Labor induction is the use of medications or other methods to cause, or induce, labor. This practice is used to make contractions start.
When would a provider induce labor?
Induction is usually limited to situations when there is a problem with the pregnancy, or when a baby is overdue.
Several weeks before labor begins, the cervix begins to soften (called “ripening”), thin out, and open to prepare for delivery. If the cervix is not ready, especially if labor has not started 2 weeks or more after your due date, your health care provider may recommend labor induction.
A health care provider may also recommend labor induction if there is a health risk to mother or fetus.
Health care providers use a scoring system, called the Bishop score, to determine how ready the cervix is for labor. The scoring system ranges from 0 to 13. A score of less than 6 means the cervix may need a procedure to prepare it for labor.
Preparing the Cervix for Labor
If the cervix is not ready for labor, a health care provider may suggest one of the following to ripen the cervix1,2:
- Stripping the membranes. Your health care provider can disconnect the thin tissue of the amniotic sac containing the fetus from the wall of the uterus. Stripping the membranes causes the body to release prostaglandins (pronounced pros-tuh-GLAN-dins), which soften the cervix and cause contractions.
- Giving prostaglandins. This drug may be inserted into the vagina or given by mouth. The body naturally makes these chemicals to ripen the cervix.
- Inserting a catheter. A small tube with an inflatable balloon on the end can be placed in the cervix to widen it.
How is labor induced?
Once the cervix is ripe, a health care provider may recommend one of the following techniques to start contractions or make them stronger:
- Amniotomy (pronounced am-nee-OT-uh-mee). A health care provider uses a tool to make a small hole in the amniotic sac, causing it to rupture (or the water to break) and contractions to start.
- Giving oxytocin (also called Pitocin). Oxytocin is a hormone the body naturally makes that causes contractions. It is given to start labor or to speed up labor that has already begun.
Can induction be requested?
In most cases, induction is limited to situations when there is a problem with the pregnancy, or when a baby is overdue. But sometimes labor induction is requested for reasons other than a problem with the pregnancy.
A woman might want labor induction for several reasons, including3:
- Physical discomfort at the end of pregnancy
- Concern with getting to the hospital in time
- Ensuring her own health care provider or midwife can be at the delivery
- Ensuring her spouse or partner can be at the delivery
- Scheduling issues with work or child care
It is best not to induce labor before 39 weeks of pregnancy (full term) unless there is a medical reason. Preterm infants (born before 37 weeks) and early term infants (born in the 37th and 38th weeks of pregnancy) are at increased risk of illness and even death.4
- American College of Obstetricians and Gynecologists. (2012). FAQs: Labor induction. Retrieved July 22, 2013, from http://www.acog.org/~/media/For%20Patients/faq154.pdf?dmc=1&ts=20120806T1152493842 (PDF – 234 KB) [top]
- American College of Nurse-Midwives. (2008). Induction of labor. Retrieved July 25, 2013, from http://www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000000643/Induction%20of%20Labor.pdf (PDF – 103 KB) [top]
- Agency for Healthcare Research and Quality. (2009). Thinking about inducing your labor: A guide for pregnant women. Retrieved July 30, 2013, from http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=353 [top]
- Reddy, U. M., Bettegowda, V. R., Dias, T., Yamada-Kushnir, T., Ko, C. W., & Willinger, M. (2011). Term pregnancy: A period of heterogeneous risk for infant mortality. Obstetrics & Gynecology, 117(6), 1279–1287. [top]