You have been counting the days down to your baby’s due date and now the plans have changed and you are getting induced. This can be a stressful change of plans. It is understandable if you need time to grieve the loss of going into labor the way that you expected. Doctors frequently recommend inductions when there is medical indication that the baby needs to come sooner or the birthing parent’s health is at risk.
Some doctors are now routinely offering to schedule inductions at 39 weeks. You will get a scheduled day and time for your induction. Depending on the reason you are getting induced, your hospital may call you before you come in to reschedule if there are a lot of patients giving birth then.
Here’s Everything You Need To Know
Once you get to the hospital for your scheduled induction time, here’s what you can expect:
Please note that we are not medical providers and this information comes from our attendance at induction births. We are providing this information because we know that information is helpful and can help you plan. Please see our full disclaimer here.
1. You will go to your hospital’s labor and delivery ward to check in.
You will need to show your ID and any support people you have with you will as well. You will get your ID bracelet.
2. Your nurse will take you to your room. They will review your medical history and your birth plan (if you have one).
They will start an IV or hep lock and take your vitals. For inductions, you can expect that your baby will be continuously monitored.
The nurse will put two monitors on your belly. One monitors your contractions and the other monitors your baby’s heart rate.
3. A doctor will come in to introduce themselves, discuss the induction plan, and assess your cervix.
The beginning of the induction process is getting your cervix “favorable”. This means that you are a few centimeters dilated and your cervix has started to soften.
4. If your cervix is not favorable, then your doctor will recommend misoprostol.
This medication will help to soften the cervix and help with early dilation. Usually, it is administered vaginally and you may do one or two rounds of misoprostol. It is possible to take the medication orally as well, though vaginally is preferred.
5. After four hours, the doctor will come and assess your cervix again.
They may recommend another round of misoprostol or if your cervix is favorable, then they will move on to the next step.
Let’s Keep Going With The Induction Process Step By Step
6. The next step is to start with pitocin. This is the medication that will get your contractions started. The nurse will start your pitocin slowly and monitor your body’s response and your baby’s response.
They are trying to get your contractions to be regularly spaced a few minutes apart and also make sure that your baby does not have any sustained low heart rate responses to your contractions. This process also dilates your cervix. This process can take quite a while; anywhere from 12- 24 hours.
7. At some point your water may break. If it doesn’t, your provider may suggest artificially rupturing your membranes.
This is frequently suggested if you have a several hour delay in your labor where your cervix is not continuing to dilate. It helps to bring your baby down in your pelvis and applies additional pressure on your cervix to help it to continue dilating.
8. Once your nurse has found a good pitocin dose for you and your water has broken, then you have to wait for your body to finish dilating.
9. At some point, you may decide that you would like pain management. There are typically three options-, fentanyl, laughing gas, and epidural.
Fentanyl is usually helpful with the pain, but also usually only works for about 20 minutes and you can only have it once an hour.
Laughing gas helps, but doesn’t take away all the pain. You hold up the gas mask to your face and self-administer by breathing in through the mask.
Epidural is the pain medication that you have likely heard of before. It’s administered through your spine and typically works very well at taking away your pain. You need to hold still for several minutes in order to receive the epidural.
There’s not usually a point when it’s too late to receive the epidural (unless you are fully dilated and ready to push), but you need to be able to hold still, and that is often difficult during contractions. If you think you might have a hard time holding still, you can talk to your nurse about having a dose of fentanyl during the epidural placement.
Epidurals are better than they used to be and you will typically still be able to move your legs a little. You will also get a button to press that will deliver more of the epidural medicine if you need more pain relief.
10. The next step is that you have reached full dilation and are ready to start pushing!
If you haven’t had an epidural, your body will tell you it’s time to push. If you’ve had an epidural, then you might not have the feeling like you need to push. Your nurse will help you find an effective pushing technique and position.
Just because you have had an epidural, doesn’t mean that you have to push flat on your back. You can do supportive side-lying positions. Ask your support team to help you move, if you want to.
11. There are a few different ways to push, check out an upcoming article for pushing tips! Your nurse will stay with you while you are pushing and the doctor will come in whenever your baby is almost ready to be born.
Hopefully this article helps you understand the steps that will happen during an induction. This is a good jumping off point to discuss your options and your specific situation with your provider. Knowledge is power!