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The Two Stages of Induction:
What They Are and How To Prepare

The views and opinions expressed are those of the authors and should not be considered medical advice. Always consult your doctor for the most appropriate treatment.

Two Stages of Induction

While “induced labor” isn’t what a mom-to-be hopes to hear, you can be assured the procedure is a common one. In fact, 1 out of 4 women in the United States is induced.

Whether induced or spontaneous, the goal of labor is the same: a healthy vaginal delivery. Getting familiar with the induction process ahead of time, just in case, better informs your birth plan and makes it easier on you when you say, “Honey, it’s time.”

What Is Induction?

Induction is the use of medications or other methods to bring about labor. It’s a two-step process that jump-starts cervical ripening and stimulates labor contractions. Inducing labor can take anywhere from a few hours to a couple of days, depending on your body’s response and whether it’s your first pregnancy.

There are several reasons why your doctor may recommend induction. For instance, if your cervix isn’t dilating, your pregnancy is over 39 weeks without contractions or your health or your baby’s health is at risk, your OB may decide it’s medically necessary to induce labor.

With induction, the goal is a vaginal birth that follows the same process your body might otherwise go through naturally.

Stage 1: Cervical Ripening

Before there’s labor, your cervix needs to get ready to deliver. The cervix is designed to open up, soften and thin out (known as cervical ripening) on its own. But sometimes it needs a little push (pun intended) to get things going.

Things can get hectic when you’re bringing a human into the world.

In the first stage, your doctor will recommend a medication, device or procedure—or a combination of these—to begin cervical ripening. It’s your body and ultimately your decision, so discuss these options with your doctor:

Dinoprostone Vaginal Insert
An FDA-approved medicated removable vaginal insert similar to a tampon that is placed by your OB or midwife.
Dinoprostone Cervical Gel
Another form of the FDA-approved medication dinoprostone. It is administered by a doctor, who will release the gel into the cervix using a syringe.
Pill (Cytotec®/misoprostol)
A medication given orally or vaginally. This option is not FDA-approved for use in cervical ripening.
Balloon Catheter
A device with a small inflatable balloon on one end. Some balloon catheters are FDA-approved.
Stripping the Membranes
A procedure performed by your OB or midwife that involves gently separating the membrane connecting the amniotic sac to the wall of the uterus. This triggers the release of prostaglandins and produces contractions.

Note: All drugs must be proven safe and effective to FDA’s regulations before companies can market them. If the FDA grants approval to a drug, it means they have determined that the benefits of the product outweigh the risks for the intended use.

Stage 2: Stimulating Contractions

Once your cervix is sufficiently relaxed and dilated, your OB will begin the second step—inducing labor. This stage involves stimulating the body to produce contractions (if they don’t start on their own).

Depending on your situation, there are a number of ways to do this:

IV Drip (Pitocin®/oxytocin)
A medication, like the hormone oxytocin, is used to encourage contractions. An IV with a small dose is administered initially, then the dose is gradually increased until contractions are strong and frequent enough to deliver.
A procedure performed using a small hook to rupture the amniotic sac (break your water) to begin producing contractions.

We know. That was a lot to take in. But the more you know, the more likely you’ll be happy with the decisions you and your OB or midwife make later. Things can get hectic when you’re bringing a human into the world, so be sure you’re gathering all the info you can about induction and labor while creating your birth plan. Here are some questions you might want to bring up when talking to a healthcare provider.

Start here. More questions can be found in
our Common Questions:

  • If my cervix isn’t ripening on its own, what are my options?
  • Are these options FDA-approved? Easily removable?
  • Is induction necessary?
  • How will it help contribute to a safer delivery of my baby?
  • What risks are associated with induction?
  • What options are available to me to help support the best possible outcome?
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