Induction of labor is definitely a process. How long will it take? What should you expect? Pregnant women often wonder how long will it take until they give birth?
But first, why would you listen to me?
Hi, I’m Hilary — The Pregnancy Nurse 👩⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. 🩺 I have started thousands of inductions (and even had one of my own) so I really am a pro in this area. While no one can tell you exactly how long your induction will take — there are a lot of factors that can help us give a guess.
In this Article:
While this article is top notch, if you really want to understand inductions from making the choice clear to when your baby is born — I really recommend my class Inductions Made Easy. In less than 20 minutes you’ll be fully informed in:
- How to make the choice for an induction
- What normally happens at an induction
- Common induction outcomes.
How long will my induction take?
Things that affect labor timing
There are a few things that can affect how long it will likely take for your cervix to open.
We qualify these as something called the “bishop’s score”. It measures how prepared your cervix is to open. It’s on a scale of 0 to 13. You don’t need to know your bishop score, but some hospitals won’t do an elective induction if your cervix isn’t open/soft enough.
What/Where is your Cervix?
Your Cervix is at the end of your vagina, it’s at the opening of your uterus.
Cervical Dilation
This means how OPEN your cervix is. I have a whole post that explains vaginal dilation on my sister site, but what you need to know is that as the baby progresses into your pelvis, the cervix opens. Kind of like when you push your head through a tight sweater neck.
The numbers go from 0 (or closed) to 10 (ten is actually when your cervix disappears behind the baby’s head).
The more open your cervix is, it normally means your induction will be shorter. Which make sense, as you don’t start to push the baby out til’ 10 centimeters (cm).
Cervical Thinning
If you keep the “head through a sweater” analogy, you’ll know that the sweater thins at the neck as you pull your head through. The same thing happens with your cervix.
Medical providers measure this as a percentage. Anything more than 50% normally just called “thick” (frankly, it’s impossible for us to know how thick your cervix is in the beginning).
We CAN measure the length of your cervix but that is done by ulrasound, rather than our hand.
That all being said, if your cervix is thick, it normally takes longer until the baby comes out.
Baby’s Station
It’s an odd way to say it, but this measures how above or below your ischial spines (your butt bones) the baby is.
I think it’s easier to envision how high or low in your pelvis the baby is.
If the baby is high it will take longer for it to descend.
NORMALLY, the lower your baby is, the more it will start to open your cervix (again, as you push your head further into the sweater it opens more).
Consistancy of your Cervix
This means how firm or soft it is.
Early in pregnancy your cervix is hard and firm like rubber, then it softens up as you progress. If your cervix is hard we know that it will take a bit of labor in order for it to soften.
If it’s your first baby, you will normally have a firmer cervix than subsequent babies.
Baby’s Position
This means the baby’s position in the womb. Is it looking at your belly button, or your spine.
If the baby is positioned looking up — it sometimes takes longer. However, babies can spin at any time.
Honestly, that’s the good news on all of these things. Babies drop or move or change and can advance your labor quickly at any time (or they can stay the same… such is mother nature, right)?
NOTE: If Baby isn’t head down that is called breech positioning and normally requires a cesarean section.
Now, most often (but not always) — as you get closer to your due date, you are more likely to be “favorable’ in these areas. So, a woman who is at 41 weeks of pregnancy most often has a more favorable cervix (and will have a quicker induction) than someone who is 37 weeks (where labor may take a long time). However, if you’re being induced early (especially for medical reasons) it may not be favorable — and that is OK too, we work with that frequently in the hospital.
As a note, most often first-time mothers take less time also, so all of those things will be considered before an induction of labor by your health care provider.
And finally, remember that ALL these things are just guesses based on statistics — who knows what will happen for you and your birth!
Ok, have we gotten your confused yet? If you’re having an induction and you have just a few dollars and a few minutes of time — can I recommend you take this class. It takes less than 20 minutes, but it’s handy video and printable will totally get you prepared for your induction. Check it out!
Problems With an Unfavorable Cervix
When doctors schedule an induction, they consider how “favorable” your cervix is.
That is an over-generalization of the items I mentioned (that are also in your bishop’s score).
If your cervix isn’t favorable (or if your bishop’s score is low) it means that it will likely take longer for your induction.
And, the longer an induction takes, the more medication we have to use, the higher risk you become as you labor longer and longer.
So, obviously we would prefer that you have a favorable cervix coming in.
However, if your induction is medically necessary (see below) it doesn’t matter how favorable it is, as we NEED to have the baby out!
Things Your Providers Can Do to Speed-Up Labor
There are things we can do to speed up your labor. They are done to hopefully create a vaginal delivery.
Make sure you get informed consent before any of these procedures, as each do have potential risks (and benefits).
Membrane Sweep
Your provider will do this in the office after a cervical exam.
It is basically them just using their finger to go between your cervix and your bag of waters.
It is non-invasive and personally I find that it might bump you if you were already close to being in labor. If you weren’t going into labor, it doesn’t do much.
It is mildly painful, but worth a try if you’re 39 weeks and would love to go into labor.
If a membrane sweet is going to work — labor usually starts within 24 hours.
Foley bulb Insertion
This is where our doctor inserts a tube up the birth canal into your cervix.
We then fill a balloon at the end of the tube with water, which slowly stretches open your cervix.
This can be done in your doctor’s office or at the hospital. Fairly non-invasive, and if it doesn’t work it’s not something you can’t walk back from.
It is annoying to have put in, but after that you will likely feel some cramping or contractions with your cervix (hopefully) starting to open.
Your cervix must be somewhat open in order for this to work (otherwise they can’t get the tube into your cervix.
Amniotomy
This is when your healthcare provider breaks your amniotic sac (the nurse can’t do it at the hospital, a doctor or a midwife has to do it).
This should be done at the hospital and is an official beginning to labor because once your water breaks we should get the baby out soon (the next day or so) There is always a risk off infection once your water is broken and the baby isn’t protected by that anymore.
Your water can also break at home.
Breaking your water is often something that doctors do once ou are are already in labor to speed things along.
Induction Agents
These are medications we give that should start uterine contractions.. When your provider schedules you as an induction, he/she will likely use one of these methods. They are used very carefully, because at too high of doses they can cause a uterine rupture. They start labor contractions similar to natural labor (vs spontaneous labor).
Cervidil / Cytotec / Prepidil
These are called cervical ripening agents. Some can be given orally, but some are placed using a gloved finger near your cervix.
These are usually given to soften your cervix, and then you move to…
Pitocin
Is given via IV. It is the same compound your body makes that puts you into labor on its own — the hormone oxytocin (it is just the synthetic version).
What if These Induction Agents Don’t Work?
In that event (and it does happen) — we have to ask ourselves:
- Does the baby medically need to come out (in which case you’d need a cesarean delivery)
- Could we wait a bit longer and try again (in which case you might go home).
DIY Induction Methods
Many women take castor oil, or try other things to start their labor. Studies show that things like this (particularly castor oil) can be very problematic, and don’t often work — so be mindful before you try an induction of your own.
Things you can do to speed up labor:
There are things you can do to help speed up labor….
Delay Epidural
It seems smart to just come in and get your epidural the minute you get your induction so that you won’t have to feel any pain.
I feel like there is a benefit to your body feeling some pain before you get the epidural.
This allows you to move more and possibly walk or sit on a labor ball to help baby find the best position.
Movement & Position Changes
As I said above, movement and position changes can help the baby find its best spot for delivery.
Some patients are unwilling to change positions. Sometimes some nurses don’t change your position once you have an epidural. I like to move my patients every hour (once they have an epidural).
So, just try to change your position and use movement to your benefit when you have it (even if you’re on pitocin you can often stand by the monitor and move in sexy hip circles or use a stool or a yoga ball).
And yes — I do talk a lot about movement, and I even have labor movement cards with images you can use to help find a comfortable position in labor in The Online Prenatal Class for Couples.
Elective vs Medically Necessary Inductions
An elective induction is something you are choosing to do. Reasons can be:
- You have childcare for a specific day
- Your husband can come on a specific day
- Your doctor is available on a specific day
- Your doctor just thinks you should have the baby
- You are tired or miserable being pregnant with no specific medical issues.
Medically Necessary Inductions
Often medically necessary inductions happen before you are due. I have a whole post on 37 week inductions.
These are done because providers feel baby’s health will be better outside your womb, than inside.
A medically necessary induction can happen for a variety of reasons — I go into the vast majority of reasons in My Online Course, but the top few are:
Diabetes
Both gestational diabetes and type 1 or 2 diabetes can be a reason to be induced early as baby might be bigger, and you have an increased risk with pregnancy.
Baby Size
The baby’s size can always be a indicator to be induced.
Large Baby
If the baby is getting too large, it might not come out of your pelvis.
Small Baby
If the baby isn’t growing as it should, it is likely that we can help it grow better outside.
Too Much / Too Little Fluid
Oligohydramnios
This means that you have too little amniotic fluid. This can be problematic because baby needs to be surrounded by fluid to both protect it and the cord (and cushion it so it doesn’t get squished).
Polyhydramnios
This means you have too much amniotic fluid. This can be a problem to over-stretch your uterus, or too much room for baby.
Preeclampisa
This is a disorder of your smooth muscle caused by something in the baby/placental development. It is often characterized by high blood pressure or lab work changes with our urine and blood.
That means the only way to stop it is to get the baby out.
Which, is why you might need to be induced.
Other Reasons
Like I said, there are a lot of reasons why a doctor will induce you — these are just the most common.
Alright, so hopefully you understand that all of these come together to show how long your induction will likely be.
Textbook Labor Plan
If your baby read the textbook — it would know that average labor progresses about 1 cm per hour and then pushing begins.
However, most babies don’t read that book and labor can be tricky.
I find that the first 5 centimeters go longer than the last 5.
I also find that none of this starts until you’re actually IN LABOR (called active labor), and sometimes it takes a while to get there (often based on how thick or firm your cervix is).
Active labor is defined as the point when your cervix is dilating at least 1 cm’ish/hour.
With all that being said, if you’re induced early, an induction can sometimes even take 2-3 days, but if you’re induced after 40 weeks and have a very favorable cervix your baby could be out in just a few hours.
Which, I realize isn’t helpful at all. There is no shame in asking your doctor how long they think it will take (believe me, they have an educated guess), or asking your nurse once you’re in labor (it’s hard to tell until you’re in active labor and actually changing your cervix).
AND, finally — I am a big fan of letting mother nature take the lead and going into labor on your own. If you can avoid an induction I would recommend that if at all possible. But, sometimes it isn’t, so hopefully this article gave you some good info as well!
I know this all seems very complicated, but it really isn’t. Let me simplify it for you in Inductions Made Easy!
Or, if you’re not quite ready for that — grab my free birth prep kit:
- About the Author
- Latest Posts
A nurse since 1997, she has worked in various fields including pediatrics, geriatrics & hospice.
She has 20 years of labor and delivery experience in the San Jose, CA and Phoenix, AZ areas.
She is also the curly head behind the website Pulling Curls and is the creator of The Online Prenatal Class for Couples — the #1 hospital-based prenatal class on the internet.
When Should I Start Wearing Compressions Stockings During Pregnancy?
[…] it may feel like it hurts more, or that it takes longer. Often you’re starting behind the ball without all those “practice” contractions […]