Are you preparing for or worried about an induction? Then you’re in the right place! In this blog, I will be sharing our top ten tips for labor induction based on our experience as a birth doula and labor nurse/student midwife!
Roxanne and I have supported hundreds, maybe even thousands, of births, many of which are labor inductions. Based on our professional experience, these are the things we find more helpful when approaching your labor induction!
Our Top Ten Tips for a Positive Labor Induction Experience
One of the key factors to having a positive birth experience is to feel that you are the primary decision maker and that you feel informed of your options throughout your birth. This applies especially to an induction where there are a lot of decisions being made throughout the entire process!
When I reflect on my first birth experience, which I do not consider a positive experience, the main thing that contributed toward a negative experience was that I felt that I was a passive participant in my birth experience. I didn’t understand why the nurse was giving me Pitocin, my request to turn it off was ignored and laughed at, and any time I tried to be a part of the decision-making process, I was ignored.
In subsequent pregnancies and births, I found a provider that I felt actually listened to me and honored the fact that I was an autonomous person and could make decisions about my birth. I chose a provider that I trusted to guide me and respect me as a patient, and it made a huge difference in my next birth experiences.
We hope that after reading this blog and joining any of our online childbirth education courses, you feel more informed of your options so you can confidently navigate a conversation with your medical team throughout your pregnancy and birth–and recognize if you need to find a new provider that will do a better job of supporting you.
Labor induction is usually an unexpected recommendation near the end of your pregnancy. Maybe you’ve developed a prenatal complication that is causing concern, and your provider is recommending a medical induction. Maybe you’re past your due date and nearing 41 or 42 weeks, and your provider is bringing up an induction. Or maybe you want to opt for an elective induction after 39 weeks for personal reasons.
You may find out at a prenatal appointment that your provider is suddenly recommending an induction, and it can create a lot of anxiety if it wasn’t your plan or expected!
In this YouTube video, we discuss our top ten tips if you find out that you need to be induced, or you can continue to read the blog for those tips!
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1) Ask Questions Until You Feel Confident to Make a Decision
Our first tip is to feel confident about making a decision–to either have an induction or to continue your pregnancy. Whichever option you decide is up to you, but feeling confident in your decision is important!
If you are unsure about why your provider is recommending an induction, or you are not sure it’s the best option for you, you can use the acronym BRAIN to help you gather information.
- B: Benefits: what are the benefits of this choice/intervention/option? How would choosing this improve my birth outcomes?
- R: Risks: what are the risks of this choice/intervention/option? Why do the benefits outweigh these risks? Do I feel that this risk is worth taking? How could choosing this negatively impact my birth outcomes?
- A: Alternatives: what other options do I have besides this one choice? What are the risks and benefits of these alternatives? Why is this alternative not the first option, or is it just as good of an option?
- I: Intuition: how confident do you feel that this is the best decision for you? This does not necessarily mean it’s the decision you like or want, but you should feel confident it’s the right decision. For example, you may not have been planning to get induced and you may not want to be induced, but you feel confident based on the information that you’ve gathered that getting an induction (or not getting an induction) is the best option for you.
- N: Nothing–what happens if you do nothing? What are the risks and benefits of waiting or taking more time to make a decision? What options are available to you if you decide you want more time, such as additional testing for your baby.
However, it can be hard to know what questions to ask when you are feeling anxious or overwhelmed by an unexpected change in your birth plan. If you are having a hard time remembering BRAIN or knowing what questions to ask, start with what is familiar to you–how do you feel right now?
If you are feeling anxious or scared, express that to your provider: “hey, I understand that you are recommending an induction, but I feel really anxious and scared about being induced.” And from there, your provider should help to ease your concerns and begin to answer questions that they know are common to this concern.
2) What is the standard induction protocol at your birth location?
Next is to understand how your birth location typically does inductions. Each hospital may approach inductions slightly differently–in general, they all should follow a general outline of introducing interventions until you are in active labor–but which interventions they choose and how quickly they progress through induction can vary.
You can ask this at a prenatal appointment–ideally before you find out you need to be induced–but if you’re at your “finding out” appointment, it can help you to understand what to expect. When we understand something, it tends to make it less scary.
You can ask your provider to walk you through what a typical induction looks like at their hospital, such as how they decide which intervention to start with and how quickly they progress through the interventions.
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3) What are the monitoring options for your contractions and baby?
Another tip is to understand what your monitoring options are for you and your baby during your birth, and what interventions your birth location requires continuous monitoring.
Some options could include:
- Wired, non-portable monitors. These monitors are attached to a stationary machine and could limit your freedom of movement while being monitored.
- Wired, portable monitors. These monitors are attached to a portable machine, usually the size of a small purse, that can be easily moved around. However, you are still attached to cords.
- Wireless monitors. These are Bluetooth monitors that are placed on your belly without any wires. Some are waterproof and some are not, so verifying with your birth team on this will be important if you want to get in the tub or shower.
Knowing what type of monitors your birth location has can help you with your expectation management of what type of movement you will be able to do! For example, if your birth location requires continuous monitoring and they only have wired, non-portable monitors, you will likely be next to your bed for most of your labor.
4) Consider a cervical exam to understand how your induction may begin
Before you head to your induction, it could be helpful to know what’s going on with your cervix–how dilated (open) and effaced (thin) is your cervix right now? If it’s pretty closed and thick, then you may want to go in at night to do cervical ripening overnight. But if you’re already 3 cm dilated, you may want to wait until the morning to start Pitocin, so you can get a good night’s sleep in your bed.
If you know what’s going on with your cervix before you head into your induction, it can help you plan when to start the induction and what steps to expect when you get there–this can also help make it less scary!
5) Ask about your options with each step--there is always another option you could explore!
This tip is similar to tip 8, but take your time with each process of the induction to ask questions and feel confident about making the next decision (if needed). If you feel unsure that you’re ready to take the next step in your induction or you want to take more time to see if things pick up on their own, take the time to have a conversation with your team.
For example, you may have just finished up your first dose of cervical ripening and are not sure if you’re ready to move on to Pitocin. You could try breast pumping to do nipple stimulation to see if it starts contractions for you before starting Pitocin.
There may be times when waiting is not the best option, such as if your water has been broken for over 24 hours and you’re starting to show signs of an infection–in this situation waiting may not be as beneficial as moving on with the next step.
Take time to explore your options with each step of the decision-making process so that you feel in control and informed throughout your entire experience.
6) Eat before you head to your induction!
This one is important–EAT before you head to your induction!! Please, eat!! There are likely food restrictions at your hospital (some do allow you to eat up to a certain point, but not usually). Induction can take hours or DAYS, so that is a long time to not eat anything other than Jello and bone broth. Before you head to your induction, eat a full meal that is ideally high in fat and protein to give you sustained energy.
Having a conversation with your provider about their food policy can help shape your expectations, as well. I have been at some inductions, where the staff was supportive of their patients eating until they received an epidural or until they received a certain intervention. I have also been at inductions where they had an ice-chip-only policy, where you could not consume anything other than water and ice chips. So, it can vary based on your hospital, and will be important to know your expectation management.
7) Ask for breaks!
Sometimes things take a while to process, and you may be at a point where it’s time to progress to the next step of induction. These lulls can be a good time to ask for a break to reset before moving on to the next step of your induction.
For example, if you just finished cervical ripening for the past 12 hours, before starting Pitocin, you could ask to eat breakfast and shower, then start Pitocin after you’re ready.
Another example could be if you’ve been on Pitocin for a long time, and you are still not in active labor, you could ask for a “pit-break” to let your body reset. This could be a great time to eat and shower, before resuming Pitocin.
But inductions can be a slow process, so it is okay to ask for breaks!
8) Be patient with the potentially slow process
Similar to tip 5 and 7, be patient with this process! Inductions can take a long time! Generally, I see them take at least 24 hours, sometimes shorter, but usually longer. It can take a while to get things going, which can be frustratingly slow.
But there is no need to rush to each step–give each intervention time to work. Sometimes each step just takes time!
9) Know the signs of labor progress beyond a cervical exam
One of the things that can contribute to infection is excess cervical exams. However, cervical exams can be frequent during a labor induction to see if there is any progress being made. If there is no change, then it may be time to take the next step–but if there is change, then you may want to stay where you’re at!
How can you still know that your labor is progressing but limit cervical exams? One, you can limit them to at least every four hours. Two, you can understand other signs of labor progress!
Some other signs of labor progress could include:
- Contractions are getting stronger and closer together--the goal is every 2-3 minutes lasting for 1 minute in length.
- Movement pattern changes during contractions--this could mean the baby is moving further down in your pelvis!
- Temperament changes–this could mean you are shifting into active labor! If you are feeling less aware of your surroundings and more internal, this could mean that you’re shifting to active labor!
- Increased bloody show--this could mean there is cervical change happening, as the cervix is really vascular.
If you are noticing a shift or any of these other signs of labor progress, it could be reasonable to forego the cervical exam and see if your labor continues to progress.
It is also okay to opt for the cervical exam if you want reassurance that there is change (or no change) happening to help you make this decision. But, overall, we do want to limit the number of cervical exams to reduce your risk of infection.
10) You can always leave if this is an elective induction and your water is intact!
And finally, you always have the option to stop the induction and leave. This applies more if you are being electively induced (no medical reason) and your water is still intact. If your induction is taking a long time and it doesn’t seem to be progressing, you can always just ask to leave and try again another day!
You can have a positive induction experience!
An induction may not have been your plan–especially if you wanted a low intervention, unmedicated birth. It may feel like the opposite of what you were preparing for, and potentially scary! The good news is that you can still have an unmedicated birth, even with an induction–check out the birth stories in this blog from our podcast that share their unmedicated induction stories.
The best way to have a positive experience is to be an active participant in our birth story–if you feel that you are the one making the decisions with guidance from your team, and you understand your options, you are more likely to feel good about your experience! Ask questions, take your time, and know that you maintain your autonomy at all times! You can make decisions about your birth with your team but know that you are the ultimate decision-maker in your experience!
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