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How Being Induced Works: A Step-by-Step Guide

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Inside: Being induced can be scary as a first time mom, so here’s exactly what will happen at the hospital during a scheduled induction.

“Nothing?” I dejectedly asked my OBGYN.

I wondered if she could see the look in my eyes, pleading for her to do something.

I was pregnant with my first and six days overdue.

She scheduled a non-stress test for the next day and sent me on my way; large, hot, and getting very impatient.

As it turns out, my baby was in distress and I was immediately sent to labor and delivery to start my induction.

I wasn’t expecting to be induced with my first baby, but I loved my experience and have had elective inductions with the rest of my babies.

RELATED: Everything You Need To Know As A First Time Mom

The How and Why of Labor Induction

Before I explain what happens in the hospital during an induction, I wanted to highlight the different ways to induce labor and reasons your doctor may suggest an induction.

Woman holds hand up showing her induction IV.

Ways To Induce Labor

Medications (such as prostaglandin or Pitocin): Prostaglandin is applied to your cervix (either in a gel or suppository form) often during the evening causing the uterus to go into labor by morning. Pitocin is given through an IV (Intravenous Therapy). 

I had Cytotec (prostaglandin) inserted into my cervix with my first baby, followed by Pitocin. With my following deliveries, I’ve only needed Pitocin.

According to the American Pregnancy Association, one downside of Pitocin is that “labor can progress too quickly, causing contractions to become difficult to manage without pain medication.” (I can attest to that!)

Breaking Your Water (artificially rupturing the membranes): If your cervix is favorable, but your contractions haven’t started, your OBGYN will probably want to break your water to jump-start contractions. 

This is done by inserting a long, crochet-like hook into your vagina to open the amniotic sac. The result is a gush of warm amniotic fluid that may contain meconium (baby’s first poop.)

Natural Ways To Induce Labor: If you’re getting antsy and want to try inducing labor on your own, here are a few things to try (Fair Warning: I’ve tried them all and have never had success, ha!):

  • Walking
  • Sexual intercourse
  • Nipple stimulation
  • Certain foods (i.e. spicy foods, oily salads)
  • Bumpy car rides
  • Strenuous activity
    Pregnant mom holds her belly.

Reasons Your Doctor May Induce You:

  • You’re overdue. If there’s no sign of labor, your OBGYN may induce you around 42 weeks.
  • There’s a complication. Things like low amniotic fluid, signs of preclampsia, gestational diabetes may force an induction. In my case, it was a sign of fetal distress that sent me to labor and delivery with my first.
  • Your membranes ruptured. If your water has broken and you’re not having contractions, your doctor may schedule an induction.
  • You ask for an induction. My doctors have always allowed me to schedule elective inductions at 39 weeks because I’m on subsequent pregnancies. This is also a good choice if you live far from the hospital.

How Being Induced Works

Whether you have a scheduled induction or you’re being sent to labor and delivery directly from your doctor’s office, you’ll encounter several (or all) of these processes:

Expecting couple takes photo in the mirror.

Call the Morning Of

All of the hospitals I’ve delivered at have asked that I call the morning of to see what time I can come in and if they have room for me that day. 

The problem with having an elective induction is that you can get bumped from the list for women who go into labor on their own or have emergency C-sections.

You usually have to call around 6:30 in the morning, and I’ve been asked to come in at 8:00 a.m. and 11:00 a.m.

Check-In

Photo of a hospital hallway.

Once you’ve gotten the OK to head to labor and delivery, you’ll grab your hospital bag and check-in at the desk.

Pro Tip: The nurses will probably tell you to eat something before coming in, but nothing with dairy or meat in it. I grabbed a McDonald’s smoothie and hashbrown before delivering my third and it was delicious!

They tell you to eat before because you get absolutely no food once you’re in the delivery room (unless you count ice chips and popsicles as food).

Change into Gown

Once you’ve checked in and have your delivery room, the nurse will have you change into a hospital gown and those slip-proof socks. Then you’ll get situated in your hospital bed.

Physical Exam

The nurse will then take your blood pressure, temperature, and check your oxygen levels. Get used to that little exam because you’ll have it done frequently while you’re in the hospital.

And you’ll most likely wear the blood pressure cuff while you’re being induced so your doctor can monitor how your body reacts to the medication.

Medical History

After your physical, your nurse will go through all of your medical history with you while she enters the information in the computer. 

And I mean ALL of it.

IV Gets Inserted

Next, the nurse will insert the IV. This is honestly the worst part about being induced in my opinion.

I do not like needles, especially when they are sticking out of my hand.

If you’re IV is uncomfortable at all, let your nurse know so she can adjust it for you.

Cervix Check/Break Water

Once you’re IV is inserted and you’ve gone through your medical history, your doctor will likely visit to check your cervix and break your water.

If this is your first baby, you will likely start with the suppositories in your cervix before your doctor breaks your water.

But if this is your second or third baby and your cervix is favorable, your doctor will probably break your water to get the contractions going.

Pitocin Starts

After your membranes are ruptured and your doctor has given the OK, the nurse will start your Pitocin drip through your IV.

Be prepared for two things:

You will have to go to the bathroom a lot.
Your contractions will start to get intense.

Fetal Monitors

Electronic fetal monitoring machine in the hospital.

Sometime before or after the Pitocin, your nurse will attach the electronic fetal monitors. These are the pink and blue belts you often see in delivery photos. One is to measure baby’s heart rate and the other is to measure your contractions.

Being connected to the monitors can make it difficult to get up and walk around and they constantly have to be adjusted, but most hospitals have a policy requiring the use of the monitors while you’re on Pitocin/have an epidural.

Epidural

Once you’ve been hooked up to the monitors and you have your Pitocin going, you can get your epidural whenever you want. I’ve had it before my water was broken, shortly after it was broken, and several hours after.

The pro to having it sooner is that you no longer feel the contractions. The con is that once you have your epidural in, you can no longer get up and move around the room.

Or you can choose not to get an epidural at all!

If you do decide to get one, the anesthesiologist will sterilize your back, mark where the tube needs to go in, numb the injection spot, and insert the tube.

The worst pain for me is the numbing shot. It feels like a bee sting.

Catheter

And once the epidural goes in, so does the catheter. But you shouldn’t feel a thing because you’re numb down there.

Cervix Checks

After you have Pitocin going and the epidural is in, it really is a waiting game to see how quickly the baby comes. You’ll have routine checks every one to two hours to see how your cervix has dilated and once you’re at a 6 or 7, things will really start picking up!

Pushing

When your cervix is at a 10, it’s time to start pushing!

If you’re a first time mom, pushing could take a while, so be prepared.

With my first, I pushed for 45 minutes; my second I pushed 25 minutes, and my third I pushed for 5!

And if you have an epidural in, you’ll have to push with your legs in the stirrups.

RELATED: What Every New Mom Should Know About Postpartum Body Changes

Pros and Cons of Being Induced

Woman holds up popsicle and smiles while she's being induced.

Even though I’ve loved my experience being induced (and recommend it to any mom who may be indecisive), there are definitely some cons to the process.

Here are all of the pros and cons (in my opinion) so you can make an informed decision with your doctor.

Pros

  • You get to pick your baby’s birthday! (Most of the time)
  • You’ll get a full night’s rest before you deliver.
  • You can make arrangements at work and for family to help with other children.
  • You can get ready before you deliver.
  • You don’t have to go back and forth to the hospital wondering if you are really in labor.
  • You can schedule a photographer/videographer.
  • You know your doctor will be available to deliver your baby.

Cons

  • You may get bumped if the hospital doesn’t have enough beds.
  • Pitocin can cause more painful contractions.
  • The uterus can contract too quickly causing stress for baby.
  • Increased risk of C-section.
  • Serious bleeding after delivery.

The risks associated with induction are rare, but it’s definitely something to be aware of!

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Want More?

If you liked this post, be sure to check out 10 Shocking Secrets About First Time Mom Labor (and How To Prepare!)

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