My 10 Tips If You Are Having an Induction: Practical Tips from a Berlin Doula

When families hear the word “induction,” many imagine it as a simple, jump-start to labor. But as both research and physiology tell us, an induction is an intervention that changes how labor unfolds (physically, hormonally, and emotionally...)

As a doula supporting parents in Berlin, I often navigate inductions with my clients.

And I learnt that, while an induction changes the path of your birth, it does not mean you lose your voice. Here are the top tips I share with my clients to help them stay centered during this process.

1. Understand Why Induction Is Needed

Before consenting to an induction, make sure you understand your specific medical indication and the personalised risks and benefits of this intervention.

Context matters ... for example inducing at 36 weeks for preeclampsia is very different from offering an induction at 41 weeks in a healthy pregnancy ; just as an induction during a VBAC carries different considerations than it does for a first birth.

Take the time to gather the facts so you can make the right decision for your care. You'd want to participate directly in the decision-making process, because an induction will change your labour and birth experience.

You should know that inductions are interventions that will impact your birth experience and are linked more medicalised births. You have the right to know the evidence, the benefits, and the alternatives so that whatever path you choose, it aligns with your values.

The top reasons for inductions are

• Overdue pregnancy, post-term pregnancy

• Pre labour rupture of membranes (aka your water breaks before labour starts)

• Gestational diabetes

• Abnormal amniotic fluid volume (too much / too little)

• Small for gestational age (baby suspected to be "too small")

• Suspected macrosomia (baby suspected to be "too big")

• Cholestasis (liver/gallbladder issue)

• Hypertensive disorders of pregnancy (incl. preeclampsia)

• Maternal request without medical indication (usually possible from 39 weeks on)

Here are some sources of information from Evidence Based Birth to support your decision making process and discussion with your medical team for:

• Evidence on inducing for due dates (simple A4 handout with key data, podcast)

• Evidence on inducing for when your water breaks before labour starts (simple A4 handout with key data, podcast)

• Evidence on inducing for a suspected big baby (simple A4 handout with key data, podcast)

• Evidence on inducing for gestational diabetes (article and link to podcast)

2. Have a Constructive Conversation With Your Doctor On A Potential Induction

Here are some tips on making the most of your appointment:

• Prepare for your appointments: bring notes, relevant medical reports, or any research you’d like to discuss. Write down your questions in advance.

• Bring someone with you if it helps to have support or to better understand the information shared.

• Be specific when describing symptoms or preferences: Don’t just say “my baby moves less than usual.” Instead, say “I usually feel strong kicks after lunch and in the evening, but in the past two days I’ve only felt a few light movements, even when I lie down – and I’m worried.”

• Rephrase what your doctor tells you to confirm that you’ve understood correctly.

• At the end, summarise the decisions and next steps you agreed on together.

• And do not hesitate to ask for a second opinion if unsure (your gynaecologist, your midwife, a prenatal consultation at an other clinic...)

  
  

  If an induction is recommended because you are past your due date or because your baby is estimated to be large for example, these are typically non-urgent cases, you usually have the time to discuss options, try lighter interventions, and plan your next steps thoughtfully with your care team.

3. You May Be Able To Get (part of) An Induction At Home

There are many different ways to do an inductions. This will depend on the reason why you are induced (is it urgent or not for example), the status of your cervix (a bit open? a bit soft? or not at all? this is called "Bishop score") and your wishes.

The first step of an induction is (often) cervical ripening (with mechanical methods or synthetic hormones), which helps the cervix soften, shorten, and begin to open if it is not yet ready.

You will do this process, unless your cervix is really ripe. After that, you may already be in labour (but this is not the majority of people), or you could need to stimulate contractions (with synthetic hormones)

There are different cervical ripening methods that are possible:

• Mechanical options:  hygroscopic dilators like Dilapan-S (rods inserted into the cervix that swell gently as they absorb fluid), baloon catheter. And to an extent a membrane sweep (that can be done when the induction is not urgent, for example you are over your due date and want /need to make things move forward)

• Pharmacological options: Prostaglandins, such as Angusta (oral tablets given every few hours) or vaginal gels/tampons.

  
  

Dilapan-S is are small, sterile rod made from a synthetic, water-absorbing material that gradually expands after it is inserted into the cervix. These used for mechanical cervical ripening.

Dilapan-S and membrane sweeps (and sometimes the baloon) are methods of induction that can be done on an outpatient basis, meaning you can start the process at home.

If you’re eligible for this option, I believe it offers a real advantage. Being able to sleep at home, in your own safe and familiar space, can help you feel calmer and get the rest you need. This can make the experience more comfortable and may even help the process progress more smoothly.

4. Schedule the Induction for Early Morning

Inductions take time. The whole challenge is to manage to balance your energy levels through induction so that you have energy left to sustain you through labour.

Many people do not go into active labor directly after starting the induction (with a mechanical method or with a dose of prostaglandins (Angusta pills). When you take the pills, you take a dose every 4 hours. Each dose can help the cervix to ripen and could trigger contractions. But it is also very possible that not much happens, and that you do not get into "real" labour before a few days.

The full induction process commonly takes 1-3 days, and occasionally even longer. This extra time is not a sign of a problem; it is often just what your body needs to start labor safely.

You could try to schedule your start for the early morning. Starting at 8:00 AM allows you to get a full night's sleep beforehand, eat a proper breakfast, and go through your first day without burning out before labor even starts.

Furthermore, many Berlin hospital wards pause administering doses overnight to allow birthing parents to rest. Even though natural labor often naturally starts at night, keeping your energy reserves high on Day 1 is key.

5. Nudge Your Body Beforehand

If you know an induction is approaching, spend the days leading up to it helping your body and cervix prepare naturally:

• Try acupuncture or acupressure sessions for labor preparation.

• Boost your natural oxytocin through loving physical contact, cuddle time, massage, or sex (if your waters are intact).

• Prioritise deep, uninterrupted sleep and physical rest.

• Do light movements to bring softness and balance to the pelvic bowl and encourage baby to engage. (I love this one, and this one). Inversions and Side Lying Release from Spinning Babies are good tools to practice before labour (and used during!)

Some studies suggest that acupuncture improves cervical readiness.

6. Prepare Your Mind & Spirit For A Potentially Long Process

Preparing for an induction is as much mental as it is physical. Shift your focus inward before heading to the hospital:

• Listen to guided meditations or positive birth affirmations.

• Create a intentional ritual, such as a Mama Blessing, a relaxing bath, or a special dinner with your partner to mark the transition and gather a lot of strength and good vibes form loved ones :)

• Talk to your baby to explain to them what is coming ahead. Babies are real actors in the birth process and you want to team up and prepare them too :)

• Shift your mindset: understand that you are going to do a process, this is a marathon not a sprint, It make take you a few days to get into labour.: this is normal, you are not failing! You really need patience, flexibility, and trust in your body.

  
  

7. Protect Your Headspace, Guard Your Space & Get Comfortable

Once you are on the hospital ward, protect your space!

You will most of the time be in a shared room, where your partner can not stay (unless you are lucky to get a private room. The clinic is not the best setting for resting, feeling relaxed and in control... It is therefore important to be prepared mentally for what comes.

• Do not stare at the clock, do not over-Google, and stop reading negative induction stories online.

• Keep eating nourishing snacks, and stay hydrated.

• Bring eye masks, noise-canceling headphones or earplugs, dim lighting, fairy lights, or playlist speakers. Sleep and rest whenever the opportunity arises.

  Your body will have more difficulties getting into labour and progressing if you are exhausted and anxious.

Your partner has a vital role here: Their job is to protect your rest, bring you good food and entertainment, filter visitors or staff when you are napping, and support you in asking questions during doctor rounds (remember: you can request a consultation with the doctor at any time).

8. Understand Pain Relief Options

An important consideration with labor induction is that it frequently leads to higher rates of medical pain relief, such as an epidural.

• Make sure you learn about pain medication options both medicated and unmedicated. I wrote about it here. And discuss with your team what they offer on site.

• Even if you are planning to use medicated pain management options, it is important that you prepare for coping with contractions without medication too (there are moments when you may not (yet) have adequate pain relief, or it may not "work" fully, or more generally, other coping techniques are great in combination with medicated pain relief). To learn about other unmedicated and medicated methods for pain relief, read here)

  • Water is one of the most effective non-pharmacological tools for pain relief during an induction. But many people ignore that they can use it then: go ahead, take warm showers or ask to use a bathtub! Using a hot water bottle on your sacrum may also help.

• Having an induction means that you may need more frequent monitoring and potentially additional interventions during labour. However, it does not mean that you have to stay in bed.

  • Ask your midwives for a wireless/telemetry CTG monitor so you can stay mobile, move around the room, sit on a birth ball, or use the shower while keeping baby monitored.

  • Even with an epidural, movement and changes of position are often possible and encouraged. Movement is key during labour: it can help you feel more comfortable, support your baby’s descent and rotation, and help labour progress. Ask your care team about the options available to you so you can remain as mobile as possible throughout the process.

    
    

    

    Many CTG monitors are waterpoof. Ask your team for a portable waterpoof device

    
    

9. Understand Your Options If Induction Of Labour Just "Doesn't Work"

Even though hospitals have protocols/schedules for inductions, these just take time. Starting labor with mechanical tools (Dilapan-S, balloon, membrane sweeps, combination of these etc.) and/or Angusta tablets can take a couple of days.

If you and your baby are safe and healthy, with good monitor readings and intact waters, doctors are usually glad to wait and let the process happen naturally.

But there are some major steps like breaking your waters or starting a synthetic oxytocin drip, that mean that the "clock starts ticking". So before starting these steps, you could ask your care team:

• Why is this intervention necessary now? What happens if we alternatively do nothing (stop the current process or just continue with the current process and not escalate to more interventions).

• Is it possible that I take a rest now, that I try to sleep and eat or move/get some air before we try something else?

• Is it possible to try an alternative induction method at this point, if the induction really needs to move forward now?

• If I change my mind and decide at a later stage that I no longer wish to proceed with the induction process, what will happen next?

• If labour does not pick up or progress with the suggested intervention, at what point will you say that it is reasonable to stop and go for a C-section? How/when will I be consulted on this decision?

10. Get a Doula For Support During Your Induction

Navigating the multi-day process of a hospital induction, language barriers, shift changes, and medical conversations can feel overwhelming. Having a doula by your side provides continuous physical, emotional, and informational support. A doula helps hold your space, reminds you of your options, supports your partner, and keeps you grounded from start to finish.

Anne Matei is a birth and postpartum doula based in Berlin, supporting French-, English-, and German-speaking families. She accompanies births in hospitals, birth centers, and home births alongside midwives. Read what families say about working with her in client testimonials. Feel free to get in touch to schedule a non-binding introductory call.