what's best for you or your baby.
Can I request an induction?
If you're interested in an elective induction, discuss it with your health care provider. Some health care providers may agree to a requested induction if it's your second or third baby, the baby's lungs are mature and your cervix has begun to prepare for labor. Keep in mind, however, that unnecessary intervention may pose unnecessary risks — such as a possible C-section, especially for first-time moms. Trust your health care provider to help you make the best decision in your case.
Can I do anything to trigger labor on my own?
Probably not.
Nipple stimulation — either manually or with a breast pump — may release the hormone oxytocin, which can lead to contractions. But the cervix must be ready to open for labor to actually begin. Nipple stimulation is unlikely to work unless labor was about to begin anyway. It may even be dangerous. Sometimes nipple stimulation can lead to contractions that are long and hard enough to harm the baby.
Other techniques for inducing labor — such as having sex or eating pineapple or spicy food — aren't backed by scientific evidence. If you want to try a certain food, go for it. Sex is OK, too, as long as your water hasn't broken. But get your health care provider's OK before trying any other home remedies, herbal supplements or alternative treatments for inducing labor.
How should I prepare for the induction?
Before the induction, your health care provider may help prepare your cervix for labor.
If your cervix is beginning to thin and soften, your health care provider may gently separate the amniotic sac — which surrounds and protects your baby — from the rim of the cervix during a physical exam. This procedure, known as stripping the membranes, may encourage labor to begin on its own.
If your cervix isn't thinning or softening, your health care provider may use synthetic forms of prostaglandins — the natural chemicals that trigger contractions — to get things started. Sometimes, the medication is given the night before a scheduled induction. It may be applied as a gel to the cervix, inserted as a vaginal suppository or tablet, or swallowed in pill form.
As another option, a small balloon-tipped catheter may be placed in your uterus. Water is injected through the catheter to expand the balloon. This irritates the uterus, causing it to soften and open your cervix somewhat. Another technique is to place small cylinders of dried laminaria, a type of seaweed, in the cervix. The cylinders draw in water and get thicker, which slightly dilates the cervix.
Your health care provider will tell you when to report to the hospital for the actual induction. You may be asked to avoid eating or drinking for several hours before your arrival.
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