How To Make Labor Induction Easier Before And During!
What if there were simple steps that answered your question on how to make labor induction easier? Could these steps also remove your anxiety about the entire ordeal and help you feel confident that the most likely outcome of your induction would be a healthy, vaginal birth?
I’ve been a doula for over 4 years and attended over 200 births. Along the way, I’ve picked up tons of strategies to help moms make the induction process easier. I would love to share them with you and help you make the process of meeting your baby a bit easier.
In this post will talk about what you can do:
before your induction begins to improve odds of the outcome you want
during active labor once you have strong and steady contractions
when you’re 10 cm and ready to push to make sure your body and baby are protected in this short space right before you meet them.
Join us as we uncover the key steps to a successful induction. Ensuring that you not only survive but thrive during this crucial initiation into your new life as a mother to this beautiful baby.
What To Expect In Your Induction
Before we dive into ways to make your induction easier, we should set proper expectations for what to expect with a medical induction.
How Long Does An Induction Usually Take?
A successful induction typically takes anywhere from 12 hours to 3 days. Some people will be more ready for the induction process than others – not emotionally, but physically.
Because of that, some people will go quickly into active labor and can have a fairly short time to delivery. Other people will take days just to have steady contractions.
When you cervix is dilating from 0-5 cm you are considered to be in early or pre labor. Early or prelabor can take some time. Usually when moms have longer labors, most of the time is spent in this part of labor.
When your cervix is dilated from 6-10 cm you are considered in active labor. Typically by this point your contractions will be at least a minute long, and as close as 5 minutes apart from the start of one to the start of another or closer.
In active labor, most moms will dilate about 1 cm every 1 to 2 hours. Once you hit the 6 cm point, you typically have 5-10 hours ahead of your before you begin pushing. Maybe longer.
Of course, this is a general guideline, you are not a statistic and will have your own story! It’s okay if your induction goes faster or takes longer.
How Often Do Inductions Fail?
It’s important to know that induction methods are not fool proof. Your body has a template to follow as it goes through labor. When your labor is induced, it’s like trying to push it through the process it already knows.
But some people’s bodies are more stubborn and don’t take the nudge as well as other people’s bodies do.
Studies show that 80% of times a medical induction will start labor. However, about 20% of times, a medical induction does NOT create contractions that put you into labor.
This is different than having an induction that starts labor, but ends with a surgical birth. An induction is considered successful if it starts labor.
From there, it’s up to your body and baby to manage the process. If either of you are in distress, a surgical birth may become the right option. But, our goal with this article is to add some safeguards to your vaginal birth plan!
Do Induction Increase Or Decrease The Risk Of A Surgical Birth?
You know, this is a great question and one we don’t have an answer to. Right now, here in the United States about 1 in 3 mothers will have a surgical birth. (I am one of them! I had a surgical birth with my first baby and went on to have a vaginal birth with her 10 pound at birth sister.)
In 2018, a group of researchers set out to see if they could reduce the c-section rate by inducing moms at 39 weeks. This was a landmark study called the ARRIVE Trial. In this study, they were successful! Moms who were induced were less likely to have a surgical birth than moms who waited for labor to start on its own. But by how much? 22% of moms who waited for labor to start on it’s own had a surgical birth, compared to 19% who started with an induction.
What this tells us is that whatever these researchers were doing, they were successful at lowering the c-section rate from 33% (the rate of mothers outside the study) to the rates inside the study. But, inducing or not inducing? It made a difference, but not a great one.
What has happened in the real world since the Arrive Trial? Well, more people are choosing to induce. It has not lowered or increased the c-section rate. But, the trend of unfavorable outcomes for babies has gone up. This means a slight increase in the number of babies being admitted to the NICU.
How To Make Labor Induction Easier Before It Starts In 3 Easy Steps
Now that we know that inductions are neither magical tools that always give us what we want or terrible processes that are determined to make you and your baby suffer through birth, let’s focus on why you came here in the first place. You are having an induction and you want it to be easier and to have less complications for you and your baby.
You may be wondering if there are things you can do to make sure your labor goes smoothly once it starts. And while birth is not always predictable, and everyone’s bodies go through the process in their own unique ways, there are several things I suggest to my clients before an induction to tilt odds in their favor for a quick and simple process.
1. How To Make Labor Induction Easier Before It Starts – A Daily 40 Minute Walk
Many moms wonder if they can induce labor by walking. Unfortunately, walking is not effective at starting labor on it’s own. But, it can help your body prepare for labor. How? Walking encourages your cervix to ripen.
If you think about a strawberry growing on a plant, it will turn from a hard white compact sour little berry, to a soft, juicy, yummy bright and delicious berry. Your cervix ripens the same way. Throughout your pregnancy it remains hard, almost like a cork keeping your baby in your uterus and anything not in your uterus OUT of your uterus.
Studies show that moms who take a 40 minute walk four times a week are more likely to have a higher Bishop Score (a number that says how ready your cervix is for labor and birth), more likely to not need an induction because labor just starts on it’s own, makes it more likely your induction will finish with a vaginal birth instead of c-section, and decreases the need for forcep or vacuum assistance at the end of labor.
Long story short – a daily (or at least 4 times a week) walk is a great and simple tool you can be doing the days or weeks before your induction date to help your body prep for the big day.
2. How To Make Labor Induction Easier Before It Starts – Nipple Stimulation
There are more natural and easy ways to help your cervix ripen. Remember when I said 0-5 cm might take a few hours or it might take days? Most of this is the work to ripen your cervix. And, there is a simple thing you can do the 3 days leading up to your induction that can help with this as well.
Basically what you do is you use your hands, or a breast pump on a low setting and you stimulate each nipple for half an hour. It’s best if you do 15 minutes on one side, then switch to the other side for 15 minutes. Then repeat the process one more time for 15 minutes on each side to total an hour of nipple stimulation.
When moms do this 3 days in a row, about 38% of moms will go into labor on their own, just from the nipple stimulation. These moms get to completely avoid the medical interventions and time in the hospital through their early labor.
For moms who don’t go into labor just from nipple stimulation, their cervix usually starts out further in the process of ripening, hopefully shortening the time for the medical induction to take effect once it’s started.
Are There Any Other Benefits Of Including Nipple Stimulation In Your Pre-Induction Plan?
One other cool benefit of including nipple stimulation as part of your induction strategy? In one study researchers found a total of an 84% reduction in postpartum hemorrhage in the group of moms that used nipple stimulation in labor, compared to those that did not.
This is a really positive outcome. Especially since in general, most induction strategies, especially medical inductions, have the opposite effect and increase the risk of hemorrhage.
3. How To Make Labor Induction Easier Before It Starts – Have Fun And Enjoy Yourself
One of my favorite things to teach about in my childbirth class is the effect that emotions have on the labor process. Did you know Oxytocin is the main hormone that drives the labor process? It’s true, this love hormone which facilitates bonding also facilitates the birth process. It is created when you do things that make you happy, that make you laugh and when you have an orgasm.
So pack your hospital bag with things that will make you laugh, have fun and enjoy yourself. By planning ahead you can have a chill and fun experience while you wait for contractions instead of a worry fest.
Here are some things I’ve seen people do to keep their mind off of the ‘what ifs’ and uncertainties of birth and ground their mind in a place where those good hormones flow:
Bring a nintendo switch so you can build a baby themed animal kingdom world
Plan a movie marathon or binge watch a show that you already tie to good memories
Grab a set of these reflection cards for hours of conversation with your partner or any family or friends that visit you.
Of course, if you go right into labor and don’t end up having a waiting space where it seems like nothing is happening at the beginning of your induction, these can add some spark and joy to your first days home as well.
How To Make Labor Induction Easier During Labor In 3 Easy Steps
Alright, so the days before labor you spent walking, stimulating your nipples and both doing things you love and planning to fill your hospital time with things you enjoy. Are these the only tools on your belt? Or are there more things you can do once those contractions are coming steadily and consistently?
Firt, congratulations. Making it to active labor is a huge milestone in the induction process and one worth celebrating. Second, the answer is yes! Let’s explore what do do (or keep doing) now that you have contractions.
1. How To Make Labor Induction Easier While You Have Contractions – Continue Walking And Moving
Did I just say walking again? I sure did. That’s because if you are walking – you are helping your labor progress.
Well if you’re moving around, your contractions are more likely to shift into high gear and cause dilation.
Not only will contractions stick around, but they will intensify (which is the goal and the way you get to the end.) For those of you worried about using Pitocin, it also often means using less of it.
When you are walking, you are also supporting your baby’s descent happening more effectively. And you know what that means, if baby comes down you are moving to the end of labor!
Walking isn’t the only movement that helps labor. Check out my childbirth class for my full early and active labor routines. There are even ways to stay proactive after an epidural when walking isn’t an option anymore! It’s all in the class for you.
2. How To Make Labor Induction Easier While You Have Contractions – Get The Best Information You Can About Your Contractions
When I was in business school there was one thing that I was told over and over and over again. That was, if you make a decision based on bad information, you’re going to make a bad decision. And the opposite is also true. To make a good decision, you need the best information.
I never knew how relevant that would become as I began working with moms through their births. We often think that with a medical procedure there would be an exact dose and the same amount of medication is given to everyone. But because everyone’s body reacts so differently, when it comes to the Pitocin (a man made version of oxytocin) given in an induction, the process is to start at a low dose and keep going up until there are enough contractions.
But what is the definition of enough contractions? There isn’t actually a standard definition. Some nurses will say it’s when contractions are every 5 minutes apart, others will say its when contractions are every 3 minutes apart and others insist that it go up until contractions are every 2 minutes apart – which basically means moms and babies do not get break from contractions.
And this is the best scenario. The other threshold for how much Pitocin given is how mom and baby are tolerating it. Often what I see is the pitocin going up every 30 minutes until baby starts to show dips in their heart rate. At this point, some nurses will decide this is the place to leave the Pitocin level and other’s will back off.
Is there a better option?
How To Get Better Information About Your Contraction Strength
If you do not have an epidural, you will have a pretty clear signal about how strong your contractions are based on how you are feeling them. This is surprisingly accurate. However, once you get an epidural, you lose a lot of information about contractions because you aren’t actually feeling them.
If you decide to get an epidural, I recommend to ask for a thing called an IUPC. This is simply a type of contraction monitor that goes inside your cervix (you can’t even feel it being placed, it’s about as thin as a piece of string). The IUPC will give you clear data not just on when you are having contractions, but how strong they are. Your contractions strength is measured by something called Montevideo units (MVUs).
And guess what, with an IUPC there is a clear and defined definition of when you are having adequate contractions. Which means there is a stop point to turning up medications to speed up your labor that is not you or your baby no longer tolerating it.
When you have 200 MVUs every 10 minutes you are considered to have ‘adequate contractions.’ This means that the contractions are strong enough and frequent enough to cause dilation and progression through the labor process.
Though 200 MVUs is the goal, I’ve seen many births where this number was not reached and the mom still had a healthy vaginal birth.
The bottom line – better information gives you a safer path through labor. After and epidural, ask for an IUPC.
How To Make Labor Induction Easier When Pushing In 1 Easy Step
Okay, so you made it through all of early labor and active labor, now you are ten centimeters and it’s time to meet your baby right?! Well, maybe not.
What’s a normal time frame to push when you’re giving birth. Well, I heard one excellent midwide state it like this.
I usually expect moms to take 2 hours of pushing to deliver a baby
I add an hour for first time moms
And an hour for pushing with an epidural.
While many moms will take less than 4 hours to push out their baby, it also is not an unreasonable or unexpected time frame. Moms pushing without an epidural – you will feel an undeniable instinct for when to push.
But What About If You Have An Epidural?
An epidural can alter the ‘urge to push’ and slow the descent of the baby once the cervix is open. Basically, it is normal for it take longer for a baby to come down and move through the last phases of birth when a mom has an epidural.
Active coached pushing the moment a mom reaches 10 cm can actually interfere with a baby’s ability to rotate, descend and complete the processes they need to go through in order to be born.
Coached pushing also makes it more likely for a baby to have hypoxia, or a lack of oxygen, more likely to need resuscitation and more likely to be admitted to a special care unit.
It can also affect the mothers chemistry.
For a mother, active, guided pushing over a prolonged period can alter her bodily fluid pH which can make her contractions spread out and become less strong. She can reach fatigue from pushing too hard when she is already tired. And, can have more severe perineal trauma.
The Answer: Delay Pushing Until You Have An Urge, Even With An Epidural
I first learned about delayed pushing after an epidural from Dr. Rachel Reed. How do you do it?
You simply wait to push until you can see baby’s head without having to do a cervical check, or until you have the urge to push during your contractions.
This may mean waiting one or two hours for baby to come down before you start pushing.
If possible, it’s best for a mom to get out of a semi-reclined position while she waits for baby to move down so that the sacrum and coccyx can shift backwards to create space for the baby. For suggestions for productive positions to move through while laboring down, please refer to my childbirth class.
It should take only a few pushes to deliver baby if you have labored down with your epidural.
Are there other benefits? Yes! moms that labor down are less likely to have severe tears and to reach a point of fatigue. And the big one – they are more likely to have a spontaneous vaginal birth instead or a surgical birth or a birth assisted with forceps or a vaccum!
When moms labor down, babies have fewer mild or prolonged heart decelerations than moms who begin pushing the moment they reach 10 cm. Meaning that they experience less distress in the birthing process as well.
How To Advocate For Delayed Pushing
One would think that since there are 20 years of research showing that delayed pushing has benefits for mothers and babies it would be standard practice. However, in the area I work in it is not. If you’d like to labor down, please put on your birth plan that you’d like to wait to push until baby is at +2 station or below.
You may have to negotiate that the clock that tracks your pushing time starts only when you start pushing not when you reach 10 cm dilated.
For example, when asking to labor down I was once told by the doctor that the client had 3 hours to deliver her baby, we could spend the time pushing or waiting, but at 3 hours she’d have to have surgery even if baby and mom showed no signs of distress. This was not helpful to anyone.
To be clear, while more studies should be done, the research shows that prolonged pushing can put moms and babies at risk, but a longer second stage of labor does not. These are still being confused in our hospitals.
Make sure you and your team are on the same page. To be clear, delayed pushing typically does reduce the amount of time a mother actually pushes. But it does not reduce the time of the second stage of labor – which is measured from when a mom reaches 10 cm dilated.
How To Make Labor Induction Easier Conclusion
I know this was a lot of information. Let’s summarize all these tips so that you have a quick reference guide here.
To make your induction easier there are three things you can do before labor begins:
Go for regular 40 minute walks as your induction date approaches unless you’ve been told otherwise by your doctor.
Consider 1 hour of nipple stimulation for the 3 days leading up to your induction date.
Make a plan to have things at the hospital that will keep your mind and body busy in a positive way.
To make your induction easier there are a few things you can in active labor :
Continue walking regularly (you can also check out our childbirth class for other movements that support the birth process.)
If you have an epidural, use an IUPC contraction monitor so your nurse and doctor can make better more tailored decisions about how much Pitocin you need rather than just as much as you and baby an tolerate.
To make your induction easier there is one powerful thing you can do when it comes to pushing :
Choose to wait to push until baby is low enough you can see their head without a cervical check or until you have an urge to push. (Waiting up to 2 hours for these things to happen is a compromise I see many providers agree too – but it usually doesn’t take that long anyways.)
I hope this helps you feel more confident in your upcoming induction! I would love to hear your birth story. Tag me on Instagram @shebirthsbravely to share! Here’s to you making choices that reflect your needs every step of the way, whether they align with these tips or not.
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