Childbirth: what happens during an induction?

If you are pregnant, you probably have a thousand and one questions about childbirth : with or without an epidural? What happens during a cesarean section? In what cases will labor be induced ? There are so many possible scenarios on the big day!

Sometimes, life's unexpected events can deviate slightly from your birth plan or any of the arrangements you've made for meeting your baby . To be well-prepared, all doctors and midwives will tell you: you need to consider different scenarios and remain open to the unforeseen.

Easier said than done, we know. You've been waiting for this moment for so long, you want everything to be perfect for your baby's first moments . Rest assured, whatever the final outcome, you will be incredibly relieved to finally hold your child in your arms, and that will be the greatest reward.

To help you plan ahead and prepare, we've broken down the process of an induced labor . It's an option that can be considered if your baby is taking a little longer than expected. According to the latest report from Public Health France , induction is used for nearly one in four births in France ! Let us explain.

When can the triggering be considered?

Induction of labor must be decided after a discussion between you and your medical team. It cannot be imposed on you. Here are the different situations in which induction may be considered.

The pregnancy has gone past its due date by several days.

Your pregnancy progressed smoothly, but your baby is taking its time and hasn't arrived by the end of the pregnancy (41 weeks of amenorrhea). You are experiencing a prolonged pregnancy .

If you are a few days past your due date, induction may be considered . Once you reach 42 weeks of amenorrhea , induced labor will automatically be offered, even if you and your baby show no worrying signs.

Rupture of membranes without contractions

Your water has broken but you don't feel any contractions? It happens! It's not exactly the vision of childbirth that is presented to you in films and series, but it's quite common.

If you are affected, induction will be offered to you quite quickly, within 48 hours, because your baby is exposed to a greater risk of infection now that he is no longer protected.

Induction of labor as a precaution

If you or your baby are in danger, your medical team will suggest terminating the pregnancy as soon as possible . For example, if you are carrying twins (or triplets, or more), if you suffer from high blood pressure or gestational diabetes, the option of induction will almost certainly be considered!

Again, nothing serious or very rare. For your information, gestational diabetes affects more than 16% of pregnancies in France, and this figure has been steadily increasing since the beginning of the 21st century. Induction of labor is a precautionary measure to protect you and your baby.

What is elective childbirth?

Have you ever heard of an elective birth ? Or a cesarean section for convenience? It's a rather special case: the date and method of delivery are planned in advance with the medical team.

The term "elective/comfort birth" is somewhat misleading. Generally, it's not a matter of personal preference on the part of the expectant mother, but rather a strategy to protect you from potential complications. Your delivery may therefore be scheduled if:

• Your pregnancy is advanced (at least 8 and a half months),

• Your uterus is not scarred,

• Is your cervix favorable (softened and slightly open)?

It allows you to welcome your baby in the best conditions and avoid emergency measures.

If your medical team suggests elective delivery but you are not keen on the idea, gather all the information you need and make your choice: you have the right to refuse.

Inducing labor step by step

It's the big day! You're finally going to meet your baby! Here's how an induced pregnancy unfolds .

How to best prepare for the triggering event?

Admission to the maternity ward is scheduled for the morning of the induction. Before starting the festivities, have a light breakfast and remember to remove your nail polish, makeup, and jewelry (your baby won't mind).

You can then go to the delivery room or the obstetric emergency room with your pregnancy file under one arm and your maternity bag under the other (or ask your partner to take care of it, why not).

There, you will be greeted by the healthcare team. A midwife will meet with you to review your case. Don't hesitate to ask her any questions and to ask her to explain the induction process if you feel the need.

The midwife will then perform a brief assessment to evaluate your baby's heart rate and the condition of your cervix. This will allow her to determine the most appropriate induction method for your situation.

At that point, don't forget to slip him your birth plan, you have the right to do so!

What are the different triggering methods?

There are several methods of inducing labor. First and foremost, you must ensure that your cervix is fully ripe.

If your cervix isn't ripe , the gynecologist will begin by ripening your cervical spine. Next, they will artificially rupture your membranes (rupture of the amniotic sac). This is done using a small hook (really small, I promise) and an injection of oxytocin. It only takes a few minutes and isn't particularly painful.

Next, how does the induction work? There are hormonal methods and a mechanical (non-hormonal) method.

1. Triggering with prostaglandins

Prostaglandin is a fantastic hormone, used here to induce labor . It serves two purposes: to help prepare your cervix and to trigger contractions. It can be administered in several ways :

• Orally , with one prostaglandin tablet every 2 hours, until the onset of labor.

• The device (a type of suppository) is inserted vaginally by a midwife. It can remain in place for a maximum of 24 hours.

2. Mechanical triggering

If you do not agree to hormonal induction or have contraindications, a drug-free option to induce labor may be offered.

Your midwife or doctor will insert a balloon catheter over your cervix . This process helps to gradually dilate the cervix and induce labor. It sounds impressive, but it's all very slow and gradual.

You are of course free to refuse this option if it does not suit you or to stop the process, even if the balloon is installed.

How does the induction of labor take place?

 Once labor has begun, your midwife will set up a monitor to track your baby's heart rate and your contractions. You will remain in the delivery room for a maximum of one hour before being transferred to your room to rest.

Yes, labor doesn't start instantly . It can take up to 48 hours . Use this time to rest, do exercises with a birthing ball, breathe deeply, watch a series… For some women, labor is very quick, for others, patience is key.

Your midwife will visit you regularly to reassess cervical dilation . If necessary, he or she may suggest reinserting a hormonal tampon or taking a prostaglandin tablet again.

Contrary to popular belief, induced labor does not present more complications than physiological births. Trust your body and everything will be fine!

Induced labor: answers to your questions

Is the induction of labor painful?

In some cases, induction can be uncomfortable or painful. Taking prostaglandins causes contractions that aren't necessarily related to labor but are natural responses of your body. If these contractions are too painful, you can ask your midwife to remove the intravaginal device or not to take another pill.

Another point: inserting the balloon catheter isn't always a pleasant experience and can cause some minor discomfort. However, once labor has truly begun, induced labor is no more painful than any other !

If you want to hear a midwife's perspective, we recommend the episode " How do you induce labor? " from the podcast Tout Sur Elles, hosted by Anna Roy.

Can I still make a birth plan if my labor is induced?

Yes! And the birth plan is even super important to help you reclaim this precious moment.

Some women have a difficult time with induction because they were expecting a “natural” birth, to experience the element of surprise and to experience birth without too much medical intervention.

“ I truly believe that induction is one of the most dreaded scenarios for women who want a natural birth, because we feel, because we believe so strongly in the power of the body, in the hormones that come in naturally, that it's incredibly traumatic. ” Testimony of Daphné,*The Birth Plan: A Qualitative Study on the Motivations of Expectant Mothers to Write Such a Plan* , Marianne Arsac

You can have a wonderful induced labor : choose music you love, your baby's first clothes, involve your partner… Make this encounter a moment that reflects who you are. Whatever happens, be proud of yourself and celebrate what your body is capable of !

Can I have an epidural if my labor is induced?

You can request an epidural from the start of labor ; it can even sometimes soothe contractions related to prostaglandin.

However, an epidural cannot be administered if labor is imminent (whether induced or not). If your cervix is dilated to 7 cm or more, your medical team may refuse to give you an epidural. Finally, note that an epidural does not prolong labor, contrary to some beliefs.

What are some natural solutions to soothe the pain associated with labor induction?

If the induction is too painful, you can seek support from alternative medicine practitioners, such as hypnosis or acupuncture, which can help relieve contractions. Another well-known option is to soak in a warm bath for hours to relax your muscles.

Finally, if you attended your prenatal classes regularly, you may have learned natural relaxation techniques based on breathing or the vibrations of your voice . This is a great option for soothing your body and strengthening the bond with your baby, who is enjoying these last moments in the warmth of the womb.

If induction is recommended, you have all the information you need to make an informed decision. If you're worried, don't hesitate to ask your medical team questions; that's what they're there for. Remember, except in cases of absolute necessity, induction is not mandatory: your body, your birth, your choice .

Discover our tips to help you rehabilitate your perineum after childbirth!