For many first time moms, induction of labor is one of those mysterious possibilities which causes worry and anxiety. We wonder what induction really means; what will happen to us and how it feels; and how long induction takes from the start of the process to the birth of our baby. Below you’ll find answers to all your induction questions.
What does ‘induction of labor’ mean?
Sometimes labor doesn’t always start on its own or there are other reasons that baby needs to come out sooner. Induction of labor, or ‘inducing labor’, is when labor is started by your doctor or midwife. There are a few different methods which health care providers can use to start labor, and the ones they choose for each woman depends on a number of factors — including how far along in her pregnancy she is; the reason why she’s being induced; the health requirements of mother and baby; and whether or not the mother’s cervix has begun to soften and open at all.
A common technique to help start labor off is the membrane sweep (also called a stretch and sweep or membrane strip) which is done at your doctors or midwife appointment around the 40 week mark, but here we’re focusing on a medical induction in a hospital setting.
How long will Induction take?
Induction is always done in hospital. Unfortunately, there’s no way of knowing exactly how long it’ll take for labor to start when you’re induced but we can give some general timings.
In general, if your body was already preparing for birth, induction will be quicker — so inductions that happen at full term (when you’re 40 weeks pregnant or more) are more likely to progress quickly than earlier inductions.
It could take anywhere from a few hours to several days before labor is established. During the whole process of induction you’ll be cared for and monitored, and will be able to ask questions if you feel uncertain about what’s going on.
Often a medical induction is carried out in a sequence. Starting with the use of prostaglandins or Foley catheter, moving onto rupturing of the membranes and then the use of pitocin/syntocinon.
The first method is given time to start labor off and if that method fails or only partially gets things going, the next method is then used.
This is not always the case though. Depending on where you live you may be put onto a pitocin drip straight away. The dose starts off low and is gradually increased over 6-12 hours.
Methods for inducing labor at hospital and how long each one takes:
1. Prostaglandin Pessary
Medicine containing synthetic hormones is inserted into your vagina, and this helps to kick-start the cervix into effacing (thinning), opening (dilating) and stimulate contractions.
Often this is the first method of induction that is used. You may only need one pessary or you could be given a number of prostaglandin pessaries over the course of a couple of days. It will take from a few hours to a few days to get labor started this way.
If contractions start and labor becomes established after the use of prostaglandins then you may not need any other methods of induction. But if things are still slow then your doctor or midwife will likely suggest breaking your waters (rupturing your membranes).
Time = From a few hours to a few days
2. Foley Catheter or ‘cervical ripening balloon’
Sometimes a Foley Catheter is used instead of, or alongside, prostaglandin pessaries in the initial stages of induction. Your doctor inserts a very thin tube into your cervix with two small, uninflated balloons attached to it.
Once inside, the balloons are filled with water and the pressure on the cervix stimulates the release of natural prostaglandins — hormones which help the cervix efface and dilate. The tube is removed when the cervix begins to open. Once the cervix reaches 3 cm dilation the balloons fall out. This can take up to 24 hours.
Time = Up to 24 Hours
3. Rupturing Membranes, or ‘breaking your waters’
If the cervix is already slightly dilated but labor hasn’t started, your health care provider may use a very small hook, inserted through the open cervix, to break the amniotic sac. This is called the Artificial Rupture of Membranes (AROM or ARM).
This often stimulates the body to go into labor within a few hours. Due to the risk of infection your carers will not want to leave you without the amniotic fluid to protect baby for long and will be keen to get labor started within a few hours if labor doesn’t start on it’s own.
Having your waters broken sounds scary, but it’s actually no more uncomfortable than a routine cervical exam; just be prepared for lots of fluid to flow out. Once your membranes have been ruptured, you’ll be monitored closely, and if your contractions don’t start — or aren’t strong enough — you’ll then be given a drip with synthetic oxytocin to move things along.
Time = From a few minutes to a few hours
4. Synthetic Oxytocin (Pitocin in the US or Syntocinon in the UK)
This hormone is a synthetic version of the hormone oxytocin that the body produces to go into labor naturally. It’s given intravenously through a cannula (a very thin tube inserted into a vein) in your hand or arm.
You’ll be monitored closely and your doctor or midwife will adjust the amount of Pitocin going through your drip so you get the right amount for your body. The amount will be increased gradually over a period of hours. An average time frame for induction with pitocin is 1 cm of dilation per hour which equates to 6 -12 hours. My own induction with pitocin took 4 hours from start to finish, but it can be quicker.
Time = From 2 – 12 hours
Total Induction Time from Start to Finish
So you’re probably starting to add up the length of time an induction can take and realizing that it can be a pretty long process. An induction that includes cervical ripening with several rounds of prostaglandins or a Foley catheter, plus rupture of membranes, plus an oxytocin drip can take several days.
Meeting your baby can take a while!
Total Time = From 2 – 72 hours
Why might I be induced?
Common reasons for the induction of labor include:
- You are already in labor, but not progressing quickly or labor keeps stopping.
- Your baby is overdue. If you go more than a week or two past your due date the risk of complications begins to rise, so most health care providers will encourage induction at around 42 weeks pregnant.
- Your water breaks but labor doesn’t start. Once the membranes have ruptured, both you and baby are at risk of infection if labor doesn’t start on its own.
- Tests have shown problems which may put your baby at risk. If the placenta has stopped working properly; you have too little amniotic fluid; if you’ve developed preeclampsia; or if your baby isn’t growing as expected, your doctor may decide it’s time to induce labor to keep baby and you safe.
- You have a serious illness that may put you or your baby’s health at risk if the pregnancy continues.
If your doctor recommends induction, they’ll discuss all of the reasons and options with you. Unless it’s an emergency, it’s always a decision that you make together with your health care provider.
Will I be able to move around during induction?
Movement is encouraged during labor as it can help to keep contractions going, and movement combined with gravity helps the baby’s head move down into the birth canal. This is no different during the early stages of induction.
However, if you’re induced using Pitocin, you’ll be restricted as you’ll be attached to the drip and to a monitor which keeps track of how your baby’s doing. Nonetheless, you should still be able to stand, squat, use a birthing ball, and move around on or near the bed.
Discuss this with your doctor, and remember that you can ask your health care provider for help with finding the most comfortable position for you during labor. They’ll be able to help you move in a way that eases the pressure you’re feeling and doesn’t interfere with the drip or monitor.
Can I still have pain relief?
Yes — during most inductions you’ll have access to the same pain relief options as you would during a spontaneous labor.
Induction using Pitocin can be more painful as contractions get very strong very quickly, so an epidural is often offered. Your pain relief choices are yours, and your health care team will be able to advise you if you’re not sure.
How long did your induction take from start to baby? Let us know in the comments.
Sources:
1. http://americanpregnancy.org/labor-and-birth/inducing-labor/
2. https://www.babycenter.com/0_inducing-labor_173.bc
3. https://www.healthline.com/health/pregnancy/foley-bulb-induction
4. https://www.verywellfamily.com/how-is-pitocin-used-to-induce-labor-2758964
5. https://www.netdoctor.co.uk/medicines/during-pregnancy/a7608/syntocinon-oxytocin/
6. https://www.marchofdimes.org/pregnancy/inducing-labor.aspx
7. https://www.nhs.uk/conditions/pregnancy-and-baby/induction-labour/