Induction of labour

Induction vs. preinduction of labour: What’s the difference?

November 26, 2024
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Contributors
Veronika Dobiasova, MD
Physician and International Product Manager

Veronika Dobiasova, MD is a physician specializing in obstetrics, gynaecology, and labour induction. She works closely with clinical experts to translate medical evidence into clear, practical information for healthcare professionals and expectant parents.

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Jan Waclav, MD
Clinical & Medical Affairs Director

Physician and Clinical & Medical Affairs Director with 30+ years of experience in clinical research, medical affairs, and evidence-based healthcare. Jan is certified in Anesthesia and Intensive Care Medicine and has held senior medical leadership roles at MEDICEM Technology, SOTIO, GlaxoSmithKline, and AstraZeneca.

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Key takeaways

Preinduction and induction of labour are related but different stages of the birth process. Preinduction helps prepare the body for labour, often through cervical ripening, while labour induction actively starts labour by stimulating contractions or breaking the waters.

  • Preinduction prepares the body before labour induction begins and may include cervical ripening or membrane sweeping.
  • Cervical ripening helps soften, shorten and open the cervix when it is not yet ready for labour.
  • Once the cervix is ready, labour induction can begin by stimulating contractions, often using oxytocin and/or by breaking the waters.
  • Understanding these different stages can help you feel more informed, confident and prepared for your induction journey.

Navigating pregnancy can sometimes feel overwhelming, particularly when you're faced with complex medical terminology. Three commonly misunderstood terms are “cervical ripening”, "induction of labour" and "preinduction of labour".

Although they are related, they refer to different steps in the process of getting labour started, and it’s important to understand these distinctions as you approach delivery.

What does preinduction of labour mean?

Preinduction of labour refers to the preparation steps taken before the actual induction begins. This process includes cervical ripening, membrane sweeping, fetal monitoring, and providing informed consent and education to support a smooth, well-understood induction experience. The most significant part of preinduction is cervical ripening, which is often necessary if the cervix has not yet softened, thinned, or started to open on its own.

It’s important to note that preinduction is not about starting contractions or active labour. Instead, it’s about preparing the body so that induction of labour can happen more effectively and safely.

The open vs. closed door metaphor


Think of labour as moving through doors, and the first door is your cervix. If it is tightly closed, it doesn’t matter how hard you push (how many contractions you have)—labour won’t progress. But if it is slightly open, it’s easier for things to move along. Cervical ripening is like unlocking and opening that door a bit, so when contractions start, they can help the baby move smoothly into the birth canal. If the cervix isn’t ready, inducing labour can make delivery harder and longer, and may increase the risk of a caesarean section. That’s why preparing the cervix through preinduction, when necessary, is such an important step.

Healthcare providers use either non-hormonal or hormonal methods for ripening the cervix. If you want to learn more about different techniques to help the cervix become more favourable for labour, please read the article on our blog here.

image source: freepik.com

And what exactly is induction of labour?

Once preinduction and cervical ripening are complete, the actual induction of labour can begin. This is the process where healthcare providers actively stimulate contractions to start labour once the cervix is fully prepared. Induction is typically considered for medical reasons, such as when a pregnancy goes significantly past the due date or if there are concerns about the health of you or your baby. Again, healthcare providers use either non-hormonal or hormonal methods to induce labour.

Non-hormonal methods might include techniques such as breaking the waters (amniotomy). Hormonal methods typically involve medications like oxytocin to trigger contractions.

Final thoughts

Just to be perfectly clear:

  • Preinduction of labour = Preparing for labour induction before it actually starts. This may include evaluating the readiness of the cervix and cervical ripening.
  • Cervical ripening = Preparation of the cervix during preinduction phase. This includes softening, opening and shortening of the cervix.
  • Induction of labour = Actively stimulating labour to start, that means triggering labour contractions and/or breaking the waters

(Note: The term “Induction of labour” is sometimes used more broadly to refer to the entire procedure, encompassing all the steps outlined above)

Understanding the distinction between induction and preinduction, as well as the role of cervical ripening, can help you feel more informed about your (and your baby's) big moment. If you have questions about the process, it’s always a good idea to ask your healthcare provider. They will help guide you through these steps, ensuring that both you and your baby are as safe and comfortable as possible as you prepare for delivery.

Disclaimer: This blog post is for informational purposes only and should not be considered medical advice. Always consult with your healthcare provider to address your individual needs and concerns.

FAQs
What are the cervical ripening methods?

Cervical ripening can be achieved using either mechanical or pharmacological methods. Non-hormonal methods, such as DILAPAN-S, help prepare the cervix mechanically, while pharmacological methods use medication to stimulate cervical changes. In recent years, mechanical methods have become increasingly popular due to their favourable safety profile and comparable effectiveness.

Who may be offered DILAPAN-S for cervical ripening?

DILAPAN-S may be suitable for a wide range of women, including first-time mothers, women with post-term pregnancies and some women planning a vaginal birth after caesarean section (VBAC/TOLAC). Ask your healthcare provider whether DILAPAN-S could be an option for you.

How long does labour induction usually take?

The length of labour induction varies from person to person and depends on factors such as the condition of the cervix and the induction method used. Labour may begin within hours for some women, while for others the process can take longer. Your healthcare team will monitor your progress and provide guidance throughout the process.

Contributors
Veronika Dobiasova, MD
Physician and International Product Manager

Veronika Dobiasova, MD is a physician specializing in obstetrics, gynaecology, and labour induction. She works closely with clinical experts to translate medical evidence into clear, practical information for healthcare professionals and expectant parents.

Show more
Jan Waclav, MD
Clinical & Medical Affairs Director

Physician and Clinical & Medical Affairs Director with 30+ years of experience in clinical research, medical affairs, and evidence-based healthcare. Jan is certified in Anesthesia and Intensive Care Medicine and has held senior medical leadership roles at MEDICEM Technology, SOTIO, GlaxoSmithKline, and AstraZeneca.

Show more
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