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Written by: Bentley Porterfield-Finn, Doula
Labor inductions, or interventions that artificially facilitate the initiation or completion of childbirth, have been on the rise recently . In 2018, the CDC reported that 27% of pregnant people were induced . However, this number is likely an underestimation, as induction of labor is underreported in federal statistics . Some labor inductions occur for medical reasons, but some do not. As with other aspects of childbirth, being informed about induction is valuable in the preparation and decision-making process. In this article, I want to review the various medical labor induction methods and things pregnant people should consider when induction is presented as an option.
Some labor inductions are necessary when there are medical problems or pregnancy complications that indicate it is safest to deliver baby as soon as possible. Medical reasons for induction include post-term dates (~42 weeks gestation) if the mother’s water breaks before labor starts (premature rupture of membranes), fetal growth restrictions, or medical complications such as preeclampsia or gestational diabetes. Inductions that occur without medical necessity are frequently referred to as “elective” inductions. For example, many pregnant people induce for due-dates, meaning they are induced because they have reached their estimated “due date” at 40 weeks gestation.
If your care provider begins to mention induction at 39 or 40 weeks, I encourage you to ask your provider questions such as:
- Am I healthy and safe?
- Is my baby healthy and safe?
- What are the medical benefits of inducing?
- Are there any health risks associated with waiting for labor to start naturally?
And when assessing the answer to these questions, use the BRAIN acronym--consider the Benefits, Risks, Alternatives, your Intuition, and Nothing (what happens if you do nothing).
There are various methods of medical labor induction. The method used will depend on factors such as the reason for induction and where your body is in the labor process.
Usually, before spontaneous labor officially begins, your cervix will ripen, efface, and dilate. If you are being induced before your cervix has begun to ripen and efface, an induction method that facilitates this process will be used first. Most of these methods use artificial prostaglandins. Natural prostaglandins are a hormone produced by your body to help kickstart labor. Cervical ripening on its own does not start labor--it’s the first step, so these cervical ripening methods are oftentimes followed up with artificial oxytocin. Natural oxytocin is the hormone your body produces that initiates and sustains labor progress. The most common cervical ripening agents are:
After a cervical ripening agent is used, artificial oxytocin is oftentimes the next step. If your cervix is already dilated or effaced, Pitocin might be the only induction method used.
Other common methods of labor induction include:
Each of these methods comes with specific risks, and I encourage you to do further research on the methods and discuss them with your care provider, especially if you are facing a potential induction. If induction is not medically necessary, it’s best to be patient, trust your body, and have faith that labor will start when baby is ready.
Bentley (she/her) is a birth, postpartum, and bereavement doula in Northern Colorado. She is passionate about providing intentional support to birthing persons through all stages of the birthing process, and witnessing birthing persons discover the power and wisdom of their bodies. Bentley is a member of the Inclusive Birth Collective, providing doula support to underrepresented community members in Northern Colorado. In addition to her doula work, Bentley is a graduate student in the Department of Communication Studies at Colorado State University, where she studies health communication, social support, and identity. Find more information about Bentley and her services on Instagram (@bentleypojo.doula) or on her website (www.bentleypojo.com).
 Little, S. E. (2017). Elective Induction of Labor: What is the Impact? Obstet Gynecol Clin N Am 44; 601–614.
 Martin, J. A., Hamilton, B. E., Osterman, M. H. S., et al. (2019). Births: Final Data for 2018. National Vital Statistics Reports. Vol. 68 No. 13.
 Declercq, E. R., Sakala, C., Corry, M. P., et al. (2013). Listening to MothersSM III: Pregnancy and Birth.New York: Childbirth Connection.