What Is Augmentation of Labor? (And Why Your Birth Plan May Change)

If you’re getting close to your due date, you might have already prepared a birth plan outlining what you ideally want baby’s grand entrance to look like. But sometimes the road to delivery is rocky, like when labor stops or stalls—and then that meticulously constructed birth plan has to go out the window.

“With my first [child], my labor was augmented with Pitocin after it stalled post-epidural,” recalls Mary M., a mom of two in Minnesota. “Contractions quickly resumed, and I was able to continue labor and have a vaginal delivery.”

Mary M.’s birth story isn’t unusual: Research suggests that around 26 percent of moms in the US receive some type of augmentation of labor. It’s estimated that of those who undergo labor augmentation, around 50 percent go on to have a vaginal delivery, with the rest needing C-sections.

Remember that even if things don’t go according to (birth) plan, labor augmentation can be a positive experience and result in the safest outcomes for you and baby. And knowing what to anticipate if labor stalls will help set you up for an informed experience. Ahead, learn more about augmentation of labor, including reasons, risks—and what’s next if it doesn’t work out.

Key Takeaways

• Labor augmentation is used to speed up labor when it has slowed down or stopped.
• The most common methods for augmenting labor are IV oxytocin use and amniotomy (rupture of the amniotic sac). These methods increase the strength and frequency of your contractions.
• Labor augmentation isn’t right for everyone and carries some risks, including uterine rupture and fetal distress.
• If your provider determines that augmentation isn’t working or can’t be continued safely, your birth plan may need to change to include a C-section.

What Is Labor Augmentation?

In a nutshell, augmentation of labor is an attempt to make labor more effective when it has stalled or slowed down by improving the strength of your contractions, explains Samir E. Hage, DO, ob-gyn and medical director of perinatal services at Redlands Community Hospital in California.

While one of the goals of labor augmentation is to help you avoid a C-section, it can still result in one—especially if labor completely stops (more on this later). A 2024 study suggests that using methods to augment labor too early—like when labor has slowed down but not stopped completely—can actually lead to a higher risk of C-section. Overall, though, outcomes vary.

Labor augmentation vs. labor induction

Labor induction is the process of trying to start a labor that hasn’t begun yet, while labor augmentation is the process of strengthening a labor that’s already in progress. “If you’re contracting but your cervix isn’t changing, you haven’t met the definition of labor, so if we start interventions it’s technically induction,” explains Andrea Hubschmann, MD, an ob-gyn at Summit Health in New Jersey. “If you’re having contractions and rapid cervical changes, then [any intervention we do] is augmentation.”

Reasons for Labor Augmentation

Your provider might recommend augmentation of labor if your contractions aren’t strong or frequent enough to keep labor safely progressing, says Hage. He adds that labor augmentation may also be recommended if your amniotic sac has been broken for a long time, but labor slows down or stops—this increases the risk of infection for you and baby.

But not everyone experiencing a stalled or prolonged labor is a candidate for augmentation of labor. Your provider won’t want to augment labor if baby isn’t in a head-down, or cephalic, position, or if you have uterine scarring or scar tissue, including from a prior C-section, according to Cleveland Clinic.

Risks of Labor Augmentation

Augmentation of labor can be safe, but there are also some risks associated with it. According to experts, they include:

• Uterine hyperstimulation. Labor augmentation can cause contractions to become very strong or intense, which can make it harder for baby to get enough blood and oxygen, leading to fetal distress.
• Increased risk of uterine rupture. Labor augmentation can cause a tear or rupture in the uterine wall, often at the site of a previous C-section scar, according to research. This risk is higher if you’re attempting a VBAC, aka vaginal birth after cesarean.
• Amniotomy-related risks. If your provider chooses to augment labor by breaking your amniotic sac, you have a higher risk of an infection called chorioamnionitis, which can be dangerous for you and baby. An amniotomy also increases your risk for an umbilical cord prolapse, which is an emergency because it cuts off baby’s oxygen supply.

How Is Labor Augmented?

The primary way to augment labor is with an IV dose of oxytocin (brand-name Pitocin). Pitocin strengthens contractions, which can help your cervix dilate more and move labor along.

If your water hasn’t broken yet, your provider may choose to perform an amniotomy, or artificial rupture of the amniotic sac, using a small, hooked tool. Like Pitocin, it can cause a sudden increase in contractions, which can push labor in the right direction.

Are There Natural Ways to Augment Labor?

While there’s no one surefire way to augment labor naturally, there are a few methods that can move things along. They include:

• Movement
• Nipple stimulation
• Eating dates
• Acupuncture
• Acupressure

Make sure to talk to your provider before trying any natural methods that could affect labor.

What’s Next If Labor Augmentation Doesn’t Work?

If your provider determines that you’re in “arrested labor,” the next step is typically a C-section. According to the American College of Obstetricians and Gynecologists (ACOG), arrested labor happens when labor stops progressing despite labor augmentation methods.

In the first stage of labor, arrested labor is often diagnosed if you’re at least 6 centimeters dilated, have been having regular contractions for four to six hours, your amniotic sac is ruptured and your cervix isn’t dilating any further. In the second stage of labor, it may be diagnosed if you’ve been pushing for two to four hours without making any progress.

Arrested labor is different from protracted labor: “If you’re moving slower but still making changes, then we can usually monitor for signs of infection,” says Hubschmann. But if labor has truly stopped, the next step is C-section. “I was leaking amniotic fluid with my first child, so they induced me with Pitocin,” recalls Lauren H., a mom of two in Georgia. “Nothing happened, other than me being in extreme pain, so they gave me an early epidural to dilate… I pushed for almost three hours before they declared her stuck and did an emergency C-section.”

A change in birth plan can be upsetting, but remember that your provider is there to keep you safe. “I was very much in the mindset that my care team knows best, and as long as baby and I are safe and healthy, I didn’t care how we made labor happen,” says Mary B., a mom of five in Pennsylvania, of her first labor and delivery. “That was how I kept my anxiety at bay, and how I continue to think about all of my labors.”

To Sum It Up

If your labor has stalled, your provider may recommend augmentation of labor to get things going again. IV oxytocin and amniotomy are the most common ways to augment labor. Labor augmentation carries some risks, especially for women who’ve had a prior C-section. If your provider determines that you’re in “arrested labor” despite labor augmentation, the next step is a C-section. Make sure to have an open conversation with your provider about all your options during labor—birth plans can and do change, and being flexible is key.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.