Ready to Become an Induction Expert? Learn the Common Ways to Medically Induce Labor

If you could pick your baby’s birthday, would you?

While some people prefer for their baby to choose their birthday, sometimes it becomes necessary to schedule your baby’s birthday. Yep, we’re talking about inductions on the blog today. So let’s dive into all the different ways to medically induce labor.

First off, why do we have to schedule inductions anyway?!

The reasons for scheduling an induction can range from pregnancy complications, like preeclampsia or gestational diabetes, to personal reasons, like needing a set date to arrange childcare for an older sibling during the hospital stay.

While there are ways you can help encourage your body to prepare for labor, the methods discussed in this post are focused on medical inductions.

Medical Inductions: Let’s Break it Down

There are several methods of induction used by care providers. The methods they use may depend on a few factors:

• their preferences,

• your preferences, and

• the state of your cervix (i.e., is it already starting to dilate (open) and efface (thin))

Cervidil, Cytotec, and Foley Bulbs! Oh My!

If your cervix is not yet beginning to open, your care provider will insert a cervical ripening agent like Cervidil. Cervidil contains a prostaglandin that signals your body to start the process of thinning and opening the cervix. You’ll need to stay in the bed for the first two hours after the Cervidil is inserted and you and your baby will be closely monitored during this time.

Some providers may use a drug called misoprostol (Cytotec) for induction if the cervix is not yet thinned or open. The Cytotec tablets can be inserted into the vagina or taken by mouth and typically work for 4-12 hours. Sometimes you will be given more than one dose. You and your baby will be closely monitored. There is some evidence that suggests the use of misoprostol may increase the likelihood of uterine rupture so it should not be used for someone who has had a prior Cesarean birth.

Some providers like to begin inductions with a Foley bulb. You will need to already be at least 1 cm dilated for them to place the Foley. Most care providers will have you come to the hospital in the evening for placement of the Foley bulb into your cervix. It is then inflated with water or sterile air and your baby is monitored for about 30 minutes. So then what happens?

• The bulb will begin to dilate your cervix to about 4 centimeters

• This can take anywhere from a few hours to the next morning

• Once the cervix is dilated to 3-4 cms, the bulb normally falls out on its own (occasionally your provider will need to give it a little tug)

If you are staying overnight in the hospital (this seems to be preferred by most providers), you may want to request a sleep aid as the Foley can sometimes cause cramping and contractions. Some providers may place the Foley and send their patients home for the night if this is not the birthing person’s first baby, but this is not commonplace.

Pit-o-what?

Pitocin! Pitocin, a synthetic version of Oxytocin, is the most common way to medically induce labor and is administered via IV. Oxytocin is the hormone that causes uterine contractions and this is exactly what Pitocin does too. Pitocin inductions usually begin early in the morning. Most providers do not want you to eat while on Pitocin so they encourage you to eat a good meal before they start the medication. Normally Pitocin is administered at the lowest possible amount and gradually increased until contractions are in a good, consistent pattern. If you are being induced with Pitocin, you and your baby will be closely monitored. Ask your nurse about using wireless monitors if you would like to be able to move around the room during your induction.

What Else You Got?

How about nipple stimulation? We are seeing more and more providers recommend nipple stimulation as a way to bring on contractions or to increase the frequency and strength of contractions. You can ask your nurse for a hospital-grade pump and ask your provider for their recommended protocol — typically pumping for intervals of several minutes over a couple of hours. Some providers will want to monitor you and baby during this time.

AROM, or artificial rupture of membranes, is another induction method preferred by some providers. Your care provider will use a tool called an amniohook to break your bag of waters. You and your baby will be monitored during this procedure and for a few contractions after your water is broken. Your provider will also take note of the color of the amniotic fluid. Most people do not describe this method as painful but they do notice that the contractions tend to increase in intensity after the water is broken. This is a good option for induction if your baby is already engaged in your pelvis.

While some of these methods are used as a stand-alone method of induction, we often see care providers use a combination of one or more of the above methods.

If you are planning to have an induction, ask your care provider about their typical process. Keep an open dialogue with your nurse and care provider throughout the induction process.

It’s ok to ask questions and discuss potential risks, benefits, and alternatives.