Inducing Labour

An induced labour is one that's started artificially. Every year, 1 in 5 labours are induced in the UK. Sometimes labour can be induced if your baby is overdue or there's any risk to you or your baby's health. This risk could be if you have a health condition such as high blood pressure, for example, or your baby is not growing.

Induction will usually be planned in advance. You'll be able to discuss the advantages and disadvantages with your doctor and midwife, and find out why they think your labour should be induced. If you want to decline an induction, you must discuss this with a health care professional and a personalised care plan will be created. If your pregnancy lasts longer than 42 weeks and you decide not to have your labour induced, you should be offered increased monitoring to check your baby's wellbeing.

Reasons why you might be induced: 

If you are past your due date

Induction will be offered if you do not go into labour naturally by 42 weeks, as there will be a higher risk of stillbirth or problems for the baby.

If your waters break early

If your waters break more than 24 hours before labour starts, there's an increased risk of infection to you and your baby.

If your waters break after 34 weeks, you'll have the choice of induction or expectant management.

Expectant management is when your healthcare professionals monitor your condition and your baby's wellbeing, and your pregnancy can progress naturally as long as it's safe for both of you.

Your midwife or doctor should discuss your options with you before you make a decision.

They should also let you know about the newborn (neonatal) special care hospital facilities in your area.

If your baby is born earlier than 37 weeks, they may be vulnerable to problems related to being premature. 

If your waters break before 34 weeks, you'll only be offered induction if there are other factors that suggest it's the best thing for you and your baby.

If you or your baby have a health problem

You may be offered an induction if you have a condition that means it'll be safer to have your baby sooner, such as diabetes, high blood pressure or intrahepatic cholestasis of pregnancy.

If this is the case, your doctor and midwife will explain your options to you so you can decide whether or not to have your labour induced.

  • Before inducing labour, you'll be offered a membrane sweep, also known as a cervical sweep, to bring on labour.
  • To carry out a membrane sweep, your midwife or doctor sweeps their finger around your cervix during an internal examination.
  • It is important to know that you can ask your health care professional to stop at any time if the sweep becomes too uncomfortable. 
  • A membrane sweep should separate the membranes of the amniotic sac surrounding your baby from your cervix. This separation releases hormones (prostaglandins), which may start your labour.
  • The membrane sweep can help induce labour but if labour does not start, a personalised plan will be created to induce labour using a different method. 
  • Plans will be made for the induction of labour to take place within a hospital, supported by a midwife, with doctors available to help if you need them. 

Each maternity unit will offer slighlty different methods of induction. 

You will discuss this in your care planning meeting with a health care professional. 

 

Contractions can be started by inserting a tablet (pessary) or gel into your vagina.

Induction of labour may take a while, particularly if the cervix (the neck of the uterus) needs to be softened with pessaries or gels. If you have a vaginal tablet or gel, you may be allowed to go home while you wait for it to work.

You should contact your midwife or obstetrician if:

  • your contractions begin
  • you have not had any contractions after 6 hours

If you've had no contractions after 6 hours, you may be offered another tablet or gel.

If you have a controlled-release pessary inserted into your vagina, it can take 24 hours to work. If you are not having contractions after 24 hours, you may be offered another dose.

Sometimes a hormone drip is needed to speed up the labour. Once labour starts, it should proceed normally, but it can sometimes take 24 to 48 hours for labour to become established. 

  • Pain is experienced differently by everyone. 
  • Induced labour is usually more painful than labour that starts on its own, and you may consider different forms of pain relief. 
  • If you are induced you'll be more likely to have an assisted delivery, where forceps or ventouse suction are used to help the baby out.

Induction is not always successful, and labour may not start.

Your obstetrician and midwife will assess your condition and your baby's wellbeing, and you may be offered another induction or a caesarean section.

Your midwife and doctor will discuss all your options with you.