Lahey Health is now part of Beth Israel Lahey Health

by Bucciarelli A

Definition

Medical induction of labor is when the birth process is started before it begins on its own. Medicine and procedures may be needed.

Reasons for Procedure

Labor may need to be started when it is not healthy for the baby to stay in the womb. Babies can get too large for a safe vaginal birth. This can make it hard for them to get enough oxygen. Labor may be started for a pregnancy:

  • That is two or more weeks past the due date
  • With twins that has reached the due date

Labor may also need to be started when there are health problems for the mother or baby, such as:

  • Water breaks and contractions do not start
  • High blood pressure or diabetes in the mother
  • Infection in the uterus
  • The baby is not growing well
  • Low fluid levels in the uterus
  • Rh incompatibility—mother and baby have different red blood cell Rh types which makes the mother's immune system attack the baby's blood cells

Some women may choose to have labor started without a medical need.

Possible Complications

Problems that may happen because of induction are:

  • Medicine that does not start labor. A C-section may be needed.
  • Contractions that are too strong. This can lead to problems with the fetus and uterus. Medicine may need to be changed or adjusted.

The doctor will review problems that may happen.

What to Expect

Prior to Procedure

Heavy meals should not be eaten when possible. Labor can make it hard for food to pass from the stomach. This can cause a problem if a c-section is needed. It is okay to have clear fluids.

Description of the Procedure

Cervical Ripening

The cervix will need to soften, thin, and open before the baby can pass through. Medicine will help to make this happen. The medicine may be a:

  • Gel that is put on the cervix
  • Pill that is placed in the vagina
  • Pill that is taken by mouth

It can take a few days to ripen.

The care team may also:

  • Free the cervix from the tissue around the baby’s head.
  • Use a small balloon to help open the cervix.
  • Place a stick of seaweed into the cervix to help open it
Changes in the Cervix During Pregnancy
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Contractions

A medicine called oxytocin can start contractions. It may be changed to make the contractions stronger or weaker as labor starts.

The labor and birth will then be the same as when labor begins on its own.

Immediately After Procedure

The induction will often lead to a delivery. Other care may be needed if labor did not start.

How Long Will It Take?

It can be hours or days until the baby is delivered. It may take 2 to 3 days if the cervix is not ripe.

How Much Will It Hurt?

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

Average Hospital Stay

The usual length of stay is 1 to 3 days. Women who have problems may need to stay longer.

Call Your Doctor

Call your doctor if your healing is not going as you expect or you have:

  • A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher in the first two weeks
  • Soaked more than one pad per hour or bleeding increases
  • Wounds that become red, swollen, or have pus
  • New pain, swelling, or soreness in your legs
  • Bad smelling leakage from vagina
  • Problems passing urine
  • Pain in the vagina gets worse
  • Cough or chest pain, nausea, or vomiting

If you think you are having an emergency, call for medical help right away.

RESOURCES

American Congress of Obstetricians and Gynecologists  http://www.acog.org 

Women's Health—US Department of Health and Human Services  http://www.womenshealth.gov 

CANADIAN RESOURCES

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

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

References

American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins -- Obstetrics. ACOG Practice Bulletin No. 107: Induction of labor. Obstet Gynecol. 2009 Aug;114(2 Pt 1):386-97, reaffirmed 2016.

Labor Induction. EBSCO DynaMed website. Available at:  https://www.dynamed.com/management/labor-induction . Updated August 29, 2019. Accessed October 22, 2019.

Leduc D, Biringer A, et al. Induction of labour. J Obstet Gynaecol Can. 2013 Sep;35(9):840-860.

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