The Do’s and Don’ts Before Being Induced
Fact-checked by Katharine Chan, MSc, BSc, PMP. Katharine has over 15 years of experience working in the Canadian healthcare system, leading patient safety incident investigations, quality improvement projects and change management initiatives within mental health, emergency health, and women's health services.
What Is Labor Induction?
Induction of labor is when a doctor or healthcare provider attempts to initiate labor before it starts naturally. This is performed by using specific medical procedures and medications to provoke uterine contractions.
Labor induction occurs when it meets specific medical requirements, most often in situations where the mother or baby is at an increased risk of complications, such as preeclampsia. In some situations, it is done when there isn’t a medical need – a pregnant woman might opt for an elective induction for multiple reasons.
Overall, the purpose is to attain a healthy vaginal birth and delivery.
There are many different methods of induction, each with its own degree of risk and invasiveness. Everyone’s body works differently, so some of these methods may work for one person but not for another. There are times when more than one method is used to jumpstart labor.
Here are some of the induction methods your healthcare provider may perform:
Stripping Membranes Or Membrane Sweep
A membrane sweep is a procedure where your healthcare provider inserts a gloved finger into the vagina to separate the thin membrane of the amniotic sac from the wall of the uterus. The amniotic sac holds the fetus and the amniotic fluid.
The body releases hormones called prostaglandins when the amniotic sac is separated from the uterine wall. Prostaglandins are hormones that can stimulate contractions and allow the cervix to be ready for labor.
Your healthcare provider may also give you certain hormones to help induce labor. Prostaglandin can help thin and soften the cervix in preparation for labor. This hormone can be offered orally in the form of a tablet or it can be administered vaginally as a gel or tablet.
The hormone oxytocin can be given as a Pitocin drug to stimulate contractions and speed up labor. This drug is usually provided after prostaglandin has been given. Pitocin is administered continuously through an IV in the mother’s arm; the uterus and baby need to be monitored closely afterward.
This is also referred to as “breaking the water”. Your healthcare provider breaks the amniotic sac using a plastic instrument during a vaginal exam. This procedure can cause uterine contractions and labor usually comes about after a few hours.
Medical Reasons for Induction of Labor
During your prenatal appointments with your healthcare provider, they will assess and review the health of your pregnancy and your baby. As your pregnancy progresses, they will measure your baby’s size, weight, position and gestational age.
Closer to your delivery date, they will examine your cervix, take into consideration your and your baby’s needs and provide you with options of whether labor induction is recommended.
One of the reasons your provider may suggest labor induction is if you are past your due date. If you are 42 weeks pregnant and still have not gone into labor, there is a risk of complications.
In addition, if your water has broken and labor has not begun after 24 hours, induction may be required to reduce the risk of infection to you and your baby.
You may also be offered the option of induction if you have a medical condition or pregnancy complication that poses a risk to you or the baby’s well-being. Some of these include
- A medical history of deliveries that are extremely short in duration
- Gestational diabetes
- High blood pressure
- Situations where the baby isn’t growing normally or is growing too slowly
- Infection in the uterus (also called Chorioamnionitis)
- Obstruction or abruption of the placenta
- Low levels of amniotic fluid or leaking of amniotic fluid (also called Oligohydramnios)
- A liver condition called intrahepatic cholestasis of pregnancy (ICP)
How Doctors Determine Whether or Not To Induce
In some situations where there is no medical reason or need to induce labor, women may be offered the option of induction due to logistical or practical reasons. For instance, if a lot of travel is required to reach the nearest hospital, it may be wise to have some certainty about when labor will occur and plan for labor induction.
It is important to note that induction may not be suggested for women with specific medical conditions as it may not be safe for them. Be sure to discuss with your healthcare provider the process, precautions, risks, benefits and options.
Some doctors and healthcare providers will use the Bishop Score to evaluate how ready your cervix is for labor. There are various features the Bishop Score uses to assess how open, soft, thin and ripe the cervix is.
These include dilation (how open the cervix is), consistency (soft, medium or firm), effacement (thickness), position (the angle including posterior, mid or anterior) and station (how low the baby’s head is in the pelvis).
Each of these features is scored and a higher score means that the cervix is more likely to be ready for labor.
5 Do’s and Don’ts Before Being Induced
There are several things you can do to prepare yourself both physically and mentally before being induced, and there are some things that you should try to avoid.
1. Do Ask Questions
One of the most important things you can do before being induced is to learn and understand what it means for you and your baby. Don’t be afraid to ask your doctor or healthcare provider questions to get a full picture of what being induced looks and feels like.
Some questions you can keep in mind to ask include:
- Why is induction an option for me?
- What are the potential risks and benefits?
- When will I know if this doesn’t work and we have to try something else?
- If this doesn’t work, what will be the next thing I can try?
- Is it painful? Is there pain management during and after the process?
- Can I use the restroom during the procedure?
- Where will this be performed?
- How many times and how often has the provider performed this before?
- Can I be mobile and move around before and after the induction?
- What is the position of my baby and the condition of my cervix?
- Will I need to be monitored closely? All the time or occasionally?
- After the induction, what type of access to healthcare support will I have?
2. Do Stay Open-Minded
In addition to asking questions, mentally prepare yourself by setting realistic expectations. This may not be something you anticipated as part of your birth plan but try to stay open-minded.
Being induced is a different experience compared to having a natural vaginal delivery; however, you should take time to weigh the benefits and risks.
2. Do Pack a Hospital Bag
The induction process can take a while. Instead of waiting and fretting over when you will go into labor after your contractions have been artificially started, occupy your mind with some much-needed entertainment. Bring books, magazines and an e-reader. Create a playlist with all your soothing and motivational music. Pack a tablet with preloaded shows and movies.
In addition, remember to bring a change of loose clothing, large pads, nursing tops, chargers and headphones.
3. Do Eat a Light and Nutritious Meal
Most healthcare providers advise not eating during labor. Enjoy a nutritious meal to give you sufficient energy for the big push. Avoid heavy meals that could cause an upset stomach and digestive issues.
After the meal, remember to make a pit stop at the bathroom to attempt a bowel movement. It will make things a lot easier and more comfortable for you when the time comes.
4. Do Not Try Natural Remedies Without Medical Permission
For some women, it may be tempting to try natural remedies to induce labor. For example, there are old wives’ tales about using castor oil, taking certain herbs and supplements, stimulating the breasts and nipples, having sex, taking a hot bath and receiving acupuncture treatment.
However, the majority of these are not backed by conclusive evidence. Therefore, it is crucial to speak with your healthcare provider before trying anything as some of these remedies can have negative health consequences. It can be frustrating to wait for your baby to come, especially for first-time moms. However, try to relax and let nature take its course.
5. Don’t Pay Attention to Horror Stories
It’s important not to read about frightening induction stories on the internet, or pay too much attention to other moms who might be ready to share their traumatic experiences. Every induction is different, and it’s important to keep your anxiety levels to a minimum. Consider only telling the family members and friends that you most trust that you will be having an induction – and lean on them to help keep you calm throughout the journey.