Before a woman is ready to give birth, her cervix must soften, efface (thin), and dilate (open). Some methods of induction prepare the cervix for labor and may cause contractions to begin on their own. Other methods are used to stimulate effective contractions.

One or a combination of the following methods may be used to induce labor.

Prostaglandins—To prepare a woman’s cervix for labor, her healthcare professional may give her a medication that contains synthetic forms of prostaglandins, which are hormones produced by the body that trigger contractions. In addition to softening and opening the cervix, the medication sometimes stimulates contractions. It may be applied as a gel to the cervix, inserted as a vaginal suppository, or swallowed in pill form. At times, the medication is given the night before a scheduled induction.

Stripping or sweeping the membranes—A healthcare professional may use his or her gloved finger to separate the membranes surrounding the fetus from the lower part of a woman’s uterus. This procedure causes the woman’s body to release prostaglandins. As a result, her cervix may become softer and more open, and contractions may also begin. The woman may feel some discomfort or pain during this procedure, and spotting may occur.

Rupturing the amniotic sac— If a woman’s amniotic sac has not already ruptured (that is, if her water hasn’t already broken), her healthcare professional may rupture it. He or she will insert a thin plastic hook through the woman’s cervix to make a small tear in the sac. The rupture will increase prostaglandin production and may lead to contractions. The woman may feel a warm gush of fluid when the sac breaks.

Oxytocin—Oxytocin is a hormone produced by the body that causes contractions. A woman may be given a synthetic form of oxytocin, such as Pitocin, to start contractions. When used to induce labor, oxytocin is most often administered through an IV tube in the arm or back of the hand. The IV allows the healthcare professional to control how much oxytocin a woman is given based on how her labor progresses.

Other methods—A woman should talk to her healthcare professional about other ways that labor is induced.

Labor may be induced for a variety of reasons. Sometimes, delivering a woman’s baby before she goes into natural labor may be safer. Induction is often recommended when a healthcare professional is concerned about the woman’s health or the baby’s health. One of the most common reasons for labor induction is carrying a baby past the due date.

Labor may be induced if:

• A woman is 1–2 weeks past her due date, and labor hasn’t started

• A woman’s water has broken, but labor hasn’t started within a reasonable amount of time

• An infection has developed in the uterus

• The baby has stopped growing or thriving

• There’s not enough amniotic fluid surrounding the baby

• The baby is not getting enough nutrients and oxygen from the placenta

• The mother has a condition that may endanger her health or the health of her baby

Labor may be induced for other reasons. For example, labor may be induced if a healthcare professional is concerned that the woman won’t make it to the hospital in time once she goes into labor. For this reason, a labor induction may be scheduled for a woman who lives far from the hospital or has delivered a baby quickly in the past. Pregnant women should discuss other reasons for induction with their healthcare professional.

Yes. Labor should not be induced when a vaginal delivery would be unsafe for a woman or her baby and a cesarean section is necessary. A woman should not be induced when:

• Immediate delivery is necessary

• The placenta is near or covering the opening of the uterus

• The umbilical cord has dropped down in the vagina ahead of the baby

• The fetus is lying sideways

• The mother has an active genital herpes infection

• The mother has had certain types of surgery on her uterus

There may be other reasons that induction is not best for a woman or her baby. For example, some healthcare professionals will not induce labor if the baby is in the breech position of if the mother has had a previous cesarean section. A healthcare professional can provide more information.

A primary risk of inducing labor is that it may be unsuccessful. If induction is unsuccessful, a cesarean section is necessary.

In addition, inducing labor may produce contractions that come too often or are too strong and long, causing the baby to become stressed. However, a woman’s contractions and her baby’s heart rate will be carefully monitored. If the baby appears to be in any danger, her healthcare professional will perform an immediate cesarean section.

Other problems can occur when labor is induced, but most of them are rare. A woman should talk to her healthcare professional about other risks associated with labor induction and specific information that relates to her and her pregnancy.

At Childbirth Graphics, we have a wide array of models, displays, posters, and pamphlets to help educate expectant parents, patients, and students about a full range of labor and birth topics. Learn more by visiting our website’s section devoted to Labor & Birth Education Resources.

The information contained in this article is not intended to replace the advice of a healthcare professional.

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