How painful is an induction?

If you’re pregnant in Singapore, chances are you’ve heard plenty about induction. Perhaps your best friend described her induction as “a walk in the park” (but a park filled with contractions!). Or maybe your neighbour warned you it felt like climbing Bukit Timah Hill—twice, without water breaks.

The truth? Inductions vary widely, just like durian preferences. And while inductions are commonplace here, knowing what’s evidence-based can help you navigate your journey more confidently and comfortably.

What Exactly Is an Induction?

Induction is a medical procedure used to kickstart labour artificially (meaning you have no contractions yet). Doctors might use medications, gels, or even physically rupture your waters to get contractions going. It’s like gently reminding your body, “Hey, it’s time to meet your little guest!”

Why Induce Labour in the First Place?

In Singapore, common reasons for induction include:

• Pregnancy going beyond 40 weeks (although WHO, Royal College of OBGyn, & American College of OBGyn all recommend beyond 41 weeks)

• Health conditions like preeclampsia, gestational diabetes, or low amniotic fluid

• Premature rupture of membranes (your water breaks, but contractions don’t follow)

• Concerns about your baby’s growth or wellbeing

However, not every induction is medically necessary. Sometimes they’re suggested due to convenience, suspected large babies, or simply routine practice. While doctors mean well, it’s totally okay—and important—to gently question whether induction is truly needed in your case.

(READ MORE from Evidence-based Birth)

Here are the recommended guidelines for Induction of Labour from WHO (World health Organization), ACOG (American College of OBGyn) and RCOG (Royal College of OBGyn, UK).

Types of Induction Common in Singapore

Here’s a quick rundown of common induction methods:

• Membrane Sweep: Your doctor manually stimulates your cervix to encourage natural labour by “tickling” your waterbag sac. If your waterbag is not strong, it may break.

• Prostaglandins: Medications inserted vaginally (as gels or tablets) to soften and prepare your cervix. This usually happens if your cervix is still thick and not ready for birth yet.

• Mechanical Methods: A balloon catheter or similar device is used to open and dilate the cervix. (Very rare in Singapore)

• Artificial Rupture of Membranes (ARM): Breaking your water artificially to kickstart labour.

• Synthetic/Fake Oxytocin (Syntocinon/Synto): Delivered via IV to stimulate contractions. Usually happens when your cervix has dilated about 3-4cm

Let’s Talk About the Pain Factor:

Is Induction More Painful?

Here’s the honest scoop: Induction can ramp up contractions faster and more intensely than spontaneous labour. Synthetic hormones like Syntocinon may cause contractions to come on quickly, leaving less time for your body’s natural pain relievers—endorphins—to kick in. But does this guarantee unbearable pain? Absolutely not!

Pain is highly personal. Some women glide through induction smoothly, especially if they’ve prepared emotionally and physically using techniques like hypnobirthing, deep breathing, or doula support. Others find it more challenging. Knowing what to expect helps you manage better and reduces anxiety.

Smart Questions to Ask Your Doctor

(Without Stepping on Toes!)

Good communication is key. Here are some important and thoughtful questions you can ask your doctor about induction of labour, to help you make an informed decision:

Understanding the Reason for Induction

1. Why are you recommending induction? Is it medically necessary?

2. Are there any risks to myself or the baby if we wait for labour to start naturally?

3. What are the risks of being induced in my specific case?

   Methods of Induction

4. What methods of induction do you plan to use (e.g., membrane sweep, Foley balloon, prostaglandin gel, Pitocin)?

5. Can I choose or decline certain methods?

6. How long does each method typically take to work?

Labour and Birth Expectations

7. How might induction affect my labour experience compared to natural labour?

8. Am I more likely to need pain relief, assisted delivery (forceps/vacuum), or a C-section if I’m induced?

9. Can I still move around, use the shower/birth pool, or have a natural birth if I'm induced?

Baby’s Wellbeing

10. How will my baby be monitored during induction?

11. Does induction affect the baby’s risk of needing NICU care or having other complications?

Timing and Planning

12. How long can I wait before induction becomes unsafe or not recommended?

13. If induction doesn’t work, what’s the next step?

14. How long can an induction take from start to delivery?

Alternatives and Support

15. Are there any natural methods I can try before scheduling a medical induction?

16. Can I bring a birth partner or doula for support during induction?

Your doctor is your partner in this journey—asking informed questions can help you both make decisions aligned with your preferences and safety.

How to Navigate an Induction Like a Pro

1. Ask your Doctor the questions above

2. Politely ask for data or studies supporting their recommendation. For example, global guidelines from organizations like the American College of Obstetricians and Gynecologists (ACOG) and the World Health Organization (WHO) define full-term pregnancy as 39 weeks to 40 weeks and 6 days. Babies born before 39 weeks may face higher risks of respiratory issues, feeding difficulties, and even longer-term developmental challenges.

So if someone suggests inducing earlier than 39 weeks without a clear medical reason, gently ask, “Can we explore the evidence behind this timeline?”

3. Get a Second Opinion

If you feel pressured into an induction without a clear medical reason, consider seeking advice from another OB or consulting a doula who can help advocate for your wishes. A fresh perspective can be invaluable.

4. Know Your Rights

In Singapore, you have the right to decline procedures that don’t align with your values or understanding of best practices. Advocate for yourself—you ARE your baby’s first protector.

Doula Tips to Ease Your Induction Experience

1. Educate Yourself: Knowledge is power. Understanding each step of the process helps reduce fear and anxiety. Ask your OBGynae lots of questions!

2. Keep Moving: Embrace the power of gentle movements! Swaying side to side and engaging in a bit of labour dance can work wonders in easing discomfort and promoting the natural progression of labour. Don’t forget about the birth ball—try moving your hips in delightful figures of eight to find your rhythm.

3. Build Your Pain Toolkit: Equip yourself with a variety of relaxation techniques. Explore the soothing realms of hypnobirthing, indulge in a calming massage, or immerse yourself in the warmth of water therapy. A supportive doula can be an invaluable ally on this journey. Consider incorporating essential oils, calming music/noises, and uplifting birth affirmations to enhance your experience.

4. Use Breathing Techniques: Deep breathing exercises aren’t just for yoga class—they’re lifesavers during contractions. Practice them beforehand so they become second nature

5. Mental Prep is Key: Knowledge is power! Understanding the birthing process can significantly reduce stress, and a calmer mind often translates to less pain. Cultivating a positive mindset is essential for a smoother journey.

6. Write a Birth Plan: Take the time to articulate your birth preferences clearly while remaining open to the possibility of changes. Flexibility is key in ensuring a fulfilling experience.

You've Got This, Mama!

I know navigating pregnancy in Singapore can sometimes feel like walking a tightrope between cultural norms and evidence-based care. But remember: YOU are the expert on your body and your baby. By arming yourself with knowledge and advocating for what feels right, you can create a birth experience that aligns with your values and priorities.

And hey, if someone tries to convince you that an induction is the only way forward without a solid reason, channel your inner boss lady and say, “Show me the evidence!” Because when it comes to bringing your baby into the world, every decision counts.

Until next time, stay curious, stay empowered, and trust that your body knows exactly what to do.

With love and late-pregnancy snacks,
Doula Jannah

P.S. Have thoughts or questions about inductions? Share them below—I’m here to chat!