Being Induced: Why Labor Is Induced, How It Works and How Long It Takes

What induction means

Induction is starting labor with medicine or other methods instead of waiting for it to begin on its own. It is very common: roughly 1 in 3 U.S. births now starts this way.

Common reasons

• Reaching 41 weeks (ACOG says induction is reasonable then and recommended by 42 weeks).
• High blood pressure or preeclampsia, diabetes, or other health conditions.
• Waters breaking without contractions starting.
• Concerns about the baby's growth, low amniotic fluid or changes on monitoring.
• Elective induction at 39 weeks. In a large U.S. trial of healthy first-time parents, this did not raise the C-section rate and slightly lowered it. Many hospitals now offer it; it is a choice, not a rule.

How it is done

Your team usually checks how soft and open the cervix is first (often called a Bishop score). A "ripe" cervix tends to mean a shorter induction. - Membrane sweep: a finger gently separates the bag of waters from the cervix during an exam, sometimes done in the office a week or so ahead. Crampy and a bit of spotting afterwards is normal. - Cervical ripening: prostaglandin medicine placed in the vagina or taken by mouth, or a small balloon catheter that gently opens the cervix. Some hospitals let you go home with a balloon. - Breaking the waters (amniotomy): a small hook makes an opening in the bag. It doesn't hurt more than an exam. - Oxytocin through an IV: the same hormone your body makes, started low and turned up until contractions are regular. Most people need a mix of these. If you've had a C-section before, some ripening medicines are avoided; ask what your plan is.

What it is like

• It can be slow. With an unripe cervix, a first-time induction can take one to two days or longer before active labor. Bring snacks for your support person, chargers, and something to pass the time.
• The baby's heart rate and your contractions are watched closely, often continuously. Ask about wireless monitors so you can move, use a ball or change position.
• Contractions from oxytocin can feel strong and close together. Epidurals and other pain relief are all still options (see the epidural guide).
• Eating rules vary by hospital; many allow clear liquids or light food early on.

Questions worth asking

• Why are we inducing, and what happens if we wait a day or a week?
• Which method do you suggest first, and why?
• Can I go home during ripening? Can I eat, walk and use the shower?
• What would make you recommend a C-section, and how long can we keep trying?

When to check in

• Ask at your 39-40 week visit whether induction makes sense for you, especially if you're past your due date.
• During ripening at home, follow the instructions you're given for when to come back (contractions, bleeding, waters breaking, fewer movements).
• If you have heavy bleeding, a severe headache with vision changes, or your baby stops moving, call 911 or go to labor and delivery right away.