A labor induction is the medical process of artificially starting labor before it begins on its own. Spontaneous labor, in contrast, begins naturally when the body and baby are ready, driven by a complex cascade of naturally increasing hormones. While pain perception is subjective, many women and clinical studies suggest that induced labor frequently leads to a more intense and painful experience than labor that begins without intervention.
How Induced Labor Differs from Spontaneous Labor
The primary difference between induced and spontaneous labor lies in the timing and introduction of uterine stimulation. Spontaneous labor begins with the gradual release of oxytocin, which causes the uterus to contract, and prostaglandins, which help ripen and soften the cervix. This natural process is slow, allowing a preparatory phase known as latent labor, where contractions are mild and widely spaced, sometimes lasting for many hours or days. This gradual onset allows the body time to adjust to the sensations and the cervix to prepare for active labor.
Induced labor bypasses this gradual preparation by using medical interventions. The methods used depend on whether the cervix is “unfavorable,” meaning it is not soft or dilated. If the cervix is not ready, methods like prostaglandin medications (oral or vaginal inserts) or a Foley bulb catheter are used for cervical ripening. If the cervix is favorable, or after ripening is complete, labor is typically initiated by an amniotomy (artificially breaking the water) or by administering a synthetic form of oxytocin, often called Pitocin, through an intravenous drip. This synthetic hormone immediately stimulates uterine contractions, creating a rapid onset of labor that contrasts sharply with the body’s natural, slow build-up.
Contraction Intensity and Pain Perception
Induced labor is frequently perceived as more painful because of the way the synthetic hormones affect the uterus. Natural labor contractions gradually increase in frequency and intensity, allowing the birthing person’s body to adapt. The body’s own oxytocin release also triggers the release of endorphins, natural painkillers that cross the blood-brain barrier and help mitigate the sensation of pain.
In contrast, the administration of Pitocin causes contractions to start more quickly and become stronger and more frequent than they would naturally. This rapid escalation means the birthing person is thrust immediately into intense, active labor without the natural “warm-up” period. Furthermore, synthetic oxytocin does not cross the blood-brain barrier in the same way natural oxytocin does, meaning it does not trigger the same release of pain-dulling endorphins. The combination of rapid, intense contractions and the lack of the body’s natural pain-relief mechanism contributes to the increased pain experienced during Pitocin-induced labor.
This difference in pain intensity is supported by data on pain relief choices. Studies show that women undergoing induced labor have a higher rate of requesting and receiving an epidural compared to those in spontaneous labor. For example, one study found that 71% of induced women received an epidural compared to 41% of those not induced. This disparity suggests that the contractions induced by medical means exceed the threshold of what a person can cope with using non-pharmacological methods. The lack of the natural “ebb and flow” of contractions, where the uterus fully relaxes between them, also contributes to physical exhaustion and heightened pain perception.
Pain Management Strategies During Induction
Because induced labor often leads to more intense contractions, planning for pain management becomes especially important. Pharmacological options are readily available and are not restricted by the induction process. The most common and effective option is epidural analgesia, which can be requested early in the induction process, often shortly after the Pitocin drip is started or when active labor begins.
Other medical pain relief methods include intravenous (IV) opioid medications, which offer temporary pain reduction but do not eliminate the sensation entirely. Nitrous oxide, sometimes called laughing gas, is another option that provides fast-acting, temporary relief and is self-administered, allowing the birthing person to control the timing. Discussing the timing of these options with the care team is advisable, as the rapid onset of Pitocin contractions means there may be less time to decide once the pain becomes severe.
Non-pharmacological techniques remain valuable, even with the increased intensity of induced contractions. Hydrotherapy, such as soaking in a tub or taking a shower, can help soothe tension and offer a distraction. Changing positions, using a birthing ball, and applying hot or cold compresses can also help manage discomfort. Utilizing focused breathing techniques and having continuous support from a partner or a doula provides emotional and physical guidance through the intense contractions of an induced labor.