Labour generally needs to be induced if:
- your baby is overdue
- your waters have broken, but labour has not started
- you or your baby's health is at risk
Inducing labour will usually be planned. You'll have time to discuss the advantages and disadvantages with your doctor and midwife, and find out why they think your labour should be induced.
It's your choice to have your labour induced or not.
Methods of inducing labour
There are many ways of inducing labour.
The treatments offered may depend on:
- if this is your first labour
- how you respond to the treatments
Membrane sweep
A doctor will examine your vagina and try to stimulate the neck of your womb (the cervix). This is known as 'a sweep'. It aims to produce hormones that may start labour.
The membrane sweep is usually done during an outpatient appointment. This means you will go home afterwards.
Propess pessary
Propess is a vaginal pessary that looks like a small tampon. Your midwife or doctor will insert it into your vagina for 24 hours.
It slowly releases the female hormone, prostaglandin.
Prostaglandin softens the cervix and dilate it enough to do one of the following:
- trigger labour
- break the waters - this is called an 'amniotomy'
There is a short string attached to the pessary to remove it easily.
Prostaglandin gel
This is a hormonal gel that is inserted into the vagina. It's used to soften and open the cervix. It can take up to 72 hours to work.
Sometimes they will need to do this more than once.
At the end of the process, either:
- the labour has started
- the membranes can be ruptured
Artificial rupture of membranes (amniotomy)
Your midwife or doctor will need to break your water if previous treatments did not induce labour.
The membranes may be ruptured using a tool, such as an amnihook or amnicot. They may also be ruptured by the doctor's finger.
Balloons
Labour can be induced by placing a small tube with a small balloon on the end of it in the neck of the womb. This method avoids any risk of too many contractions.
This may be recommended:
- if you have had 1 previous caesarean birth
- if other methods have not made the cervix dilate enough to break your waters
- on the advice of your obstetrician
Oxytocin
The body produces a hormone called oxytocin in labour. Sometimes you will need synthetic oxytocin during labour, to induce or to make your contractions more regular.
Oxytocin is usually only used after the membranes have ruptured. You'll only get it when you are in the delivery suite (labour ward). It is given to you through a drip.
Oxytocin is started at a very slow rate and increased slowly until you are having regular contractions. Hospital staff will monitor how your body responds to oxytocin to avoid too many contractions close together.