By Lovetti Lafua
Nurse • Midwife • Biologist • Human Optimization Researcher

Induction is not one single action.
It is a three-step medical process designed to make the body begin labour before it has naturally chosen to.

You may move quickly through these steps or you may spend days in them.

But when you agree to induction, you are agreeing to the entire pathway.

Let’s break it down.

Step 1: Preparing the Cervix

During pregnancy, the cervix is:
• Closed
• Firm
• Positioned toward the back

You can have contractions but without cervical change, labour does not progress.

In spontaneous labour, cervical ripening is a complex hormonal symphony involving:
• Oestrogen
• Relaxin
• Prostaglandins
• Immune cells
• Structural tissue remodeling

It is not just one hormone.
It is a coordinated biological preparation.

In induction, however, we focus heavily on prostaglandins.

How cervical ripening is done:

Pharmaceutical methods
Synthetic prostaglandins (gel, pessary, or tape) are inserted near the cervix.
These can trigger uterine hyperstimulation and fetal distress which is why continuous monitoring is often used.

Women frequently describe sharp “prostin pains.

Mechanical methods
• Membrane sweep
• Balloon catheter inserted into cervix

These mechanically stimulate prostaglandin release but can increase discomfort and occasionally alter baby’s position.

This stage can take hours or days.

And if your body is not hormonally ready, it can feel like pushing against a locked door.

Step 2: Breaking the Waters

Once the cervix opens enough, the waters are artificially broken.

Why?
• To allow baby’s head to press more firmly on the cervix
• To strengthen contractions
• To move the process forward

But once waters are broken:
• The clock often starts ticking
• Infection risk gradually rises
• There is no going back

If contractions do not begin naturally, we move to Step 3.

Step 3: Creating Contractions

In physiological labour:

The brain releases oxytocin.
It works in two places:
1. The uterus to regulate contractions
2. The brain to create the altered, instinctive, inward labour state

This is why spontaneous labour often feels primal, rhythmic, trance like.

In induction:

Synthetic oxytocin (Pitocin / Syntocinon) is delivered via IV.

It stimulates the uterus.
But it does not cross the blood brain barrier.

It does not create the same neuro hormonal experience.

What women often report:
• Contractions feel sharper, faster, more intense
• There is less gradual build-up
• Pain escalates quickly
• Anxiety increases under constant monitoring

Artificial oxytocin is also one of the most common causes of fetal distress in labour, which is why continuous CTG monitoring is typically used.

And after birth?

Artificial oxytocin is often continued to deliver the placenta safely.

Because your body has not produced its own full hormonal cascade.

Read Part One Induction of Labour: What Every Woman Deserves to Know Before Saying Yes