Natural Labour vs Induced Labour – 6 Main Differences

Natural Labour vs Induced Labour - 6 Main Differences

These days, it’s very common for parents-to-be to face an important decision: whether to induce labour or wait for labour to begin spontaneously.

An induction of labour is when labour is started artificially, usually with a synthetic form of oxytocin (Syntocinon or Pitocin).

Women and their partners should be aware that, for a low risk pregnancy, induction of labour introduces a number of risks to a potentially normal labour and birth.

Many parents are not aware of the reasons why waiting for labour to start without any interference is preferable, and beneficial, when there are no medical complications.

Unfortunately, it’s not as simple as having some medication and then having labour begin (and end) just as it would normally. The reality is actually very different.

Here are some of the many differences between a natural labour, which begins spontaneously, and one that is started artificially.

#1: Labour Hormones Work Differently

When you go into labour spontaneously, oxytocin is released to stimulate contractions in the uterus.

Oyxtocin acts like a key to unlock the oxytocin receptors in your uterus.

During the first and second trimesters of pregnancy, your uterus has few receptors, to protect you from going into labour too early.

As you reach full term, the number of receptors increases significantly.

Once labour begins, they are activated by the oxytocin in your bloodstream. Then they work effectively to contract the muscle, and dilate the cervix.

The oxytocin is released in a pulsing action, and comes in waves. This is so your uterus is not continuously contracting or having very strong contractions from the start.

Oxytocin levels also increase gradually. At the start of labour, contractions might come every 20-30 minutes, and last around 30 seconds. As the tempo of labour increases, the contractions will get closer together (2-5 minutes apart) and longer (60-120 seconds in length).

This progression of natural labour usually happens over 10 or so hours, so that you have plenty of rest time between contractions, and your body is able to adjust to the intensity of contractions over time.

When you are induced, it’s likely to happen before your body and baby are ready. This can mean there aren’t enough receptors available in your uterus, and so a large amount of synthetic oxytocin is required  to start labour and to keep contractions going over time.

The artificial oxytocin level is increased until you are having 3-4 contractions in a 10 minute period. Each contraction should last 40-60 seconds, and there should be at least a minute between each contraction.

Syntocinon or Pitocin is given to you continuously, via IV.  Your uterus goes literally from standstill to contracting ‘X’ number of times in an hour. This means the contractions are very long and strong from the start, and your body doesn’t get a break.

And of course, once you hop on the induction train, you can’t get off or make it stop. You’re now committed to getting your baby out, even if that means via c-section.

Here are 5 Things Oxytocin Does That Syntocinon/Pitocin Doesn’t.

#2: Contraction Pain Is Different

The main difference between a natural and artificially started labour is the intensity of the contractions.

In a natural labour, oxytocin works to stimulate your uterus to contract and dilate the cervix.

As the cervix stretches, pain receptors send messages to the brain, which responds by releasing endorphins. This substance is ten times more powerful than morphine, and acts to counteract the sensation of pain. As oxytocin levels increase, more endorphins are released.

When labour is induced, the artificial oxytocin used to stimulate contractions does not cross the blood-brain barrier. Your body doesn’t receive signals to release the endorphins and you experience more intense pain.

Natural labour usually begins slowly, with a gradual build up of spaced out contractions that are short and mild. Over time, these contractions get closer together, longer, and more intense.

During an induced labour, this can’t happen. The intense pain begins immediately. Your brain can’t respond to the pain of these contractions, and is not able to ‘be involved’ in the labour. As a result, you’re more likely to request pain relief, such as an epidural.

#3: Movement During Labour Is Different

In a natural labour, women usually seek out the positions and places in which they feel most comfortable. During early labour, you might want to move during contractions, which helps your baby to find the optimal position for birth.

In late labour and in transition, you might seek the comfort of a warm bath or shower. Your partner or birth support can support you during the pushing stage, encouraging your baby to move down and using gravity to assist.

During an induced labour, it is recommended that you have constant monitoring at the beginning, and then intermittent monitoring, unless there is an indication of fetal distress. This is because the labour is now high risk. You will also have an IV drip attached. These limit your ability to move freely and work with your body, and your baby, during labour.

You are less likely to have access to a shower and won’t be able to use a birth pool to ease the pain of contractions. If you have an epidural in place (which is more likely with an induction of labour), you will be either lying on your side or sitting up in bed. This increases the risk of fetal distress, and the likelihood of a c-section.

Read about Everything You Need To Know About Having An Epidural.

#4: The Fetal Ejection Reflex Only Occurs In Natural Labour

The fetal ejection reflex was first discovered by Niles Newton in the 1960s. The reflex involves a powerful and uncontrollable urge to push, as if the body has flicked a switch and is ready to ‘eject’ the baby.

In a natural labour, oxytocin levels increase steadily, culminating in a huge flood of the hormone when the cervix is dilated. This oxytocin peak stimulates the powerful and irresistible contractions that push the baby down and out. This is the fetal ejection reflex. Adrenaline is also released at the same time, to provide you with the energy and alertness you need to birth your baby.

During an induced labour, this oxytocin peak doesn’t happen. The synthetic oxytocin is provided by a pump and cannot be increased to offer this boost at the end of labour. If you are induced with synthetic oxytocin, or have an epidural during labour, you will not experience a fetal ejection reflex. Women who have induced labours often require interventions at this stage of labour, such as ventouse or forceps (which also means an episiotomy), to help the baby be born.

#5: Natural Oxytocin Protects Baby’s Brain

In a natural labour, the oxytocin your body produces crossed the placenta. The oxytocin ‘silences’ your baby’s brain during labour and protects it from damage that could occur due to oxygen deprivation. As contractions begin slowly and build up, oxytocin levels also increase simultaneously. This helps to keep your baby safe.

During an induced labour, the synthetic oxytocin interferes with your body’s ability to produce its own hormone. Therefore your baby is much more likely to be exposed to hypoxia (oxygen deprivation) during an induced labour. Your baby will respond to this situation by showing symptoms of distress. The most notable is when the heart rate does not pick up sufficiently after contractions. If this continues, your care provider will recommend an emergency c-section to avoid possible brain damage to your baby.

#6: The Third Stage Of Labour Is Different

When your baby is born after a natural labour, your body is on an oxytocin high. In fact, you’ll never experience an oxytocin high like this in your life. Oxytocin, the ‘hormone of love’,  is responsible for promoting the bonding that happens between you and your baby. This bonding is critical for your baby’s survival, but also has an important effect on your body.

As the empty uterus contracts down, the placenta sheers away from the uterine wall. Exposed blood vessels are clamped, and any post birth bleeding should be minimal. In most cases, this happens without any interference from care providers. It is called a physiological or natural third stage.

Many hospitals prefer to give women an injection of synthetic oxytocin as the baby is being born. This speeds up the third stage, and potentially reduces the risk of excessive bleeding after birth (postpartum haemorrhage). However, women who have experienced a spontaneous, undisturbed labour are less likely to require this injection, as their own bodies will produce oxytocin in large enough amounts.

If you have an induced labour, you will not experience that last boost of oxytocin naturally. The empty uterus might not be able to contract down effectively, increasing the risk of postpartum haemorrhage (PPH). The injection would most likely be necessary, at this stage, to avoid potential PPH. Find out more about how inductions increase the risk of PPH.

Synthetic Oxytocin Can Affect Bonding

Below is a clip from the world’s most famous Obstetrician, Michel Odent. He explains how, in an induced labour, bonding behaviours in the mother are affected, because the mother is not releasing her own oxytocin. Sadly, the number of women going into labour naturally is decreasing at an alarming rate.

A growing amount of research appears to confirm Odent’s long held beliefs. When synthetic oxytocin interferes with natural labour hormones, it can influence a mother’s stress, mood, and behaviour. Coupled with plummeting rates of breastfeeding (another source of natural oxytocin), could this have anything to do with our high rates of postnatal depression and anxiety?

Having A Positive, Empowered Induction Of Labour

If you need to have an induction of labour, it is still possible to be empowered and have a positive experience .

See our article 8 Tips For A Positive Induction Of Labour.

You might also like to read Why All Inductions Aren’t The Same – 5 Different Induction Methods.

If you are presented with the option of an induction of labour, you might want to ask your care provider whether it’s required for a genuine medical reason. Ask, for example, if there is proof in the form of a test, or abnormal results. Or whether waiting, with patience, is the better answer.

Making a comparison between natural labour and an induced one is dependent on many factors. There is no simple guarantee that your choice is the right one. The best you can do is ensure you’re aware of the differences, and the risks. And avoid making a choice based on convenience.

 
Last Updated: July 11, 2016

CONTRIBUTOR

Sam McCulloch enjoys talking so much about birth that she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she watches Downton Abbey and has numerous creative projects on the go. She is mother to three beautiful little humans.


24 comments

  1. I was induced on the 40 week mark and only had a 5.5 hour labor with 5 minutes of pushing. All my contractions were in my back and I only had a small amount of demeral about half way through. I don’t like needles so an epideral is off the table. My daughter is healthy and 16 months and still breastfeeding. A good attitude and positive thinking is key.

    1. Thanks for this comment. I’m being induced this weekend and this article scared me but your comment made me feel much more optimistic.

      1. I was induced at 40 weeks my little princess did not want to budge had everything to try and make her come out in the end I was on the drip had two epidurals both didn’t work I could feel her there and my body automatically pushed was only pushing for 4 mins and she was here had a slight tear but nothing major didn’t need stitches was very lucky Caitlyn 22/9/15 born 10.28am 8lbs xx

  2. I was induced in my 37th week because of bleeding (bloody show).Labour pain took 5 hours and then my baby delivered through ventouse (6.2lbs weight). my baby have eczema.. cause is not known but i have no family history of eczema or any type of allergies. i also suffered from depression.

    1. Found yours an interesting read as my baby has eczema also after an induction.. No history and unlike my other children born naturally

  3. This is true.. i was induced at 41 week.. i waited 4 hours until the real labor started and I had 18 hours of labor Iafter, the worst part that when they tried to get the placenta out my uterus came out with it and that was deadly painful : ( I believe that everything happened because of the early induce.. I wish if I waited

  4. I had to be injected twice to induce labor when I was to give birth to my eldest child. It was critical for me to give birth because my water bag was leaking and the doctor found the liquid was greenish — meaning, my baby had already pooped inside the womb — but my cervix was not yet dilated (only 2cm). I was admitted to the hospital before 9pm, cervix opening was 2cm. I was injected to induce labor at 9pm and experienced intense pain that came as a surprise (since I hadn’t gone into natural labor yet). It was so painful, I kept my eyes closed, fighting back the tears. I was told to hold back the urge to push the baby out, as my cervix opening was only 2cm. I was feeling the urge to push already but I was told I can’t so it was really a struggle. At around 11pm, they checked again but my cervix opening was STILL 2cm. They injected me once again to induce labor and I kept feeling the sharp pain in my lower back and the urge to push the baby out, but still I was told not to. After another 2 hours, the nurses checked (under my doctor’s orders) and found my cervix opening was not dilating as expected after 2 shots to induce labor. I demanded for a c-section at that time because I couldn’t take the pain anymore. I was prepped for emergency c-section but when my doctor came in at around 2am, she found that my cervix opening was now 6cm. Since my baby was small (low birth weight), she suggested we proceed with a normal delivery but she would have to cut (episiotomy). I agreed because the urge to push was already so strong, I wanted it to be done and over with. In a few minutes, my baby was out and my ordeal was over. I wouldn’t recommend induced labor to anyone.

  5. You are scaring people for no reason. Some people need to be induced. Not everything you have written it’s true! Birth without fear should be the main proposition here not silly scary articles! Shame on you!!

    1. I agree with you. I read this thinking “holy shit” AND I’ve had 2 very positive inductions so know that not everything written here is true. I was induced at 38+2 and 37+5 due to PROM but labour failed to start naturally. I was active throughout, never had a drip attached and had 2 natural, vaginal deliveries without assistance using just gas&air. My second labour was 45mins for all 3 stages. I breastfed my girls for 17 and 22mths respectively. I’m due again in 5 weeks and wish I hadn’t read this article. Obviously I can’t compare to spontaneous labour experiences but I am glad I have my own positive induction experiences to draw upon.

    2. This is an amazing article. People are so impatient, today! I know numerous of women who get their doctors to induce them as early as 38 weeks. Women have been having babies for centuries and if there is NO medical need they should wait. The risks we see during labor always falls under the ones who had to be induced.
      As far as scary… This isn’t scary!! This is the truth!!!

      (Mother of soon to be 3)
      1st born: induced for medical emergency (hospital for 4 days)
      2nd born: labor came on its own.. 3 pushes and my sweet boy was out. Little pain. (Hospital stay- day and half)

  6. Hello Anna
    I don’t think this is a silly article. Of course some people need to be induced as is inherent in this article. However there are far more medical interventions during birth than ever before- do some research you I’ll find this is correct.
    This is an article that highlights real factual differences between natural vs induced labour. Absolutely if you need to be induced then go with what’s right but there is no substitution for natural labour.
    Selina

    1. I would agree with Anna to a degree. I am preg with my 4th and not one of them came naturally. My first (now almost 21) was 2 weeks late and I was induced. He was jaundiced, had the cord wrapped around his neck 3 times and almost died. Breastfed 9 months and bonded well. My waters broke with my 2nd but no contractions. I was induced as they felt it was safest option. Breastfed 8months and bonded well. No medical issues at all either mum or bub. My 3rd was 11 days late, contractions started but no waters. Taken into hospital after 8 hours of close contractions and monitored until bub was getting upset. Waters broken but no other intervention until I had been in labour 20 hours then induction was started. Turns out Bub was stuck in my pelvis and ended up with a cephyhaematoma which subsided after 6 months. Needed physio due to favouring the side without it and was an extremely unsettled Bub. Breastfed for 18 months and all is good now at 3. I am using an OB this time not the public system as I believe that had I received proper care with my last he would not have suffered the way he did stuck in my pelvis. End of the day your article was just shy of fear mongering and you have lost a lot of respect from me. From my experience what was outlined in the article did not happen to me at all through 3 induced labours. Not to mention my 3yo was 10lb 38cm head circ and I did not receive one stitch. Or require forceps etc. What a way to make anyone who has the prospect of induction feel like absolute crap! I will be monitoring this Bub closely and if it looks as though I will have a similar result to mr3 then I will be opting for the health and wellbeing of my baby without worrying about the crap you have dished out here claiming for it to be the truth.

  7. I had three births:

    First was induced by stripping the membrane, and there was an epidural.
    Second was not induced, and there wasn’t time for an epidural.
    Third was Pit induced in the UK, and epidural wasn’t an option.

    Gotta say, that in my experience, some of the info in this article is not accurate. Despite the one epidural, when that male doctor yelled at me “DON’T PUSH!” I felt like sticking my finger down his throat and yelling at him, “DON’T VOMIT!!!”

    I made sure that the two following pregnancies were with OBGYs who were not only women, but women who had actually given birth.

  8. I was induced without the iv. Breaking my water was enough to get the show on the road.
    I think that my induction was different than the induction they used as example

  9. This is a terrible article and very biased. Shame on whoever wrote this. Inductions are usually not optional but mandatory for whatever medical reasons. Stop scaring people

    1. Actually, many women are having unnecessary inductions. It’s not natural or normal for a quarter of pregnant women to need an inductionto make labour happen. In fact there was a quote from a very recent ACOG conference from a doctor, along the lines of, “A funny thing happens when you stop inducing women… they go into labour.” A doctor said that. In fact, you’ll find many doctors who are speaking out about too many inductions being done, and the result – increased c-sections. The documentary “The Business Of Being Born” is a great start to see what is really going on. Doctors, researchers and midwives say it from their very mouths.

      http://www.bellybelly.com.au/birth/reduce-chances-induction-of-labour/

  10. I was induced due to pre-eclampsia, and I most definitely experienced the ejection reflex! It happened so fast, the nurses had to grab a doctor from the floor to deliver the baby before my OB arrived. So I’m not sure what research you were looking at, but the ejection reflex most certainly can happen during an induction!

    1. This happened to me as well! I was trying not to push because I thought it was way too soon. It was scary but it was only 2.5 hours from when they broke my water to when my daughter was born. Midwife said the drip barely got started! Definitely had strong ejection reflex!

  11. This article is a really good insight into induction.i have experienced induced labour because my water broke at wk 38 and after 10hr waiting, no contractions started naturally.so they induced me with a gel tablet(dont know medical term) into vagina at 8am.it kept me in severe pain for 12 hrs till 8pm but cervix opened only 2cm after 24hr of water leakage.after 8pm my artificial contractions subsided then they started IV induction around 11pm.it was hell because it gave me really strong contractions with no success of cervix opening.i only could go to 3cm after being on IV for 2hrs. Got so tired after being in the induced labour for like 16hrs and 27hrs after water leakage.baby’s head was still high.so ended up in c-section at 1pm.couldnt starts breasfeeding due to stitches and now baby is habitual to bottle.all the induced labour didnt help any bit unfortunatelly.i always wanted a vaginal birth n breastfeeding how i ended up feels depressing till today.baby is a month now.

  12. Ivwas induced 3 weeks early for medical reasons. I am a natural birth advicate so I was pretty scared. But once it all started I calmed myself and got down to business. I chose to do everytbing as naturaly as possible so had no pain meds. was also allowed to sit on a ball beside my bed still attached to the moniters. My labor was only 5 hours. But my natural labors are fast anyway. I had such a strong push urge that the Dr didnt make it in time and I tore pretty bad. But all in all it was a very good experience. Baby had lots of bonding time before his medical support team arrived. I did need something for heavy bleeding. Again that was a normal thing for me.
    Its good to know all the risks and side affects but also good to know that many women have successful induced labors. I do believe that the Dr and the hospital policies have alot to do with your outcome. Its a good idea to check that all out before labor time.

  13. 40weeks started..but no Labour pain..two times artificial labor is given but no signal of pain…why..my baby is healthy and proper shape…

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