Induced Labor — How Long Does it Take?

Induction of labor is definitely a process. How long will it take, what should you expect? How long will it take until you give birth?

Hi, I’m Hilary — I’m The Pregnancy Nurse. I have been a labor nurse since 2001 and I’ve done a LOT of inductions in my time (including being induced once myself).

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How long will my induction take?

Things that affect labor timing

There are a few things that can affect how log 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’s 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 int he 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.

Problems With an Unfavorable Cervix

When doctors schedule an inductions, they consider how “favorable” our 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.

Stripping Membranes

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.

Foley bulb Insertion

This is where our doctor inserts a tube 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 medical provider breaks your water (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 is broken we should get the baby out soon. There is always a chance of 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 can put you into labor. When your provider schedules you as an induction, he/she will likely use one of these methods:

Cervidil / Cytotec / Prepidil

These are usually given to soften your cervix, and then you move to…

Pitocin

Is given IV. It is the same compound your body makes that puts you into labor on its own (just made synthetically).

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).

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 of 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.

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 preganncy

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 a 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.

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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 me some good info as well!

Please consider joining me in my Online Prenatal Course where we discuss all the aspects, and really SIMPLIFY them to get you ready for your baby!