In some cases, a woman may need to have her labor induced. This may be recommended for either fetal or maternal indications. Induction can be performed using several methods. These include:

• Cervical dilators. A mechanical method of dilating the cervix, which is among the oldest inducement techniques. A number of methods may be used, including the rupturing of membranes surrounding the fetus (amniotomy) and the insertion of a balloon catheter (which is then inflated to dilate the cervix).  
  
  
• Prostaglandin E suppositories or gel. These medications help make the cervix more favorable to induction. In many cases, administration of the suppository or gel will cause labor and delivery to follow within 24 hours. In other cases, another method of induction is necessary to finish the process.
  
  
• Oxytocin. Medication used to induce the uterus to contract. The drug is given to the expectant mother through an intravenous (I.V.) drip. This allows the physician to closely control the amount of medication given based on the mother’s strength of contractions and the baby’s response to the contractions.
  
  
• Misoprostol. Tablets that are placed high in the vagina that help make the cervix more favorable to induction. To date, this method is considered experimental.

Circumstances that may require induction for medical reasons include:

• Placental insufficiency. This occurs when the placenta is not getting enough nutrients and oxygen.
  
  
• Chorioamnionitis. Infection of the placental tissues.
  
  
• Post-term pregnancy. Induction may be performed when a pregnancy has extended to 42 weeks or more.
  
  
• Danger to the fetus. Occurs when the fetus is no longer thriving in the uterus due to poor placental function, maternal disease or other conditions.
  
  
• Poor result from stress test or nonstress test. These tests measure whether or not the placenta is still functioning properly. If not, induction may be necessary for the health of the fetus.
  
  
• Delay in labor after membranes rupture. If membranes have ruptured but labor has not started spontaneously within 12 to 24 hours, labor may be induced.
  
  
• Serious maternal medical condition. Women who develop preeclampsia or another serious medical condition that cannot be controlled by medication may need to be induced.

In some cases, a physician may induce labor for reasons that are not strictly medically necessary. These include lack of access to nearby hospital or specialist, family circumstances or other reasons.

Inductions are not always successful in bringing about the baby’s birth. In such situations, a second induction or a Caesarean section may be necessary. Women should discuss the pros and cons of an induction with their physician before deciding to undergo the procedure.

In addition, natural labor is not always strong enough to produce adequate contractions. In this case, labor can be augmented using medications that make contractions stronger.

Induction of labor using drugs carries a small risk of amniotic-fluid embolism (tearing of the amniotic sac resulting in leakage of amniotic fluid into the mother’s blood), according to a new study. Although this is an extremely rare occurrence, it can be life-threatening for the mother.