Inducing labour

When is labour induced?

An induced labour is one that is started artificially. It's fairly common for labour to be induced. Every year, one in five labours are induced in the UK.

Sometimes labour can be induced if your baby is overdue or if there is any sort of 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 if your baby is failing to grow.

Induction will 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. It's your choice whether to have your labour induced or not.

Most women go into labour spontaneously by the time they are 42 weeks pregnant. 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.

Why you might be induced

• if you are overdue
• if your waters have broken
• if you or your baby have a health problem

If you are overdue

Induction is offered to all women who don't go into labour naturally by 42 weeks, as there is a higher risk of stillbirth or problems for the baby if you go over 42 weeks pregnant.

If your waters break early

If your waters break more than 24 hours before delivery, there is an increased risk of infection to you and your baby. You may need a caesarean, and your baby may be vulnerable to problems associated with being premature if your waters break before 37 weeks of pregnancy.

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

If your waters break between 34 and 37 weeks, your doctor and midwife should discuss your options with you before you come to a decision about having an induction. They should also discuss the neonatal (newborn) special care hospital facilites in your area with you.

If your waters break at 37 weeks or over, you should be given 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.

If you have a health condition or your baby isn't thriving

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

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.

Membrane sweep

Before inducing labour, you will be offered a "membrane sweep", also known as a "cervical sweep", to bring on labour.

During an internal examination, your midwife or doctor sweeps their finger around your cervix. This action should separate the membranes of the amniotic sac surrounding your baby from your cervix. This separation releases hormones (prostaglandins), which may kick-start your labour.

Having a membrane sweep doesn't hurt, but expect some discomfort or bleeding afterwards.

If labour does not start after a membrane sweep, you'll be offered induction of labour. Induction is always carried out in a hospital maternity unit. You will still be looked after by midwives, but doctors will be available if you need their help.

Watch this video, which shows you what it's like to have a membrane sweep.

How labour is induced

If you're being induced, you'll go into the hospital maternity unit.

Contractions can be started by inserting a tablet (or pessary) or gel into the 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 had no contractions after six hours

If you've had no contractions after six 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 aren't 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 to get you into labour.

What induced labour feels like

Induced labour is usually more painful than labour that starts on its own, and women who are induced are more likely to ask for an epidural.

Your pain relief options are not restricted by being induced. You should have access to all the pain relief options usually available in the maternity unit.

Women who are induced are also more likely to have an assisted delivery, where forceps or ventouse suction are used to help the baby out.

If induction of labour doesn't work

Induction isn't 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.

Side effects of induction of labour

One in every five births in the UK in 2004-05 were induced, according to NICE. Among these induced births, when labour was started using drugs:

• less than two-thirds of these women gave birth without further intervention
• about 15% had instrumental (assisted) births (such as forceps or ventouse)
• 22% had emergency caesarean sections

You can find out more about the induction of labour compared to staying pregnant in the leaflet Choices when pregnancy reaches 41 weeks (PDF, 536kb).

Natural ways to start labour

There are no proven ways of starting your labour yourself at home.

You may have heard that certain things can trigger labour, such as herbal supplements and having sex, but there is no evidence that these work.

Other methods that are not supported by scientific evidence include acupuncture, homeopathy, hot baths, castor oil, and enemas.

Having sex won't cause harm, but you should avoid having sex if your waters have broken as there is an increased risk of infection.

For more information on induction, you can read the National Institute for Health and Care Excellence (NICE) guidelines on induction of labour. NICE also has information for the public on induction of labour.