Induction is not a quick process. Once it has started, it may take more than 24 hours until your baby is born. If your cervix needs to be primed, it may take two days or more.
Women who have induction at 39 weeks should be allowed up to 24 hours or longer for the early phase of labor. They also should be given oxytocin at least 12–18 hours after stripping of the membranes.
It also tells us that many women may not want to have labor induced. And, while the chance of cesarean was lower in the induced patients, labor took longer than it did for those women who waited for labor to kick in on its own.
Pitocin is a synthetic form of the naturally occurring hormone oxytocin and should induce contractions. Contractions typically start about 30 minutes after you've been given the medication, and they're usually stronger, more regular, and more frequent than natural labor contractions.
For first-time moms, it can last from 12 to 19 hours. It may be shorter (about 14 hours) for moms who've already had children. It's when contractions become strong and regular enough to cause your cervix to dilate (open) and thin out (efface).
When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.
In this phase, your cervix will finish effacing and dilate to the full 10 centimeters. This phase may take anywhere from 10 minutes to two hours.
Labor contractions can be quite painful and feel like very strong menstrual cramps. However, depending on when labor induction occurs, you may have already had an epidural (the most common pain medication for childbirth). In this case, you may not feel anything.
Inducing labor involves intervening in the body's natural processes by breaking the amniotic sac, using medication, or both. However it's done, it can lead to fetal distress (such as abnormal heart rate).
Contractions help push your baby out of your uterus. Your provider may recommend inducing labor if your health or your baby's health is at risk or if you're 2 weeks or more past your due date. For some women, inducing labor is the best way to keep mom and baby healthy. Inducing labor should be for medical reasons only.
Moderate amounts of liquid usually are fine, such as water, tea, black coffee, juice, carbonated beverages, or clear broths. We don't want you to have a huge meal when you're going into labor, but Jell-O, applesauce, Popsicles, or toast may be OK during early labor, while you're still at home.
Induction keeps the baby from getting any bigger, which lowers the risk of Cesarean. Elective Cesareans for big baby are only beneficial; that is, they don't have major risks that could outweigh the benefits.
Most women will be able to go home afterwards, but sometimes you will have to stay in hospital because of medical reasons or the method of induction being used.
Risks of Induction
Pitocin causes contractions that both peak and become stronger more quickly than naturally occurring contractions. The result is a labor that is more difficult to manage. In addition, the uterine muscle never totally relaxes between contractions, increasing stress on both the uterus and the baby.
However, the proportion of cesarean delivery was significantly lower for the induced group (18.6 percent), compared to the other group (22.2 percent).
The results, published in the New England Journal of Medicine, revealed that the women who were induced had 3 percent fewer C-sections than those who weren't. “I think it clearly shows that labor inductions do not cause cesareans,” said Dr. Cahill, who was not involved with the study.
Some people report an induced labour to be more painful, and the hospital stay during and after birth may be longer. It is also associated with a more negative birth experience (Adler et al, 2020; NICE, 2021a).
(Some OBs will go ahead and break your water at 3 or 4 centimeters.) The reasoning behind this: “Artificial rupture of membranes” (popping a hole in the amniotic sac) will usually jumpstart labor by getting serious contractions underway.
Traditionally, in most hospitals, induction of labour starts early in the morning, with the start of the working day. In human and animal studies however, spontaneous onset of labour is proven to have a circadian rhythm with preference for start in the evening.
The second, pushing phase of labor continues after the cervix is fully dilated (open) to 10 cm until the delivery of your baby. It averages 4 to 8 hours but can be as short as several minutes.
Although it is the shortest phase, the transition phase is the most challenging. Transition typically lasts 30 minutes to 2 hours as your cervix fully dilates from 8 cm to 10 cm.
Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated. In a 1st pregnancy, the time from the start of established labour to being fully dilated is usually 8 to 18 hours. It's often quicker (around 5 to 12 hours), in a 2nd or 3rd pregnancy.