What is labor induction?

Labor induction includes several methods to start labor contractions. Labor induction is performed when continuing a pregnancy threatens the health of the mother or baby. Labor induction may be necessary when a pregnancy has lasted too long; the baby has a growth problem; or the mother has diabetes, Rh disease, preeclampsia, or separation of the placenta from the uterus. 

There are several methods of labor induction that your doctor or midwife may use alone or in combination with one another. They include breaking your water, stripping your membranes, applying mechanical devices that soften and prepare your cervix for birth, and giving you intravenous medication that signals your uterus to begin contractions. 

Labor induction is a common procedure, but it does have risks and potential complications. Risks include injury to the baby, infection, and increase risk of cesarean section. Discuss all of your options to induce labor with your healthcare provider to understand which options are right for you.  

Why is labor induction performed?

Your doctor or midwife may recommend labor induction to start labor contractions in order to preserve the health of you or your baby. Labor induction is used in the following situations: 

  • There is not enough amniotic fluid around your baby.
  • There is a placental abruption (separation of the placenta from your uterus).
  • You have health problems including Rh disease, cancer, preeclampsia, chronic hypertension (high blood pressure), and diabetes. 
  • You have a uterine infection or other type of infection.
  • Your amniotic sac (bag of water) breaks but labor contractions do not start or are not strong enough.
  • Your baby is not growing or has grown too big to be sustained in the womb.
  • Your pregnancy lasts more than 41 or 42 weeks. A normal pregnancy is 40 weeks.

In some cases, labor induction is an alternative to a cesarean section, in which a baby is surgically removed through a woman’s lower abdomen through an incision (cut). 

Who performs labor induction?

Obstetrician-gynecologists (Ob/Gyns) and midwifes perform labor induction. An Ob/Gyn is a doctor who specializes in women’s health and pregnancy. Midwives deliver babies, provide initial newborn care, and may serve as a woman’s primary healthcare and gynecologic care provider. 

How is labor induction performed?

Your doctor or midwife will perform your labor induction in an office or in the labor and delivery room of a hospital or birthing center, depending on the method of induction. Your provider may combine different labor induction methods that include:

  • Artificial rupture of membranes (amniotomy or “breaking your water”) involves inserting a small surgical hook through your vagina and cervix into your uterus. Your provider will scratch the surface of your amniotic sac to break your water. You will feel the amniotic fluid flow out of your vagina. It may be a trickle, a small stream, or a gush. 
  • Cervical ripening techniques help your cervix soften and dilate (open) in preparation for delivery through the vagina. There are medications and mechanical devices that do this. The medications, called prostaglandins, include pills you take orally and vaginal suppositories that are placed directly on your cervix. Your provider may also use a soft catheter with a small saline-filled balloon at the end to place gentle pressure on your cervix to dilate it. Laminaria is another form of mechanical dilation. It is a type of seaweed that may be applied directly to the cervix to dilate it. The seaweed absorbs tissue fluids and expands, dilating the cervix in the process.
  • Oxytocin (Pitocin) is an intravenous (IV) medication that starts contractions to induce labor. It is also used to make contractions stronger.
  • Stripping the membranes typically occurs in a medical office. Your provider inserts a finger into your vagina and through the cervix. Your provider then gently separates the bag of water (amniotic sac) from the uterus. This causes your body to release hormones. This can help prepare your cervix for labor and start contractions within a few hours to a couple of days.