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What you can expect

By Mayo Clinic staff

During the procedure
There are various methods for inducing labor. Depending on the circumstances, your health care provider might:

  • Strip or sweep the amniotic membranes. With this technique, your health care provider inserts his or her gloved finger beyond the cervical opening and rotates it to separate the amniotic sac from the wall of your uterus. This technique can be done during an office visit and doesn't truly induce labor. However, it might speed the beginning of spontaneous labor — especially if your cervix has already begun to dilate. You might experience intense cramping and spotting. If bleeding becomes heavier than a normal menstrual period, contact your health care provider.
  • Ripen your cervix. Sometimes synthetic prostaglandins, which can be taken by mouth or placed inside the vagina, are used to dilate the cervix. In other cases, mechanical dilators are used — such as a small balloon-tipped catheter or small rods made from seaweed (laminaria). The balloon-tipped catheter is inserted beyond the cervical opening. Saline injected through the catheter expands the balloon, causing the cervix to widen. Dilators inserted into the cervix absorb moisture and get thicker, opening the cervix. Use of laminaria can cause cramping. Cervical ripening techniques are typically done in the hospital. After prostaglandin use, your contractions and your baby's heart rate will initially be monitored.
  • Break your water. With this technique, also known as an amniotomy or rupturing the membranes, your health care provider makes a small opening in the amniotic sac with a thin plastic hook. You might feel a warm gush of fluid when the sac opens. An amniotomy is typically done only if the cervix is partially dilated and thinned and the baby's head is deep in the pelvis. Your baby's heart rate will be monitored before and after the procedure. Your health care provider will examine the amniotic fluid for traces of fecal waste (meconium).
  • Use an intravenous medication. In the hospital, your health care provider might give you a synthetic version of oxytocin (Pitocin) — a hormone that causes the uterus to contract. Oxytocin is more effective at inducing labor if your cervix has already begun to dilate and thin. The medication is also used to augment or stimulate contractions if labor isn't progressing. Your contractions and your baby's heart rate will be continuously monitored.

Keep in mind that your health care provider might also use a combination of these methods to induce labor.

How long it takes for labor to start depends on how your body responds to the induction techniques. If your cervix needs time to ripen, it might take two days before labor begins. If you simply need a little push, you might be holding your baby in your arms in a matter of hours.

Contractions might become stronger and more painful earlier in induced labor than they would in a naturally occurring labor. If relaxation and breathing techniques aren't enough to control the pain, ask for relief. Your health care provider might recommend an epidural block or other options.

After the procedure
In most cases, labor induction leads to a successful vaginal birth. If labor induction doesn't lead to delivery, a C-section might be needed.

The issues that lead to an induction might require special care during recovery. If you have a successful vaginal delivery after induction, there might be no implications for future pregnancies. If the induction leads to a C-section, your health care provider can help you decide whether to attempt a vaginal delivery with a subsequent pregnancy or to schedule a repeat C-section.

How you prepare
References
  1. Wing DA. Induction of labor. http://www.uptodate/com/home/index.html. Accessed March 30, 2011.
  2. What to expect after your due date. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp069.cfm. Accessed March 30, 2011.
  3. Tita ATN, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. The New England Journal of Medicine. 2009;360:111.
  4. Wing DA. Induction of labor in women with prior cesarean delivery. http://www.uptodate/com/home/index.html. Accessed March 30, 2011.
  5. Clark SL, et al. Neonatal and maternal outcomes associated with elective term delivery. American Journal of Obstetrics & Gynecology. 2009;100:156.
  6. Wing DA. Techniques for cervical ripening prior to labor induction. http://www.uptodate/com/home/index.html. Accessed March 30, 2011.
  7. Labor induction. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp154.cfm. Accessed March 30, 2011.
  8. Battista LH, et al. Abnormal labor and induction of labor. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Elsevier Inc.; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-443-06930-7..50015-3&isbn=978-0-443-06930-7&uniqId=243410035-2#4-u1.0-B978-0-443-06930-7..50015-3. Accessed May 11, 2011.
  9. Cunningham FG, et al. Williams Obstetrics. 23rd ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/content.aspx?aid=6026579. Accessed May 11, 2011.
  10. Belogolovkin V, et al. Umbilical cord prolapse. http://www.uptodate.com/home/index.html. Accessed May 11, 2011.
  11. American College of Obstetricians and Gynecologists. Induction of labor. ACOG Practice Bulletin No. 107. Obstetrics & Gynecology. 2009;114:386.
  12. Healthy pregnancy. U.S. Department of Health and Human Services. http://www.womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.cfm. Accessed May 11, 2011.
  13. Management of labor. Bloomington, Minn.: Institute for Clinical Systems Improvement. http://www.icsi.org/labor/labor__management_of__full_version__2.html. Accessed May 12, 2011.
  14. Meconium aspiration syndrome. The Merck Manuals: Home Edition for Patients and Caregivers. http://www.merckmanuals.com/home/sec23/ch264/ch264i.html. Accessed May 12, 2011.
  15. Grotegut CA, et al. Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony. American Journal of Obstetrics & Gynecology. 2011;204:56.e1.
  16. Thinking About Inducing Your Labor: A Guide for Pregnant Women. http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=353#toc. Agency for Healthcare Research and Quality. Accessed June 1, 2011.
  17. Berghella V. Cesarean delivery: Technique. http://www.uptodate/com/home/index.html. Accessed July 1, 2011.
MY00642 July 22, 2011

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