Induction of Labour: Risks, Benefits, and What Informed Consent Actually Means in Canada

If you are pregnant in Canada, there is a very real chance that at some point someone will mention induction of labour for one reason or another.

Sometimes it is clearly for medical reasons. Sometimes it comes up because you are getting close to or past your due date. And sometimes it is presented as a pretty routine next step, without much explanation at all.

Across Canada, about one in five pregnancies (and rising) now involve an induction rather than labour starting on its own. That number has been climbing for years, which means this conversation is becoming more and more common for expecting families. But… it’s not as routine as it may seem and comes with some pretty significant risks.

Here’s the kicker: most people I work with were never really taught what induction actually involves, how it changes labour, or what informed consent is supposed to look like here.

So let’s really talk about it, in a way that gives you the info you need to know before you actually get into this.

What is an induction of labour? And what does it mean for you in Canada?

An induction of labour is when labour is started artificially, instead of beginning on its own. 

This often starts with medications to soften and open the cervix, maybe mechanical methods like a balloon catheter, breaking the water, or prostaglandin medications.

After the cervix is a bit more favourable, synthetic oxytocin (Pitocin) is given through an IV to make you start having contractions. At this point, you are hooked up to the continuous fetal monitoring machine in the labour room.

I will never deny that some inductions are necessary or recommended because there is a medical reason to get the baby out sooner rather than later.

However, often, even when it’s framed as “probably a good idea to get things moving,” this is still considered elective, meaning there is no urgent medical issue, but labour is being encouraged for reasons like timing, policies, or provider preference.

Both happen in all parts of Canada and for many reasons. The important part is not whether induction is good or bad. It is whether you are being given enough information to actually make a choice.

How induction changes the experience of labour

Spontaneous labour is driven by a really cool hormonal feedback loop between your brain, your uterus, and your baby.

Oxytocin is released in waves.Endorphins rise alongside contractions to control pain in your body.Your body gradually builds intensity in a way that allows you to adapt.

Pitocin works differently.

Pitocin is synthetic oxytocin delivered through an IV pump continuously. It creates strong, regular uterine contractions, but without the same feedback loop with your brain. Pitocin doesn’t cross the blood-brain barrier either, so your brain isn’t releasing the endorphins it does with your own contractions.

For many people, this means contractions feel more intense, come closer together, and ramp up faster than labour that starts on its own.

In real life, that often translates to higher pain perception, earlier need for pain medications, more monitoring, and less freedom to move around.

This does not automatically make induction unsafe. But it does make it a different experience, and one that deserves a different kind of preparation.

What the research shows, in real life terms

The research on induction is nuanced, and it is often oversimplified online.

Some large studies suggest that elective induction at 39 weeks does not increase C section rates in low risk, first time parents when compared to waiting (ARRIVE trial).

However, recently new research, especially observational studies, shows higher rates of cesarean, longer labours, more epidural use, and more continuous monitoring in induced labours compared to spontaneous ones.

This lines up much more with what we know in practice to be true: there is a cascading effect of interventions that increase the risk of more interventions for every intervention you have. (yeah, I know that’s a lot of ‘interventions’, but thats the point).

We also see consistent evidence that the use of Pitocin is associated with higher rates of postpartum hemorrhage, because it can affect how well the uterus contracts after birth. The muscles are forced to work harder than they would on their own and then fatigue after, having a hard time keeping itself strong to reduce bleeding. 

What matters most is not memorizing specific percentages. It is understanding the overall pattern.

Induction tends to increase:

• How intense labour feels

• The likelihood of needing pain medication in increasing strengths

• The amount of monitoring involved

• The chances of additional interventions

Sometimes those tradeoffs are absolutely worth it. Sometimes they are not. The key is that they are real and should be part of the conversation.

The cascade of interventions

One of the most important things parents are rarely taught is how interventions tend to stack on top of each other.

A very common pattern looks like this:

Induction → stronger contractions → increased pain → epidural → less movement → slower descent → more monitoring → more interventions → less of your own contractions → add in augmentation of labour with pitocin → increased risk of Postpartum Hemorrhage, impacts on baby, breastfeeding, and postpartum mental health.

This is not inevitable, and many induced labours go smoothly.

But statistically, once labour is medically started, the overall likelihood of needing further interventions does go up.

Knowing this ahead of time is not meant to scare you. It is meant to help you feel oriented and prepared!

Informed consent and induction in Canada

Informed consent means you should be told:

• What is being recommended

• Why it is being suggested

• The benefits and risks

• The alternatives

• What happens if you choose to wait or do nothing

• What does your gut say?

This is a legal requirement in Canada. If you have not had these full conversations, you have not given Informed Consent.

But in real life, induction is often framed as the obvious next step, without much space for questions or reflection.

A good informed consent conversation sounds like:“Here is why we are recommending this. Here are the real tradeoffs. Here are your options. What feels right for you?”

Not:“This is what we’re doing next.”

Questions I would ask if it was me

If induction is being offered to me (and it has been twice), this is what I would ask:

Why is this being recommended right now?

What is the specific risk we are trying to prevent?

What are the risks of waiting?

What methods will be used?

What other methods are available?

How might this change my labour experience?

What alternatives exist?

These are not confrontational questions. They are thoughtful, responsible, and completely reasonable.

And truly, if you are not given a full account of the answers… this provider is leaning a little more to the coercion side of the conversation than creating a safe and informed environment.

Induction is not failure

Choosing induction does not mean you failed. Declining induction does not mean you are reckless.

The goal is not to avoid interventions at all costs. The goal is to make decisions that feel informed, supported, and aligned with your values and your actual clinical situation.

And that requires real information, not rushed conversations at the end of pregnancy.

Want more support as you prepare for labour?

If you want ongoing, practical, Canadian specific education about labour, interventions, and your options, I host a free live workshop each month called Prepping to Pop.

It is designed for pregnant parents who want to feel confident and prepared, without fear mongering or pressure! 

You can sign up for the next one at this link.