What is Cervidil and how long does it take to induce labor?
Pregnant women all dream of the perfect birth, but sometimes things don’t go as planned. Sometimes a pregnant woman may come to a point in her pregnancy, usually at the end of her pregnancy where she may need medical help to induce labor.
This is sometimes necessary for a specific medical reason, either present or due to a medical history. Other times, mothers are given the option for an elective induction once they’re past their due date, or around 40-42 weeks pregnant.
There are a few different ways to induce labor, whether naturally or with medication use such as hormone-like substances. Cervidil is one of the first go to medications.
You may wonder what the induction process is like and whether there’s any potential risks to you or your baby that you need to know.
Remember, you are always entitled to all of the evidence-based information so that you can make an informed choice on what’s best for you and your baby. Always discuss any questions or concerns that you have with your doctor.
What is Cervidil?
Cervidil is the brand name of a type of drug that can be used to activate labor. It’s a cervical ripening agent, used for the softening and the ripening of the cervix to help labor progress. The active ingredient in Cervidil is Dinoprostone, a synthetic (artificial) molecule that is similar to Prostaglandin E2 (PGE2).
PGE2 is a naturally occurring hormone-like chemical in our bodies that has an important role in labor. Dinoprostone in Cervidil has the same effect as PGE2 and prepares the cervix for labor.
What is cervical ripening?
The cervix connects the uterus to the vagina and is thick and firm to protect the baby in the uterus. PGE2 is released by the placenta and other tissues of the uterus when your body is ready for labor, the cervix becomes soft and thin.
The opening of the cervix widens to allow the baby to pass through the birth canal. This is called cervical ripening. Once the cervix is dilated to approximately six centimeters, active labor commences, and contractions become longer and more intense.
When is Cervidil used?
Your doctor may decide that you need an induction when you are overdue, there is a complication, your water broke but contractions haven’t started after 24 hours, your baby isn’t thriving, or other issues.
Induction always ends in delivery, be it vaginally or via C-section. There are various methods for inducing labor, one of which is drugs that cause cervical ripening.
Drugs containing either Dinoprostone, Mifepristone, Misoprostol, or Oxytocin may be administered if your cervix does not become soft, thin, and dilated by itself.
How is Cervidil administered?
Brand names for Dinoprostone include Cerdivil, Prepidil, and Prostin E2, and can be administered in a gel form or through a vaginal insert. Cervidil is delivered through a vaginal insert which looks like a slim tampon with a ribbon attached to it.
The insert contains the active ingredient Dinoprostone and the ribbon is used to remove the insert. Cervidil should always be administered by a medical professional in a hospital setting.
The insert is placed inside the vagina near the cervix (opening of the uterus). The Dinoprostone is absorbed from the insert and the cervix starts to prepare for labor the same way it would have in reaction to PGE2.
How long does Cervidil take to induce labor?
After the administration of Cervidil, it will release Dinoprostone for twelve hours. During this time, it is recommended that you stay lying down for the first two hours to keep the insert in place.
You should also avoid wiping when using the bathroom and instead just blot. You may start to experience some light cramping which will later intensify into contractions.
Tell your doctor or nurse if you experience any discomfort or irritation from the insert or if the insert has shifted.
Data from clinical trials showed that Cervidil usually induced labor between seven and twelve hours after it was administered. However, every person is different, and your doctor will carefully monitor you and your baby to determine when the insert should be removed.
What if I don’t go into labor after an induction with Cervidil?
If contractions haven’t started after cervical ripening, your doctor might break your water (called an amniotomy) to stimulate your body to increase the speed and power of your contractions.
If you are still not having contractions, your doctor may administer Pitocin intravenously. Pitocin is a drug that contains a synthetic form of oxytocin. Oxytocin is a hormone your body produces which triggers contractions during labor.
Is Cervidil safe?
Cervidil is considered effective in activating as well as speeding up labor and delivery. It also doesn’t require any injections or needles and is generally considered pain-free.
Of course, there is always risks to inductions and medications and it’s very important to discuss this with your medical provider to help you outweigh the benefits and risks of an induction.
Reasons for an Induction
Every woman needs to be considered as an individual about whether she needs induction. Common reasons for induction of labor include:
- Post-dates pregnancy (42+ weeks)
- Pregnancy-induced hypertension or preeclampsia (high blood pressure in pregnancy)
- Gestational diabetes
- Prelabor rupture of membranes – your water breaking without contractions
- Intrauterine growth restriction – baby not growing well
There may be other reasons based on your own pregnancy and situation that might mean you need to be induced.
Cervidil side effects
Side effects are considered uncommon. However, not everyone can use Cervidil. Among the contraindications are previous uterine surgeries of any nature (including C-sections).
Most common side effects include:
- Frequent or prolonged contractions
- Changes in the baby’s heart rate
- Fever
- Nausea and vomiting
- Diarrhea
- Abdominal pain
- Headache
- Low blood pressure
Some rare but serious side effects include:
- Blood clots
- Excessive bleeding
- Amniotic fluid embolism syndrome
You are at a greater risk of side effects if you suffer from glaucoma, take oxytocin, are over 30 years old, or have a complicated pregnancy.
It is critical to discuss existing conditions, supplements and medications, as well as the possible side effects of Cerdivil with your healthcare provider.
What should I discuss with my Doctor before labor induction begins or before CERVIDIL is given?
As you would throughout your pregnancy, be sure to tell your doctor about all prescription or over-the-counter herbs and medications that you’re taking. Before Cervidil is given, be sure you have told your doctor about all your current and past medical conditions, including:
- Glaucoma
- If your water breaks or has already broken
- Any unexplained vaginal bleeding during pregnancy
- Asthma, even if you had childhood asthma and have had no asthma attacks as an adult
- All uterine surgeries, especially previous cesarean section
- A history of contractions lasting more than 2 minutes
WHO SHOULD NOT BE GIVEN CERVIDIL?
You should not be given Cervidil if you have:
- Experienced unexplained vaginal bleeding during your pregnancy
- Already started receiving drugs to induce labor
- Given birth six or more times in your lifetime
- Experienced an allergic reaction to prostaglandins (certain hormone-like substances)
You should also not be given Cervidil if your doctor has determined that:
- Your baby is in fetal distress and needs to be delivered urgently
- Your baby may be too large to fit through your birth canal (“cephalopelvic disproportion”)
- Drugs used to induce labor are not appropriate for you or that prolonged contraction of your uterus may be harmful to you or your baby such as if you have had a previous cesarean section or major surgery on your uterus.
Natural ways to induce labor
NB: Before trying to induce labor, talk to your healthcare provider.
There are a lot of anecdotes about doing certain things and eating or drinking certain foods to help get labor started. However, there isn’t much scientific evidence to back up many of these claims, but it’s still well worth the try.
There is quite recent research that evaluates the following ways to induce labor:
- Exercise
Walking may induce labor and reduce the need for interventions during delivery.
- Sex
Although there is not sufficient evidence to link the act of sex to labor induction, oxytocin (the “love” hormone) released during sex may jumpstart contractions.
- Nipple stimulation
Nipple stimulation results in oxytocin to be released into the bloodstream which in turn triggers contractions; research also finds that it reduces postpartum hemorrhage.
- Acupuncture
Acupuncture may assist cervical ripening.
- Eating dates
Research found that eating dates during the final weeks of pregnancy increases cervical ripening and dilation and decreases the need to use Pitocin during labor.
Benefits of waiting for labor to start naturally
In healthy, uncomplicated pregnancies, doctors may wait up to 42 weeks for labor to start naturally before considering induction. Most babies will come when they’re ready without any medical interventions.
There are benefits in waiting for labor to start on its own, given that both the mother and baby are healthy.
Infants born full-term have:
- More time to build muscle and strength
- A reduced risk of low blood sugar
- A reduced risk of infection
- A reduced risk of jaundice
- Improved breathing
- Better breastfeeding success after birth
- Increased brain development
Important notes on the use of Cervidil
Every pregnancy and every woman are unique. Cervidil has some benefits in inducing labor, and although side effects are uncommon, it should not be considered without weighing its risks.
Prepare for labor and talk about different scenarios with your partner and health care provider or trusted healthcare professionals. You may even want to create a birth plan! Even if things don’t always go as planned, having certain goals is very beneficial.
Whether you get an induction or not, it is important to remember that labor is a marathon, not a sprint.
Prepare yourself for the marathon by packing snacks and things to do to relax.
Stay calm and tell those around you what you need and want and allow them to take care of you. Don’t be afraid to ask for some space too!
If you ever have any questions or concerns, discuss them with your medical provider for the best possible medical advice.
Additional information and resources
CERVIDIL® (Dinoprostone) (2021)
Dinoprostone (vaginal route) description and brand names (2024) Mayo Clinic
Marcin, A. (2023) 6 natural ways to induce labor, Healthline. Edited by S. Heningsman
