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Pregnancy & birth

Induction of Labor: Reasons, Methods, Process, and Experiences

When is labor induced? How do balloon catheters, prostaglandins, and labor drips work, and how long does it take? Includes a checklist of questions for your hospital visit.

By the LIINI editorial teamUpdated 10 min read19 sources

Contents

In short

During labor induction, contractions are artificially induced because waiting any longer would pose a greater risk to you or your baby. Common reasons include going past your due date, your water breaking without contractions, or high blood pressure. In the case of a healthy pregnancy, according to the guidelines, induction is offered starting at 41+0, recommended starting at 41+3, and strongly recommended starting at 42+0. Depending on the condition of the cervix, balloon catheters, prostaglandins, an oxytocin drip, or the rupture of the amniotic sac may be used. This can take hours, sometimes several days, and you get to have a say in the decision.

Your due date has passed, and your doctor is talking about inducing labor? You’re not alone in this: According to the Federal Statistical Office, in Switzerland in 2023, labor was induced in 33% of deliveries that did not involve a planned C-section. Here you can read about when it makes sense to induce labor, how the process works, and how you can be involved in the decision-making.

When is labor induced?

Inducing labor is intended to reduce risks for you and your baby. The main reasons:

Missed Deadline

According to the German Institute for Quality and Efficiency in Health Care (IQWiG), most babies are born within two weeks before or after their estimated due date. The guide ” Calculate Your Due Date” explains how this date is calculated. Once the appointment is over, IQWiG recommends about two checkups per week using CTG and ultrasound. The joint guideline issued by the German, Austrian, and Swiss professional associations (DGGG, OEGGG, SGGG; as of 2020, currently being revised) specifies the following time points for a healthy pregnancy:

When is labour induced? If you go past your due date in a healthy pregnancy: from the due date (40+0), about two check-ups a week with CTG and ultrasound; from 41+0, induction is offered; from 41+3, it is recommended, and your midwife and doctor will discuss the next steps with you; from 42+0, it is strongly recommended. If your waters break without contractions from 37 weeks, induction is recommended after 24 hours at the latest. If your waters break, always call the hospital straight away.When is labour induced?Past your due date, healthy pregnancy40+0 · Due dateAbout 2 check-ups a weekwith CTG and ultrasound41+0 · Induction offeredYou can be induced orkeep waiting with check-ups41+3 · Induction advisedDiscuss with midwife anddoctor what happens next42+0 · Strongly advisedWaiting longer isriskier for your babyWaters broken, no labourfrom 37 weeksInduction advised after 24 h at the latestAlways call the hospital now41+3 means: 41 weeks and 3 daysSources: labour induction guideline(DGGG, OEGGG, SGGG), IQWiG

The notation 41+3 means 41 full weeks and 3 days.

Water breaking without contractions

If the amniotic sac ruptures at 37 weeks or later and labor does not begin on its own, the guidelines recommend inducing labor no later than 24 hours afterward. According to the British National Health Service (NHS), this increases the risk of infection for you and your baby. If your water breaks, call immediately—especially before 37 weeks. The guide ” Labor and Water Breaking” explains how to recognize labor and when your water breaks, and when you should go to the hospital.

Attention

Call your hospital or midwife right away—even in the middle of the night—if your baby is moving less than usual, if you’re bleeding, if your water breaks (especially if it’s discolored or has an unpleasant odor), if you’re having contractions before 37 weeks, or if you’re feeling unwell. This also applies when you’re at home with the balloon catheter.

Medical reasons

Sometimes it makes sense to introduce the topic before the meeting. For example, the IQWiG and the NHS cite high blood pressure or preeclampsia, diabetes, intrahepatic cholestasis of pregnancy (a liver disorder during pregnancy), a baby estimated to be larger than average, or health problems your baby may have.

Introduction upon request

If you’re exhausted and don’t want to wait any longer, speak up about it. According to IQWiG, experts generally recommend not inducing labor before the start of the 42nd week of pregnancy (41+0 or later). If you specifically request it, induction may be considered starting at the 40th week (39+0).

An Overview of Methods for Inducing Labor

Which method is best depends primarily on the condition of the cervix. If it is still firm and closed, it is prepared first. If it is soft and slightly open, labor can be induced immediately.

Methods of inducing labour. Which one is suitable depends on the cervix. First, preparing the cervix: membrane sweep, in which the midwife or doctor uses a finger to detach the membranes (amniotic sac) around the cervix; balloon catheter, one or two small balloons widen the cervix for about 12 hours; prostaglandins as a gel, pessary or tablet soften the cervix. Second, starting contractions: breaking the waters, only when the cervix is open, usually together with the oxytocin drip; oxytocin drip into a vein, takes effect within a few minutes. Methods are often combined.Methods of inducing labourThe right one depends on the cervix1Preparing the cervixSweepA finger detaches the membranesaround the cervixBalloon catheterOne or two small balloonswiden the cervix, about 12 hoursProstaglandinsGel, pessary or tabletsoften the cervix2Starting contractionsBreaking the watersOnly if the cervix is open,usually with the dripOxytocin dripHormone given into a vein,works within a few minutesMethods are often combined.Sources: IQWiG, SGGG, labour induction guideline
MethodHere’s how it worksGood to Know
Eipolo solutionA midwife or doctor uses her finger to detach the amniotic sac around the cervix from the uterine wall. This releases hormones that induce labor.According to IQWiG, this is usually uncomfortable; slight bleeding may occur but is generally harmless. Studies suggest that taking two doses of egg yolk solution in a week is more effective than taking just one.
Balloon catheterA thin tube with one or two small balloons is inserted into the cervix and filled with fluid. That dilates the cervix.According to IQWiG, that leaves about 12 hours. It is less likely to cause a storm of contractions than the prostaglandin dinoprostone.
ProstaglandinsHormones in the form of a gel, tablet, or vaginal insert (tampon) inserted into the vagina, or misoprostol in the form of a tablet to be swallowed. They help soften the cervix.According to the IQWiG, dinoprostone and misoprostol can cause nausea, vomiting, diarrhea, fever, and chills. Misoprostol (approved in Switzerland under the brand name Angusta) must not be used after a cesarean section.
Break the amniotic sacThe amniotic sac is punctured through the dilated cervix using a small instrument.According to familienplanung.de, it’s painless. Usually taken together with the labor-inducing drops. An umbilical cord prolapse may occur.
Oxytocin (labor drip)The labor-inducing hormone is administered intravenously as an infusion.It usually takes effect within a few minutes. Only if the cervix is ripe. You and your baby will be closely monitored.

Attention

Medications can trigger contractions that are too strong and too frequent, a condition known as “contraction storm.” That’s why the team administers the medication cautiously and monitors your baby with the CTG. According to the SGGG, a uterine rupture is very rare (less than 1%). According to the IQWiG, the risk is slightly higher after a cesarean section.

The Induction Process: How It Works at the Hospital

Every hospital has its own procedures; here is a typical one:

  1. During the consultation, the midwife or doctor will explain the reason, the method, and the alternatives—such as waiting a little longer while continuing with checkups or having a C-section.
  2. Examination: The CTG records your baby’s heartbeat and your contractions, and then the cervix is examined.
  3. Preparing the cervix: Depending on the findings, you will be given a balloon catheter or prostaglandins, multiple times if necessary.
  4. Inducing Labor: Once the cervix is ripe, the amniotic sac may be ruptured and an oxytocin drip administered, if necessary.
  5. Giving Birth or Rescheduling If effective contractions have not started within 24 to 48 hours after the onset of labor, the team will reassess the situation in accordance with SGGG guidelines and discuss it with you. According to the NHS, options such as another attempt or a C-section are then possible.

Induction of Labor: Experiences and How Women Experience It

Specialized agencies describe what many women experience:

  • A lot of waiting: Hours often pass between steps. According to the SGGG, labor can last several days.
  • More examinations: According to the IQWiG, induction leads to more vaginal examinations. The CTG cables might get in your way when you move.
  • Often more painful: According to the NHS, an induced labor is usually more painful than one that begins on its own. But you do have access to the same pain relievers, including an epidural.

Good to Know

Our previous post (2021) was an opinion piece, not a birth story. He encouraged women not to let doctors unsettle them, to listen to their gut instincts, and not to wait any longer if there is no medical reason to do so. We still believe it is right to ask questions and have a say in decisions. Today, we see things differently: waiting is definitely worth it. According to the IQWiG and Cochrane, inducing labor about one week after the due date has benefits (see table below).

Pros and Cons: What You Can Help Decide

Even waiting is not without risk after a certain point, as studies on treatment delays by the IQWiG show:

Out of every 1,000Induction in Week 42 (starting at 41+0)Wait until the start of the 43rd week (42+0)
Cesarean section120 women130 women
Treatment in the Neonatal Intensive Care Unit60 children70 children
Children who die at or shortly after birth1 child3 children

A 2020 Cochrane review reaches a similar conclusion: In the studies—which mostly induced labor after 41 completed weeks—induction was associated with fewer perinatal deaths and possibly fewer cesarean sections than a wait-and-see approach. On the other hand, there are the long duration, more tests, often more severe pain, and rare complications.

You have a say in the decision: According to the NHS, it’s up to you whether you want to go into labor. The IQWiG provides a printable decision-making guide on this topic. These questions will help you during your conversation with your midwife or doctor:

  • Why do you recommend an induction for me, and how urgent is it?
  • What happens if I wait a little longer, and what tests will I need then?
  • What procedure is planned for my cervix, and why?
  • How long does it usually take for you, and what happens if the induction doesn’t work?
  • What pain relievers can I take, and can I move around freely?
  • Can my companion stay the whole time?

Inducing Labor at Home: How Effective Are “Natural” Methods?

According to the NHS, there is no proven method for inducing labor at home on your own. The University Hospital of Zurich warns that some commonly “recommended” methods pose risks to both mother and child.

Attention

Don’t try any home remedies, oils, or “labor cocktails” on your own. Talk to your midwife or doctor first. Experts advise against using castor oil.

  • Castor oil: It has a laxative effect and can cause nausea. According to IQWiG, the safety and efficacy of labor induction have not been sufficiently studied. Embryotox (Charité Berlin) advises against using castor oil during pregnancy under any circumstances and expressly warns against using it to induce labor. There is also concern that the baby might pass meconium while still in the womb. In addition, there have been isolated reports of serious consequences.
  • Acupuncture: According to the IQWiG, studies have found no evidence that it induces labor.
  • Sex and nipple stimulation: According to the IQWiG, it is unclear whether they induce labor.
  • Tea, oils, and homeopathy: According to the IQWiG, there is no scientific evidence supporting the use of raspberry leaf tea, homeopathic remedies, or clove oil tampons.

If you’d like to start your pregnancy without medication, ask about an Eipol program or a midwife consultation, such as those offered by the University Hospital of Zurich.

Hospital Bag: How to Prepare for Induction

Since labor can last several days, pack your hospital or clinic bag as if you’ll be staying for a while. You can find the complete list in the ” Hospital Bag Checklist.” You can find everything your baby needs in the checklist for newborn essentials. The following are particularly helpful for the introduction:

  • ID, health insurance card, and pregnancy-related documents
  • Comfortable clothes, warm socks, lip balm, and a hair tie
  • Charging cable, headphones, and something to read or listen to
  • Snacks and a water bottle (ask what you’re allowed to eat)

A diaper-changing backpack that doubles as a diaper bag afterward is very practical. The checklist for packing a diaper bag shows you what to include.

Frequently Asked Questions

At what point is labor induced?

In the case of a healthy pregnancy, according to the guidelines issued by the DGGG, OEGGG, and SGGG, induction is offered starting at 41+0, recommended starting at 41+3, and strongly recommended starting at 42+0. If the amniotic sac ruptures at 37 weeks or later without labor, it is recommended within 24 hours at the latest. If there are medical reasons, it may happen sooner.

How long does labor induction take?

According to the SGGG, hours, and occasionally several days. According to IQWiG, many women are surprised by how long it takes. If effective contractions have not begun after 24 to 48 hours, the team will discuss the next steps with you.

Can I refuse an introduction?

Yes, according to the NHS, it’s your decision. Let us explain the risks of waiting in your situation. After your appointment, you’ll need regular checkups—according to IQWiG, about two per week. If your baby is moving less than usual, call right away.

Can I go home with the balloon catheter?

In some hospitals, yes. According to a senior physician at the University Hospital of Basel, this is possible for women without any particular risk factors, provided they are easily reachable and do not live too far from the hospital. Ask your hospital about this and have them explain exactly when you need to come back right away.

Is it possible to induce labor after a C-section?

Basically, yes. According to IQWiG, however, the risk of a uterine rupture is slightly higher in this case, so your doctor will discuss with you in advance whether induction is an option and which method is appropriate. According to the DGGG, misoprostol must not be used after a cesarean section.

Does castor oil help induce labor?

No, there is no reliable evidence to support this; according to the IQWiG, its safety and efficacy have not been sufficiently studied. Embryotox (Charité Berlin) advises against using castor oil during pregnancy and cites isolated reports of serious consequences for both mother and child. Never take it on your own.

Does health insurance cover the cost of inducing labor?

In Switzerland, yes, if it is medically justified. In that case, according to the SGGG, it is a mandatory benefit.

Sources

  1. Guideline on Induction of Labor, AWMF Registry 015-088 (S2k, as of 12/2020, Version 1.1 March 2021; revision announced, PDF), DGGG, OEGGG, and SGGG
  2. Induction of Labor (Notification of Revision, August 3, 2026), AWMF
  3. Informed Consent Form for Induction of Labor (Revised Version 2017, PDF), SGGG
  4. Expert Opinions (Note on the Approval of Angusta), SGGG
  5. FAQ – Frequently Asked Questions and Answers About Angusta® for Induction of Labor (PDF, July 2025), DGGG
  6. Gentle Induction of Labor with Cervical Stripping, University Hospital of Zurich
  7. Natural Childbirth Preparation and Labor-Inducing Measures, University Hospital of Zurich
  8. Induction of Labor: How, When, Why?, Medical Tribune Switzerland, Dec. 10, 2025 (featuring comments from a senior physician at the University Hospital of Basel)
  9. Shortly before giving birth, Lucerne Cantonal Hospital
  10. 30% more births on weekdays than on weekends, Federal Statistical Office (FSO)
  11. How can labor be induced?, gesundheitsinformation.de, IQWiG
  12. When the Baby Is Late: When Should Labor Be Induced?, gesundheitsinformation.de, IQWiG
  13. Decision-Making Guide: Past Your Due Date: Wait It Out or Induce Labor?, gesundheitsinformation.de, IQWiG
  14. Induction of Labor and Labor-Inducing Drugs, familienplanung.de, Federal Institute for Public Health
  15. Castor oil, Embryotox, Charité – Berlin University Medical Center
  16. Inducing Labor, NHS
  17. Your Baby’s Movements, NHS
  18. Signs That Labor Has Begun, NHS
  19. Induction of Labor in Women with Uncomplicated Pregnancies at or After 37 Weeks of Gestation (2020), Cochrane
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