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Helpful Tips for Labor Induction in a Larger Body from a Nurse

Want to know what to expect for a labor induction in a larger body?

Lilly Schott, a reproductive and community health nurse, offers essential advice on preparing for labor induction.

With nearly 20 years of experience, Lilly provides valuable insights into the induction process, emphasizing informed consent, shared decision-making, and the need for compassionate care, especially for individuals with a higher BMI.

sign, baby is coming

Before we dive in, it’s important to note that there’s nothing wrong with needing or wanting an induction; it can be a vital and sometimes necessary part of the birthing process.

However, it’s crucial to fully understand what you are getting into, especially if the induction is not medically indicated.

This involves having thorough discussions with healthcare providers about the reasons for the induction, the risks and benefits involved, and any alternative options.

Informed consent and shared decision-making are essential to ensure that the induction process aligns with your health needs and personal preferences. This is particularly important for individuals with higher BMIs, who may face additional considerations and potential biases in medical recommendations.

person in a larger body with baby on their chest following a labor induction

High Rates of Induction

Care providers regularly recommend induction for plus size patients, often citing concerns about potential complications such as fetal macrosomia (large baby for gestational age) and stillbirth.

Induction rates have increased across all body sizes due to the influence of the ARRIVE trial, which suggests that elective induction at 39 weeks reduces the rate of cesarean deliveries.

This study has faced considerable criticism.

Critics argue that the trial’s findings may not be universally applicable, pointing out potential risks associated with increased interventions and questioning the overall benefits vs risks of elective induction.

This rise in induction rates makes it crucial for patients of all sizes to engage in informed decision-making and advocate for their preferences and needs.

Informed Consent and Shared Decision-Making

One of the most crucial aspects of labor induction in a larger body is informed consent.

Lilly emphasizes that informed consent involves a thorough discussion of the risks and benefits of any procedure and the option of not proceeding with the intervention.

It’s essential that patients feel empowered to ask questions and express their preferences without feeling coerced.

Questions to Ask:

“Is this an emergent situation?”
“What are my options here?”
“How strongly do you feel about me medically needing this induction?”
“What is my Bishop score?” (A scoring system to assess the favorability of the cervix for induction)

Lilly highlights the importance of early and continuous conversations with healthcare providers to build trust and ensure shared decision-making throughout the prenatal care journey.

Calendar, due date

Understanding the Induction Process

Cervical Ripening

The induction process often begins with cervical ripening, particularly for those not already dilated.

This can involve medication taken orally or inserted vaginally to soften the cervix.

Another method is the use of a Foley catheter, a small balloon inserted into the cervix to create pressure and help it dilate.

For individuals undergoing labor induction in a larger body, it’s crucial to discuss with your provider which method might be most effective and comfortable.

Breaking the Water

Once the cervix is sufficiently dilated, a common next step is breaking the water (amniotomy).

This procedure can stimulate contractions through a hormonal cascade, helping to progress labor.

However, it comes with the risk of infection, so it’s important to limit internal exams afterward. This step should be carefully considered and discussed.


Pitocin, a synthetic form of oxytocin, is frequently used to induce or augment labor.

Administered via IV, Pitocin helps start a pattern of uterine contractions.

It’s important to note that Pitocin acts quickly and its effects can be adjusted or stopped if necessary.

Coping Mechanisms and Pain Management

The induction process can be lengthy and challenging, often requiring various coping mechanisms and pain management strategies.

Lilly suggests bringing personal items to the hospital, such as pillows, pictures, and sound machines, to create a comfortable environment.

Additionally, using tools like birthing balls, hydrotherapy, and peanut balls can aid in managing discomfort and progressing labor.

For those experiencing labor induction in a larger body, ensuring that these tools are available and suitable for your body type is essential.

Fetal Monitoring

Fetal monitoring is a critical component of the induction process, ensuring the well-being of both the baby and the birthing parent.

Lilly explains that there are different types of monitors, including wireless options that allow for more freedom of movement.

Working collaboratively with nurses to adjust and manage the monitors can help maintain comfort and ensure accurate monitoring.

Plus size individuals should feel empowered to discuss monitoring options and any concerns with their healthcare team.

Learning how to place the monitors themselves can be an excellent way to stay involved in the process. By understanding how to adjust and manage the monitors, patients can help maintain accurate monitoring, enhancing their overall birthing experience.

Addressing Bias and Advocating for Yourself

Lilly acknowledges the presence of bias in healthcare and emphasizes the importance of advocating for oneself.

She encourages patients to speak up if they feel uncomfortable or judged and to request a different nurse if necessary.

Building a supportive and respectful healthcare team is essential for a positive birthing experience.

This is particularly important for those undergoing labor induction in a larger body, who may face additional biases and assumptions in a medical setting.

newborn laying on mom's chest after childbirth

The induction process, while sometimes necessary, can be overwhelming. However, with informed consent, shared decision-making, and compassionate care, it is possible to have a positive and empowering experience.

Lilly Schott’s insights highlight the importance of preparation, communication, and advocacy in navigating the induction process, particularly for individuals experiencing labor induction in a larger body. Learn even more from Lilly during episode 219 of the Plus Mommy Podcast.

Recording & Show Notes: Plus Mommy Podcast Episode 219

Transcript happily provided upon request.

Resources Mentioned On The Show

Lilly Schott , RN

I’ve been a nurse working in reproductive and community health for nearly 20 years. Most of that work has been in hospitals around the country, or for groups like Doctors without Borders outside of the country. I’m now a Board Certified Lactation Consultant, and health coach and content expert for Oviahealth. I’m also the mom of two little boys, which has caused an increase in my passion for the support of families!