Inducing labour

Labour usually starts naturally on its own, but sometimes it needs to be started artificially. This is called induced labour.

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:

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 wouldn’t 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.

Intrauterine growth restriction

If your unborn baby has intrauterine growth restriction (also known as fetal growth restriction) induction isn’t recommended. This is because there is a risk that the baby may die before or after birth.

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. Your partner's 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.

 
 

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    Getting your baby into the best birth position

    The ideal position for your baby to be in for labour and birth is head down, their back towards the front of your stomach.

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    4 ways your body gets ready for labour

    At the end of your pregnancy, you may have some signs that your baby will arrive very soon, even though you may not go into labour for a little while yet.

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    What is a membrane sweep?

    The membrane sweep is a drug-free way of helping to bring on labour when you are going past your due date.

Sources

NICE (2014). Inducing labour National Institute for health and care excellence https://www.nice.org.uk/guidance/cg70

NICE (2014). Intrapartum care for healthy women and babies National Institute for health and care excellence https://www.nice.org.uk/guidance/cg190

NHS Choices. Inducing labour https://www.nhs.uk/conditions/pregnancy-and-baby/induction-labour/ (Page last reviewed: 06/11/2017. Next review due: 06/11/2020)

NICE (2010). Hypertension in pregnancy: diagnosis and management National Institute for health and care excellence https://www.nice.org.uk/guidance/cg107

Royal College of Obstetricians and Gynaecologists. Breech baby at the end of pregnancy (Page last reviewed: July 2017. Next review due: 2020)

NHS Choices. Sex in pregnancy https://www.nhs.uk/conditions/pregnancy-and-baby/sex-in-pregnancy/ (Page last reviewed: 30/01/2018. Next review due: 30/01/2021)

Mozurkewich EL, Chilimigras JL, Berman DR, et al (2011) Methods of induction of labour: a systematic review. BMC Pregnancy Childbirth 11: 84. www.ncbi.nlm.nih.gov 

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    Last reviewed on July 3rd, 2019. Next review date July 3rd, 2022.

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    Comments

    Please note that these comments are monitored but not answered by Tommy’s. Please call your GP or maternity unit if you have concerns about your health or your baby’s health.
    • By Kathryn Davies (not verified) on 30 Nov 2019 - 22:18

      Hello to any mums to be...My first and second son were induced at 42 weeks. The first labour was much longer and it can be more painful the fact that you are started before your body is actually ready. I think if you go into labour naturally it is a gradual build up so your body accustoms to it as you go, you also can spend the first part waiting at home or getting things done, rather than being pretty much on a bed from the start as with induction. I tried to manage without pain relief. about 12 hours in I was dilating really slowly, so decided to have an epidural...I wished afterwards I had accepted it earlier, it was a welcome relief as I was getting tired. It took a fairly long time with my first baby, but once my son was born I was overjoyed. My second son was induced, again at 42 weeks. I was started at 9.30am and he was born at 12.30pm, this labour, again the pain of contractions is a bit intense straight away, but this time, being much shorter duration, I managed without pain relief and used a rocking chair to help with contractions. I wondered how I could possibly feel as thrilled as with my first son, but the feeling was just the same. My third son was born at 41 weeks, and went into labour naturally which took around 6 hours, the contractions were not quite as intense and it was much more gradual but then it was my third. Again, I felt just as overjoyed as he was born as with the other two. All births were remembered as wonderful and the pain becomes a distant memory.. part of the anxiety can be the concern about what's ahead and wanting it all to be okay. Contraction pain once over is forgotten and the absolute joy of holding your newborn child is so very special and never forgotten.I have arrived at this site while researching on Google about being induced at 39 weeks as my daughter in law has been induced today and we are a little anxious, waiting to hear how she is....it brings back all the memories and I will be very glad to know all is well. And I am so excited to see my first grandson very soon.....I don't really think the above comment is something I would want to have read when about to go into labour. Sorry you felt as you did, that was your decision but I don't know of anyone else whose labour put them off having any more children. I also don't see how this helps any expectant mums when researching who may be anxious and concerned or just researching for knowledge and advice. So anyone about to have their first baby, there can be temporary pain or discomfort but if you cannot handle it there are amazing pain killers to help you through and the end result is absolutely wonderful....the more relaxed you are about it the better you will be...if you are being induced with a second baby you are likely to be fairly quick. I always found the midwives to be amazing and so helpful and reassuring. My first son was born 32 years ago and my daughter in law has found her midwives and health visitors to be really helpful so far. I have heard from my son that his wife is a little uncomfortable at the moment but all is very good and going well....Learn your breathing and look up good exercises to help with contractions...they definitely do help. x x x x

    • By Caroline Hobbs (not verified) on 26 Oct 2019 - 23:47

      I was induced, my first and only child, as the pain was so intense I decided not to ever have another child.

    • By Betani Wawe (not verified) on 28 Feb 2019 - 22:07

      Thank you for giving detail ideas about and this time hope that you will help similar ideas about topic mentioned above.

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