Induction of labour

Everything you need to know about induction of labour at DBTH.

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Induction of labour

An induced labour is one that’s started artificially. Every year three in 10 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 could be if you have a health condition such as high blood pressure, for example, or your baby is not growing as much as expected.

Induction will usually be planned in advance. You’ll be able to discuss the risks and benefits with your doctor and midwife, and find out why induction is being advised to you.

After being given all the relevant information, it will be your choice to have your labour induced or not and your decision will be respected and supported.

If your pregnancy lasts longer than 41-weeks and you decide not to have your labour induced, you should be offered increased monitoring to check your baby’s wellbeing if you wish.

Why you might be induced

  • If you’re overdue.
  • If your waters have broken.
  • If you or your baby have a health problem.

If you’re overdue

Induction will be offered if you do not labour naturally by 41 weeks, as there can be a slightly higher risk of stillbirth and admissions to neonatal unit after this time.

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 will discuss your options with you before you make a decision.

They should also discuss with you about neonatal special care facilities in the area if you choose to be induced as your baby will be 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 have a health condition or your baby is not thriving

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.

You may be offered/advised an induction if you have a condition caused by pregnancy that means it will be safer to have your baby delivered a little sooner than 40 weeks, such as diabetes, high blood pressure or intrahepatic cholestasis of pregnancy or there are concerns with your baby’s growth on ultrasound scan.

Membrane sweep

A sweep is performed to help promote labour. A membrane sweep is where the midwife places a gloved finger just inside your cervix (neck of the womb) and makes a sweeping circular motion to separate the membranes (sac around the baby) from the cervix. It is your choice whether to have this procedure.

There is evidence that this can start natural labour hormones. Labour may start naturally within a couple of days of the sweep, but if not, your midwife may discuss repeating it.

You may also experience some contractions or spotting (a very small amount of blood loss) in the 24 hours after the sweep. If you have any concerns, please call your local maternity unit. Membrane sweeps are not associated with increased rates of infection or an increased likelihood of your waters breaking before labour begins. They do not cause any harm to your baby.

Important – the above film has been created by colleagues at Barking, Havering and Redbridge University Hospitals – please disregard the numbers contained within as they do not relate to DBTH. All numbers for our services can be viewed here: https://www.dbth.nhs.uk/services/maternity/

How labour is induced

We offer both inpatient (stay in hospital) and out –patient (allow home) induction at the Trust. This depends on the reason for your induction this will be discussed and offered if suitable.

We offer different methods of induction. The type recommended to you will depend on your health, pregnancy and your baby’s wellbeing. These methods will be discussed in length including risks and benefits (please see information leaflet below for more in-depth information) and the choice will be yours. The options are:

  • Mechanical – Cervical Ripening Balloon
  • Prostaglandin – Propess or Prostin
  • Artificial Rupture of Membranes – ARM/Breaking your waters.
  • Oxytocin (Hormone) drip.

Some of these options follow on from each other.

Induction of labour may take a while, particularly if your cervix (the neck of the womb) is unfavourable and needs to be softened.

What induced labour feels like

Induced labour is usually more painful than labour that starts on its own, pain relief options will be discussed and offered if required.

Your pain relief options during labour should not be restricted by being induced however having a water birth may be impacted due to monitoring your baby during the induction, this can be reviewed and discussed with you at the time regarding other options.

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.

If induction of labour does not work

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

Your Consultant and midwife will assess your condition and your baby’s wellbeing, and you may be offered a rest and re-start the induction process or a caesarean section.

All options will be discussed with you and the decision will be yours.

Busting the myths

There are lots of myths about how you can make your baby arrive quicker and start your labour naturally, but most of these are nonsense!

There is no available evidence that supports the following methods to induce labour:

  • Raspberry leaf tea
  • Herbal supplements
  • Acupuncture
  • Homeopathic methods
  • Castor oil
  • Hot baths
  • Enemas
  • Sex

Having sex will not cause harm, but you should avoid having sex if your waters have broken as there’s an increased risk of infection.

For more information on induction, you can read the NICE information for the public on induction of labour or our guide to induction of labour.

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