What You Need To Know About Labour Induction

Let's be honest: birth plans are great to have, but babies often have their own plans and doctors do what they can to make sure everyone stays healthy.

Hearing the word 'induction' can bring up emotions and questions. But before anxiety takes over, it's important to know that induced labour is a common part of many birth stories. To help you feel informed and reassured, experts share what the process involves—from why it’s needed and the methods your care team may use to what the experience actually feels like as it happens.

What is labour induction?

Labour induction is exactly what it sounds like: starting labour with medical support instead of waiting for your body to take the lead. Jennifer Wood, a labour and delivery nurse, childbirth educator, and birth doula, explains that it can involve medications tailored to the parent and baby.

"Urgency, patient preference, or a provider's philosophy can shape how the induction unfolds," she explains. "That might mean interventions like cervical ripening, amniotomy, or giving oxytocin."

Still, no two inductions are alike, and the type of induction greatly depends on each situation. “Sometimes just one dose of Cytotec is enough; other times, induction may take days—and can include meals and multiple rounds of Pitocin,” Wood says.

The different types of induction

There isn’t just one way to bring on labour. Your care team can choose from several approaches depending on your health, your baby’s needs and how ready your body already is. Here are the most common methods:

• Cervical ripening agents (prostaglandins): Medications such as Cytotec (misoprostol) or Cervidil (dinoprostone) are placed in or near the cervix to soften and thin it. This makes it easier for contractions to become effective once labour starts.
• Foley balloon catheter: A small balloon is gently inserted into the cervix and inflated to apply pressure, helping it open gradually. This is a non-medication option often used before moving on to other steps.
• Membrane sweep (stripping): Your provider uses a gloved finger to separate the amniotic sac from the wall of the uterus. This can trigger the release of natural prostaglandins and sometimes gets contractions going.
• Amniotomy (“breaking the waters”): Using a small plastic hook, the provider makes a tiny opening in the amniotic sac to release fluid, which can help intensify contractions.
• Oxytocin (Pitocin): A synthetic form of the natural hormone oxytocin is given through an IV to start or strengthen contractions in a controlled way.

Most often, induction is a combination. For example, a provider might start with a Foley balloon, follow with prostaglandins and then use Pitocin if labour needs more encouragement. The choice depends on your body’s readiness, your baby’s position and how quickly your care team needs labour to progress.

How common is labour induction

Labour induction rates are rising globally, and there's way more shaping the story than medical protocol.

Board-certified OB-GYN Dr. Greg J. Marchand. explains, "Technology gives us a better understanding of pregnancy risks, making induction safer than ever,” he says. "For example, effective cervical ripening agents, like prostaglandins, make inductions more predictable and successful. Doctors can carefully initiate labour at the right moment."

But technology isn't the only reason for the uptick. Marchand points out that elective inductions (meaning, starting labour for non-medical reasons like personal preference or logistics) at 39 weeks of pregnancy have notably increased, thanks to major studies like the ARRIVE trial, which showed that induction may help lower certain risks in appropriately selected pregnancies.

Shifting demographics play a role, too. "Changes in demographics, like higher maternal age, higher rates of obesity, and more pregnancy-related conditions—such as diabetes or fetal growth concerns—are making earlier inductions a smart choice for protecting parents and newborns,” Marchand adds.

Why might labour induction be recommended?

Inducing labour isn't just reserved for emergencies. It can happen for plenty of medical and personal reasons. According to Sarah Lavonne, a board-certified labour and delivery nurse and educator, common triggers for induction include pregnancies that stretch past 42 weeks, more serious hypertensive disorders of pregnancy like preeclampsia and gestational hypertension, and concerns about the baby's development.

“If the placenta isn’t working as well as it should, or doctors spot fetal growth restriction, that's when induction might come into play,” she says. “And sometimes, if your water breaks without contractions kicking in, there’s not enough amniotic fluid (which is oligohydramnios), or conditions like gestational diabetes or intrahepatic cholestasis pop up, induction becomes necessary.”

But the call isn't always clinical. Lavonne points out that some expectant parents choose induction for personal reasons, such as wanting to guarantee their doctor’s presence, feeling a rush to meet their baby, or facing a long drive to the hospital. “Elective induction is only an option from week 39 onwards to ensure safety comes first,” she emphasizes. “Families need the full rundown on the risks, benefits, and alternatives before saying yes.”

The benefits of labour induction

The idea of being induced can make parents nervous, but Marchand says it comes with some surprising benefits.

“Research shows that inducing labour at or beyond 39 weeks in the right pregnancies can lower the risk of stillbirth and reduce perinatal mortality,” he explains. "Studies like the landmark ARRIVE trial have also found that induction may lower rates of preeclampsia by halting hypertensive issues before they fully surface—and it can even improve chances of a vaginal delivery, often cutting down on unnecessary C-sections."

For families, having a set birth date can also make life a lot more manageable. “If there are older kids at home and childcare is an issue, parents often find it incredibly helpful to have a scheduled birth date,” adds Amy Lowell, CNM, Director of Midwifery at MetroHealth in Cleveland. "And for pregnant people who feel uncomfortable as the final weeks drag on, induction can sometimes feel like the right step forward."

Opting for induction also means getting eyes on you a little sooner. “Labour is very safe for most women without risk factors, regardless of whether it starts on its own or is induced,” Lowell explains. “But when induction is chosen, we begin monitoring from the very first step. The goal is to make sure parents are well-informed about what induction really looks like—including the fact that it doesn’t always follow a predictable timeline.”

Potential risks and drawbacks of induction

Induction can keep birth safe, but it's not risk-free. “Induction might mean a longer hospital stay, extra interventions like epidurals or C-sections, and stronger contractions—especially with medications like Pitocin,” says Lavonne.

Possible complications include postpartum bleeding, tears, NICU admission, or shoulder dystocia, though these risks usually stay low. “Risk doesn’t instantly mean high risk—most of the time, it’s going from very low to a little less low,” Lavonne explains.

Here's what you might encounter with common induction methods.

• Breaking the water: Rare risks include infection, shifts in the fetal heart rate, or umbilical cord prolapse.
• Prostaglandins (Cervidil/Cytotec): These soften the cervix but can sometimes cause strong or frequent contractions. Rare issues include uterine rupture or infection.
• Foley balloon catheter: Carries a small risk of infection but is less likely to cause strong contractions.
• Pitocin (oxytocin): Can mean strong, frequent contractions, changes in the baby’s heart rate, postpartum hemorrhage, or very rare water intoxication. Long inductions can be associated with higher rates of some complications (like infection or hemorrhage), depending on clinical factors; your team monitors for this.

Other things to know about induction:

• Induction may mean a higher cesarean risk, longer labour, and more frequent contractions, Lavonne notes.
• If the cervix isn't quite ready, labour may stall or the baby may not tolerate it, raising the chances of a C-section.
• Early labour takes longer to get into than active labour.
• Medications sometimes cause overly strong contractions, so both the patient and baby are watched closely.

The induction process: What to expect

Step 1: Hospital admission and assessment

Marchand explains that labour induction begins with admission to the hospital, where health checks and monitoring are performed for both parent and baby. “Blood tests and urine samples are standard,” he notes.

Step 2: Cervical ripening

If your cervix is not ready for labour, medications such as prostaglandins can be used to soften and thin it, making it easier for the wall of the uterus to contract effectively when labour starts.

Step 3: Starting induction

Once your cervix is 'ripe,' induction begins. "Labour may be started by gently breaking the amniotic sac with a small plastic tool (known as amniotomy), which releases the fluid," Marchand explains. "Alternatively, oxytocin can be given through an IV to speed up labour in a controlled medical setting.

Step 4: Pain management

Pain management options are available throughout induction and labour. “Epidural anesthesia provides significant relief, while intravenous medications offer rapid comfort, and nitrous oxide (or laughing gas) is also an option,” says Marchand.

Step 5: Progressing  to active labour

Medical teams closely monitor each patient’s progress, adjusting medications as needed for a safe experience leading up to the moment your baby is born. “It can take up to 72 hours for first-time parents; those who’ve delivered before often progress faster,” Marchand explains.

Step 6: What to bring/How to prepare

Pack comfortable clothes, snacks, entertainment, and personal items," Marchand recommends. "A support partner or doula helps, and planned rest periods conserve energy."

Making an informed decision about induction

Induction is generally safe, but making an informed choice matters. Dr. Sara Cramton, MD, Medical Director at Unified Women’s Healthcare, emphasizes that expecting parents should feel empowered to choose providers who listen, answer questions, and leave space for discussion.

“Parents-to-be play an important role in every decision about their care,” she says. "Coming to appointments prepared, speaking up, and turning to trustworthy resources—whether from your provider’s office or sites like ACOG.org—can make the process less overwhelming."

Cramton also recommends asking about your Bishop Score, a tool doctors use to gauge how ready your body is for labour. "Having that conversation helps you better understand your options and ensures that decisions reflect not just medical guidance, but also your personal values," she suggests.

When to discuss induction with your care provider

The best time to bring up induction with your doctor? Anytime, says Dr. Clodagh Mullen, MD, a board-certified OB-GYN. But in reality, these conversations tend to happen in the third trimester, once it’s clearer whether induction might be needed. As due dates approach, providers often walk patients through the difference between medical induction for health conditions and elective, risk-reducing induction.

“We see patients weekly in the final month, because new concerns can come up quickly,” Mullen explains. “If there’s high blood pressure or reduced fetal movement, for example, that’s when induction often becomes part of the plan.”

Above all, Mullen suggests preparing for both possibilities. “I recommend patients create a birth plan and an induction plan,” he says. “That way, you’re not setting expectations for spontaneous labour on a medically guided induction.”

Experts

• Jennifer Wood, BSN, RN, CD (DONA), is a labour and delivery nurse, childbirth educator, and birth doula.
• Greg J. Marchand, MD, is a board-certified OB-GYN.
• Sarah Lavonne, RN, BSN, is a board-certified labour and delivery nurse and childbirth educator.
• Amy Lowell, CNM, is Director of Midwifery at MetroHealth, Cleveland.
• Sara Cramton, MD, is Medical Director at Unified Women’s Healthcare.
• Clodagh Mullen, MD, is a board-certified OB-GYN.