Why might I need to be induced?
Most women will go into labour naturally by 42 weeks, but sometimes it may be best to induce labour.
Being induced is fairly common. Every year, 1 in 5 labours are induced in the UK. Your midwife will talk to you about the possibility of having an induction at your 38-week antenatal visit.
If your baby is late
Usually, babies arrive anywhere between 37 and 42 weeks of pregnancy. But if your baby is very late (if you are pregnant for more than 42 weeks), the placenta may not be working as well as it used to and the risk of stillbirth increases. In this case, you’ll be offered an induction between 41 and 42 weeks of pregnancy. Being overdue (also known as a prolonged pregnancy) is the most common reason for an induction.
If labour doesn’t start after your waters break
You may be offered an induction if you’re more than 34 weeks pregnant and your waters break, but labour doesn’t start on its own after 24 hours. This is because your waters breaking increases your baby’s risk of infection.
If your pregnancy is uncomplicated, you may also be offered expectant management. This is when your midwife or doctor monitor you and your baby, and your pregnancy progresses naturally as long as it is safe.
If you’re more than 37 weeks pregnant, you may be offered an induction within 24 hours of your waters breaking. If you don’t want an induction, your midwife will put together a plan for monitoring you.
If your waters break before 34 weeks, you’ll only be offered an induction if there are other factors that suggest it’s the best thing to do. For example, if you have an infection or there are concerns about the baby’s health. If your baby is born earlier than 37 weeks, they may be at risk of problems related to being premature.
If you or your baby has 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. This could include:
- type 1 or type 2 diabetes
- gestational diabetes
- intrahepatic cholestasis of pregnancy (ICP)
- pregnancy-induced hypertension.
If your healthcare professional thinks that being induced is the best option for you and your baby, they should talk to you about this. They can help you assess the benefits and any potential risks so you can make an informed decision.
Are there any reasons why I might not be offered an induction?
If your baby is breech
If your baby is breech and you want to deliver vaginally, it’s important that your labour progresses steadily, so induction isn’t usually recommended. Instead, you’ll be offered an emergency caesarean if there are any issues during labour.
If you’ve had a fast labour before
If you’ve given birth quickly before (known as precipitate labour), you may be tempted to ask for an induction if you’re worried you may give birth before a midwife reaches you. But it’s unlikely you’ll be offered an induction for this reason. Also, there’s no evidence that induction will prevent your labour from being fast.
If your baby is big
Unless there are any other issues, your healthcare professional won’t induce you because they suspect your baby is large for their gestational age. This is because accurately assessing your unborn baby’s weight is difficult.
If your baby has fetal growth restriction
Your healthcare professional may not recommend an induction if there is severe fetal growth restriction and there are related concerns about your baby's health.
How is labour induced?
You’ll be given drugs called prostaglandin, which act like the natural hormones that kickstart labour. These are inserted into the vagina as a gel, tablet or pessary. This can take a while and you may need more than 1 dose of prostaglandin if you haven’t had any contractions after 6 hours.
If you have a controlled-release pessary inserted, it can take 24 hours to work. If you aren't having contractions after 24 hours, you may be offered another dose.
You may need a hormone drip to speed up the labour. Once labour starts, it should progress normally, but it can sometimes take 24 to 48 hours to get you into labour.
Your midwife or doctor may also break your waters if they haven’t broken yet. This method of induction is called artificial rupture of the membranes (ARM) or amniotomy. This will feel a bit like an internal examination and it doesn't hurt your baby.
You shouldn’t be offered an artificial rupture of membranes unless the doctor or midwife can’t use prostaglandins.
Read more about what to expect if your waters break.
Is induction painful?
No, the induction process itself is not painful, but you might feel some slight discomfort.
You may be kept in hospital if you have prostaglandins (although some hospitals may offer you to go home), and you will be kept in if you’re having your waters broken.
Your birth partner may be able to stay with you , although this depends on hospital policy and your birth partner may need to leave for a while. You could bring a book, magazine or iPad with you to pass the time. When you pack your hospital bag to come in for an induction, pack it as you would for the birth of the baby.
Induced labours can be more painful than labours that start on their own. But you should have access to the same pain relief as you would with a natural labour.
What are the side effects of induction?
There’s no guarantee that an induction will work. There's also some evidence that if your labour is induced, you may be slightly more likely to need instruments such as forceps or ventouse to help your baby to be born safely.
What if the induction doesn’t work?
If you don’t go into labour after an induction, your doctor or midwife will talk to you about your options. You may be offered another induction or a caesarean section.
How do I decide if I want an induction?
It is up to you whether you have the induction or not and you should be supported in whatever decision you make.
Before you are offered the procedure, you should be offered a membrane sweep. This makes it more likely that you’ll go into labour naturally and won’t need an induction.
To help you decide, your doctor or midwife should give you more information about:
- why you’re being offered an induction
- when, where and how the induction will be carried out
- what support and pain relief is available
- what other options are available
- what the risks and benefits are
- what your options are if induction doesn’t work.
Don’t be afraid to ask any questions and take some time to think about your options. You may find it helpful to talk to your partner, family or trusted friends before making a decision.
What can I do to get labour going if I'm overdue?
Although none of these methods have been backed up by research, some women have tried these ideas when they’ve been past their due date:
- Sex. Semen contains natural prostaglandins that may stimulate labour. Don’t worry, having sex during pregnancy is safe and will not make you go into labour early. But don’t have sex if your waters have broken because there’s an increased risk of infection.
- Stimulating your nipples.
- Keeping active with lots of walking.
Don't listen to anyone who tells you that castor oil will help – it won’t. It will just make you feel sick and may give you diarrhoea and stomach cramps that aren't labour pains.
Read more about reported ways of bringing labour on.